NOS | Jeroen van EijndhovenPhoto for illustration
NOS Nieuws•vandaag, 16:10
Sander Zurhake
healthcare editor
Sander Zurhake
healthcare editor
Since the beginning of this year, half of the general practices in the country have implemented a patient freeze. The healthcare problem within this care, which should be accessible, is structural. A shortage of general practitioners is often cited as an important reason. But remarkably, there are more GPs than ever.
The number has even increased by half in the past ten years. While there were approximately 10,000 general practitioners in 2012, including basic doctors in training to become general practitioners, there are now more than 15,000.
Nevertheless, many general practices are currently unable to cope with the increasing demand for care. This is partly due to the declining number of doctors who are practice owners themselves. In 2012, almost 78 percent of these doctors were practice owners, by 2022 that percentage had fallen to 49.
NOS Source figures: SPH pension fund and Nivel research institute
“The time when you could run a practice together with an assistant and mainly deal with patients is over,” says Jettie Bont, professor of general medicine at Amsterdam UMC. “You now employ several assistants and also practice assistants.”
“So you are now very much a manager. You negotiate with health insurers and consult with community nurses, hospitals and mental health institutions to get more complex patients who need help to the right place.”
These tasks take up time, meaning practice owners often need help from locum physicians to meet the increasing demand for care. But finding that help often proves difficult. Practice owners are then faced with an overwhelming task.
Maastricht GP Katrien Boots has experienced this. “You notice that these self-employed people want a lot of freedom to organize their own time. So the responsibility felt very heavy, on your own, while you have to provide most of the care and have all the administrative tasks. The weight you then Having to wear it all the time is not nice.”
What types of general practitioners are there?
Broadly speaking, the following distinction can be made: the practice owner, the employed general practitioner and the self-employed locum. The first two categories have an average full-time working week of 61 and 55.9 hours respectively. For doctors who formally work part-time, this is 49 and 36.1 hours. The last category, freelance general practitioners, can often decide for themselves how much they work, while they can charge high rates. The increasing need for healthcare means there is a high demand for general practitioners.
Boots stopped as practice owner after a few years and became an observer himself. “A regular observer,” she emphasizes. “That way I know my patients well and can provide better care.”
It has been proven that, thanks to this familiarity, GPs contribute to better health and limit healthcare costs. There is often less need for referrals to the hospital. Because more and more general practitioners work freelance in different locations, this familiarity and health benefits are slowly but surely being lost.
Practice owners grumble a lot about the new generation. That group now carries the stereotype of a doctor who mainly wants to treat the easy patients and refers the difficult patients too quickly. In between, there is plenty of time for vacation thanks to the high rates and the lack of sense of responsibility, it is said.
Bont does not think this criticism is entirely justified. “Surveys show that 85 percent would like to become practice owners.”
General practitioner consultant Bob Verhagen also finds the criticism easy. “People want to, but it is quite intimidating, that responsibility. Especially if you have to be an agile entrepreneur for the success of the practice. And you don’t learn that enough during medical training.”
‘Need for knowledge is great’
Verhagen is the founder of Buurtdokters, an organization that assists practices in non-medical aspects. Buurtdokters recently opened an academy where doctors can take monthly courses on how to run a modern practice. The enthusiasm is increasing. There were only nine registrations at the first session, and 24 at the second.
“The need for knowledge about how to gain control over financing and the deployment of practice staff, for example, is great,” says Verhagen. “And rightly so. This way you can turn buttons to reduce the workload.”
For example, by using practice assistants smartly as a doctor, a GP has to make fewer (simpler) consultations. This gives time for a communication plan for patients about when a doctor’s visit is or is not necessary. Which can also save time.
This freed up time allows a practice to accept more patients, which yields more revenue.
“Then you can hire additional staff, which reduces the workload while you can help more patients,” says Verhagen. “If doctors feel that they can gain control over their practice, the enthusiasm for practice ownership will hopefully increase again. That is partly the solution to the healthcare problem.”
2023-10-15 14:10:00
#shortage #general #practitioners
