Many people in the Netherlands experience physical, psychological and social problems at the same time. They therefore rely on support from multiple professionals across different organisations. Fia van Heteren examines how these professionals work with each other and with clients, and which factors strengthen or hinder that collaboration.
Collaboration is not a given
If you struggle with both physical and psychological complaints, you may need help from your GP as well as a mental-health practitioner. Van Heteren's research shows that collaboration between such professionals is far from self-evident. In so-called fluid teams-teams whose composition varies frequently-cooperation depends heavily on fragile, personal relationships and improvisation. Professionals must continually search for suitable partners because fixed structures are lacking. This generates tension and wastes valuable time.
From September 2025, the Supplementary Care and Welfare Agreement (AZWA) will take effect, aimed at improving cooperation between the medical and social domains. But if the government wants to deliver on this promise, learning to collaborate in fluid, real-life situations must become an explicit part of the agreement. Without day-to-day collaboration in frontline practice, AZWA risks remaining little more than an ambition on paper.
How professionals assess clients - and why it matters
Van Heteren's dissertation not only focuses on collaboration between professionals, but also on the relationship between professional and client. In 15 interviews with GPs, she examined how they make treatment decisions for patients with different socioeconomic backgrounds. The findings show that doctors-often without realising it-make different judgements based on socioeconomic status (SES). Three factors play a role:
- Status preservation: doctors consider the extent to which someone's job, stability or social position needs to be protected.
- Social distance: a sense of recognition or closeness between doctor and patient influences the motivation to help.
- Reasoning about shared responsibility: education level or a busy life can determine how genuinely a treatment plan is created together.
Better collaboration and greater self-reflection
According to Van Heteren, these insights show that both interprofessional collaboration and the way professionals assess clients are crucial for accessible and fair care. She therefore advocates training that prepares future doctors for patients with complex problems-and teaches them to reflect on their own behaviour in the process.
PhD Defence
Fia van Heteren will defend her dissertation on Tuesday 2 December at 13.00 hrs. in the Academy Building of Leiden University.
