General Practitioner Shortage in the Netherlands: Council Warns of Impending Crisis

• Sonja Pleumeekers

  news editor

• Judith Pennarts

  news reporter

Quick measures are needed to prevent general practitioner care and district nursing from coming to a standstill. The Council for Public Health and Society (RVS) warns against this in a new report on primary care.

“Basic care is the foundation for the healthcare system behind it,” says RVS chairman Jet Bussemaker. “So we now have to arrange this properly to keep the care going.”

The Council is concerned about the affordability of healthcare, but especially about the quality and accessibility. There is a shortage of GPs in places all over the country: 60 percent of GP practices are currently on a patient freeze.

Although the number of GPs is increasing, they are more likely to work part-time. On top of that, it is expected within six years 30 percent of GPs retire.

Nieuwsuur spoke to three women who cannot find a GP:

The village of Nieuw-Buinen in Drenthe is one of the places where the problem is acute. GP Marinka van Dijk has been trying to keep her practice running since the summer. Where she first worked with two other general practitioners, she is now alone. The other two both got burned out as a result of the high workload.

Van Dijk now deploys remote observers who help patients by telephone. “We have a few, in Amsterdam for example, but also one in South Africa and one in Denmark.”

Due to the many different observers, GPs who work in different practices, the care for patients is fragmented, says Van Dijk: “On five days a week I have five different doctors who all cooperate for half or a full day. Each time they have to read into the story again, the patient has to tell it again and again from the beginning.”

The number of GPs with their own practice has been declining for several years. Worrying, says the stainless steel. Bussemaker: “We have always looked at cost savings, and we no longer look sufficiently at the values ​​for which the general practitioner and district nursing were established. That is long-term contact with a group of patients in a district.”

The RVS chairman adds that a GP must be nearby, must have a fixed group of patients and must also be physically there. “It is not a solution if you have to call someone in a call center 300 kilometers away and get someone else on the phone the next time. That ignores the core value of the GP.”

Due to the shortages in basic care, the Ministry of Health is working on a new vision for 2030. Then that care must be organized differently. But according to Frans Meijman, former general practitioner and professor at VUmc, 2030 is much too late. “Taking that year as a target date for a rescheduling is irresponsible.”

According to Meijman, there is currently no party that can intervene when GP care is lost. “It is the health insurers who have a duty of care. But they can invoke force majeure if all general practices are already full.”

One of the solutions he proposes is to adjust the registration requirement. At the moment, GPs still have to work at least two days a week to keep their registration. “If that is increased for general practitioners without their own practice, their commitment could be increased,” says Meijman.

The RVS advocates more regional cooperation between practices. Bussemaker: “The essence of this is that you have a small-scale practice and that the work that GPs find annoying, such as administrative burdens and regulations, is done jointly.” She also believes that there can be more cooperation between general practitioners, district nurses, physiotherapists and social workers.

General practitioner Van Dijk thinks the future is “very exciting”: “Of course we will see that there are fewer and fewer general practitioners compared to the number of patients requiring care. You can call in all kinds of auxiliary forces for this, as we are doing now, but I think it is important that we also continue to provide small-scale care in rural areas, with the involvement of the doctors here.”