The idea is that GPs will have more time for their patients by working differently and more efficiently. This would reduce the workload for GPs, patients should feel more heard and they would receive appropriate advice more often. Health insurers also expect unnecessary referrals to hospital less often.
GPs have been arguing for years for more time for patients, but there is still quite a bit of resistance to this regulation. Not much improves in the new scheme, GPs say to RTL Nieuws. Moreover, according to them, it only entails even more administrative hassle.
To work more efficiently
According to the health insurers, the new scheme could actually work more efficiently. Examples given for this are the possibilities for digital appointments with the patient or contact via chat.
General practices could also list frequently asked questions about, for example, the flu shot on their website, in order to reduce the workload and administrative burden in this way.
More Time For The Patient
As of today, general practices will gradually switch to the More Time For The Patient scheme (MTVDP). This is spread over four quarters, the last 25 percent of practices will only switch on 1 January 2024. It is determined by drawing which practice will switch and when.
The scheme arises from the new Integral Care Agreement. It has been agreed that from now on GPs will receive an extra reimbursement per patient. Health insurers do set a number of conditions for this reimbursement. For example, the GPs must adapt their way of working in practice with the intention of working more efficiently and they must evaluate this method with colleagues in the region.
In order to qualify for that extra fee, practices must account for what changes they want to make and why. To comply with the regulation, GPs must make at least five adjustments to their practice within two years.
“GPs have been in need of 15-minute consultations for years,” says GP Arjen Göbel from Amstelveen. “I doubt whether the current plans will provide more time. Most GPs already work very efficiently. Although suggestions such as digitization improve care in certain respects, the question is whether this will actually lead to more time for the patient.”
According to him, the only real solution is to add more doctors and practices, but there are hardly any. “Fortunately, I have already hired an extra GP for two days a week and I am also a GP trainer. This means that we employ a GP in training who can speak to patients independently. That way we can take longer for the patients .”
Positive results
In Christof Zwart’s general practice in Haarlem, they already work with longer appointments. “We do consultations of ten and twenty minutes. If an older lady is going to tell her story, you have to ask questions, undress, examine and get dressed again, that cannot be done in such a short time. We also use e-consultations, so we discuss patient complaints no longer only in the consulting room, but also digitally.”
Still, Black doubts whether he wants to participate in the More Time For Patient Control (MTVDP). “There are all kinds of measurement moments that are attached to it, where we have to evaluate. As a practice, we have to make plans and continuously account for ourselves. In short, all of this is time and energy that does not go to the patient. We were already promised that extra reimbursement per patient in 2018, now it finally comes with extra conditions. That is not reasonable.”
Last year we made the video below about why waiting times at the GP are sometimes so long:
Ton van Houten, board member of the association Zorgverzekeraars Nederland, is very positive. “We first ran all kinds of pilots and the results that came out of that are very good.”
“Ultimately, the patient feels more heard, receives appropriate advice and the GP experiences more job satisfaction.”
He therefore does not recognize the criticism that the changes that GPs have to make would entail a lot of administration. “There are also changes that do not entail any additional administrative burden. The pilots also show that the changes ultimately lead to a reduced workload, more job satisfaction and more satisfied patients.”
Helped better
General practitioner Hedwig Vos, from The Hague, is also enthusiastic about the scheme. “We will start from today. The fact that we are facilitated to provide more time for the patient is of course very nice. I hope that this gives patients the idea that they are being listened to more, that they are being helped better.”
“We previously hired an extra GP on our own initiative and the practice nurse was already working more hours,” says Vos. “Many GP practices already work with longer consultations, but on their own initiative and at their own expense. This is at the expense of breaks or free time, or it results in extra expenses.”
Not just positive
Yet Vos is not just enthusiastic. “It is a pity that all kinds of conditions are set in the form of hoops that we have to jump through. General practitioners know their patients and the practice best, it is a pity that it is not left to them how you fill this in.”
Another major pain point, according to Vos, is that several colleagues in her region who wanted to participate in the scheme were drawn by lot. “They already make extra time for their patients on their own initiative and are disappointed. They now have to wait months for that extra reimbursement.”
