Beyond clinical care: A qualitative study on the leadership role of general practitioners in dutch interprofessional care for older adults

BACKGROUND: Frail older adults increasingly require coordinated, interprofessional primary care, yet leadership within these loosely organised teams is often informal and poorly understood. While general practitioners (GPs) are often seen as having a central role in leadership, little is known about how they themselves perceive and enact this role. OBJECTIVES: To explore how Dutch GPs understand and operationalise informal leadership within interprofessional primary care teams caring for frail older adults. METHODS: A qualitative interview study was conducted with ten Dutch GPs using semi-structured interviews. Data were analysed inductively through thematic analysis. RESULTS: GPs expressed ambivalence about being labelled as 'leaders', associating the term with hierarchy. Nonetheless, they enacted leadership through responsibilities embedded in everyday practice, including ensuring continuity of care, coordinating professionals, and maintaining oversight. Leadership was largely pragmatic and reactive: GPs often initiated collaboration and provided oversight but rarely engaged in shared goal setting or facilitating team learning. Satisfaction with current collaboration and competing priorities resulted in limited motivation to optimise interprofessional practice. CONCLUSION: GPs enact informal leadership primarily through responsibility and accountability for continuity and oversight rather than through strategic or explicitly shared leadership practices. Because collaboration is generally perceived as adequate, motivation to further develop team processes appears limited. More strategic elements, such as shared goal setting and proactive team learning, are less developed. Strengthening awareness of leadership roles within interprofessional teams may support more balanced responsibility-sharing and enhance care for frail older adults.