Citizens, take note. There is a risk of losing a care innovation that could have yielded you a lot, should you ever end up in hospital as a patient. For ten years now, doctors in the Netherlands have been trained to be medical generalists, to supervise all aspects of your care when you are admitted with a medical problem.
Whether you have to undergo an operation, have had a brain haemorrhage or suffer from heart failure. Unlike the more well-known medical specialists (eg neurologist, orthopedic surgeon or cardiologist) these so-called hospital doctors are broadly trained. Not for one organ (system), but for basic medical problems on all fronts. After all, a person is more than a number of organs put together.
Why was that not always there, I hear you ask. The GP at your home and the emergency room doctor (ED doctor, also relatively new) in the hospital are examples of medical generalists, but at a different place in the healthcare chain. It is a bit far to write down the entire history of hospital care here, but the nursing department did not yet have such a doctor. There care depended on the whims of the specialist’s work schedule. Often sufficient for ‘healthy’ patients with one problem.
Specific expertise
But if there are more, it will chafe. There is not always a specialist nearby to help unstable patients (and to guarantee continuity of care), and if the medical specialist does have time to visit the nursing ward, the question is whether the looming The patient’s problem lies within the specific expertise of this physician.
About the author
Jeanne Heijnen is a KNMG hospital doctor, currently working as a senior policy officer at the Ministry of Health, Welfare and Sport.
In some hospitals, other new healthcare professionals, physician assistants (pas) and nurse specialists (us), embraced to tackle the continuity problem in the nursing wards. These are nurses with extra training and a good solution to always have someone available. But not so much for the increasing complexity of care.
A team of dads and us, in addition to a more broadly trained hospital physician and, of course, the ever-present nurses, would be a tremendously powerful weapon against the increasingly complex care issues faced by the aging patient with multiple chronic illnesses. Always the right healthcare professional at the patient’s bedside. No delays because the surgeon is in the operating room (as it should be) or the gastrointestinal liver doctor is on duty at the outpatient clinic. And therefore does not also have time to immediately appear at the bedside of a patient who is not feeling well.
parliamentary questions
In response to parliamentary questions from the VVD about the hospital doctor, Minister Ernst Kuipers of Health, Welfare and Sport stated that medical specialists already have the necessary broad basic knowledge to recognize and treat all problems that patients experience in the nursing ward. I invite him to take a look in any hospital at how many medical specialists are asked for advice by, say, the surgeon, the moment a sugar level goes out of control in a patient with diabetes, or shortness of breath occurs in a patient with a diabetes mellitus. lung disease. For which very expensive declarations go to the health insurer. And who pays for that? Right, you, the citizen.
Fortunately, the representatives of the people have paid attention. On Tuesday they voted in favor of the motion by Member of Parliament Judith Tielen (VVD) who still asks for an investigation into the added value of medical generalists. Because turning off the money tap for training to become a hospital doctor threatens to destroy capital and lead to a drop in quality. Of course, as always, it’s about money. But make no mistake. By labeling and categorizing money, you don’t tackle the biggest challenges of a squeaky and creaky health care system. You do that by showing guts and giving innovations a chance.
Patient safety
Yes, training hospital doctors is expensive. But no, that does not necessarily mean that healthcare will become more expensive. On the contrary. The gains in quality, patient safety and more efficient care could easily compensate for this.
You can ask yourself whether all those new players in healthcare are ‘must do’. But you can also ask yourself what the underlying challenges are that led to these developments. History never stops. But that’s not to say it’s always good to cling to it, while the changing world cries out for a new approach. A patient is more than a few organs. It sometimes seems clear, but pigeonholing has never made anyone better. Neither do patients.