Hi Michiel, time pressure, administrative pressure, shortage of GPs: the problems are piling up. What exactly are the doctors at Malieveld calling attention to today?
‘I just saw a banner pass by here that adequately sums up the feeling here: ‘Do you have a moment? Because we don’t’. The main complaint of the general practitioners is that they have too little time for the patient. A consultation is now only 10 minutes, they think it should be 15 minutes so that they can have a better conversation and be there for the patients better.
‘In addition, GPs are concerned about the crowds at GP posts. At the weekend, in the evening, at night: patients just keep coming. It is officially an emergency post, but people also regularly come for sore toes or stomach pain. That problem is related to the busyness at regular practices: if people can’t get through that, they just try it in the evening at the GP post.’
How did those problems arise?
‘One of the main causes is the waiting lists that have arisen everywhere in healthcare. At hospitals, mental health institutions, youth care, care homes: everywhere people have to wait an extremely long time. And as long as those people in need of care cannot go there, they fall under the responsibility of the GP. They do not always have the expertise to care for those people, which in turn creates extra pressure.
‘Another problem is that there are simply fewer and fewer GPs who can take care of themselves. Due to the aging population, many GPs are retiring, and too few new ones have been trained. In addition, fewer GPs are working full-time than in the past. It’s a cocktail that gets it stuck on all fronts.
‘An additional problem of late is that GPs drop out due to the high workload. Some even leave the profession as a result, including young doctors who have only just started. As a result, the problem will only get worse in the end: because the more GPs leave, the more the pressure increases.’
The warning has been heard for some time that healthcare is coming to a standstill, the corona crisis painfully exposed it. How come there is still no solution?
‘That is mainly because there is no ready-made solution. We also have a healthcare system that you cannot change just like that. And many of the problems therefore lie outside general practitioner care, such as those waiting lists at hospitals or homes. To solve that, you have to intervene on every level.
‘But of course people could have chosen earlier to train more general practitioners. That is now happening. But that has been delayed too long, so that we are now running behind the facts. It often happens: people only see the problem when it is there. I also think that the share of part-time doctors has been underestimated for a long time.’
Are there ways to reduce the workload in the short term? Or will we soon see the general practitioners on the Malieveld again?
‘GPs can look at digital solutions. But the profession itself is skeptical about this. Doctors believe that the personal bond and patient contact are central to their profession. They are certainly right about that, but there is still care that you can provide from a distance, digitally.
‘Something could also be done about the pressure on GP posts. Perhaps the government should set up a national campaign to make it clear to people that they are only there for emergencies. Or perhaps we can introduce an emergency number, just like in Denmark. For people it feels different: there must be a good reason to call a number with such a name.
“In any case, this demonstration makes it clear that something has to be done. The general practitioners also pay particular attention to the government. When the name of health care minister Ernst Kuipers fell on the podium, there was booing. The doctors agree on one thing: far too little has been done so far.’