Physicians as partners of the State to promote primary care teams’ coordination: Between instrumentation and professionalization

Abstract

In France, the increase of the number of the Multidisciplinary group practices within the community has been a major policy objective in recent years. Nevertheless, independent frontline health professionals (professionnels libéraux) show little interest to those Multidisciplinary group practices. In 2014, a coalition of key actors was formed to conceive a special training program called Pacte. It was dedicated to Primary care team coordinators and implemented in six Regional Health Authorities. By analyzing its implementation, we hypothesize that a new form of regulation of primary care activities has emerged at the regional level. The author shows that training PC team coordinators was used as a tool to change frontline health professionals’ practices and to cope with resistance to team work. Thus, the implementation of the program can be analyzed as an instrumentation process performed by Regional Health Authorities to reorganize the primary care sector.