Life threatening situation? Always call 112

Welcome and farewell practice owners 

By Aster van der Boon – Board Secretariat

In the previous newsletter you could read a report of the welcome and farewell meeting of our new doctors and retirees which took place on December 13th. Such a meeting took place on 12 January. Eight new practice doctors and three retirees were present. Below you will find a transcript of these two conversations.

The welcome meeting took place first.
Present were Jelle de Gelder, Rosemarie de Jong, Elske Vonk, Mieke Westerbeek, Ariane Nagelkerken, Sabine Vrugte, Kim Groothuis and Roy den Haan. Present on behalf of De LIMES were: Renske de Groot, Aster van der Boon and Gerben Welling. Attendees introduce themselves:

Jelle de Gelder has only been a general practitioner for nine months. He holds a PhD from the LUMC. He succeeds Margit Smid, who retired in December 2021. 

Rosemarie De Jong was trained as a general practitioner in Utrecht. Three and a half years ago she moved, after which she became an observer and Hidha at General Practice Alkemade. She succeeds Wim Sleeuw, who retired at the end of December.  

Elske Vonk is a general practitioner at the Dillenburg Health Centre. As of 1 January 2022, she has taken over the practice from Hans Van Selm. 

Mieke Westerbeek was educated in Leiden. She has been observing in Noordwijk for three years. She succeeds Corry Vliet Vlieland, who has retired.  

Ariane Nagelkerken was also trained in Leiden and as of 1 January 2022 she will take over from Leny Van Klei of General Practice De Vondel in Leiden. She has been a general practitioner for three years now.  

Sabine Vrugte graduated from Leiden two years ago. She knows Jelle de Gelder from Praktijk Prelude where they were colleagues. She takes over the practice from RobertJan Hoogendoorn.    

Kim Groothuis has been a general practitioner for ten years. She has worked in Zoeterwoude-Rijndijk and recently started in the Stevenshof near Zaaijer and Hensing. Geert Zaaijer will retire next year. Kim takes his place. 

Roy den Haan is a general practitioner in Valkenburg together with Thomas Hazenoot.  

Renske de Groot has been working for DDDB and Huisartsenposten De LIMES for 19 years. She is a financial employee and deals with the GP schedule. From 1 February, she will focus on quality and scheduling matters. 

Aster van der Boon is an executive secretary and has been working at SHR for 13 years and at Huisartsenposten De LIMES since 2021. She supports the Executive Board and the Supervisory Board and deals with roster matters. 

Gerben Welling has only been a director of De LIMES for a few weeks. He will be succeeded by Gos de Vries on 1 February. He has been working in acute care for 40 years. He asks the doctors what themes are important to them.  

Mieke is especially curious about the future of the out-of-hours GP service. Gerben says that the organization just merged a year ago and that the employees are working hard to shape this further. He says that there is good low-threshold contact with the Alrijne, the LUMC and the VVT organizations. He hopes to maintain this line. The demand for care continues to increase, but there are fewer and fewer people doing the work. There is a need for decent housing in Leiderdorp. Drawings are currently being made for the Leiderdorp location. It is expected that a new triage centre will not be in place for another three years. Until then, we will remain guests at the children’s outpatient clinic. Voorhout is a great place to work. The Alphen aan den Rijn location is currently being renovated.  

Gerben says that given the number of patients in our catchment area, there should be three posts during the day for the evenings and weekends. For the nights, it’s a different story. Discussions are currently being held with staff, observers and practitioners. The central question is what people think about night care and how they see the future. The safety of patients and staff is our top priority. The outcome is open. When it comes to quality and safety, Gerben says that every doctor has to deal with complaints. Gerben advises not to fight with the complainant but to start a conversation. Furthermore, Gerben says that the BOT team is used as standard. Even in the event of a calamity, we look carefully at where exactly lessons can be learned. It is important that we are open to each other and to the feeling that we are not going well.  

Gerben talks about flexible scheduling. The idea behind this is to include all doctors, including observers, in the schedule so that everyone can register for services in advance. Elske and Mieke do not think that observers should be given the first choice when selecting services. The annoying services are then left for the practice owners. A survey will soon be sent out to the practitioners and later to the observers to get their opinion on this.  

Rosemarie says she doesn’t like the intranet. A lot of emails are sent, but it is difficult to find out the most up-to-date information. Gerben says that work is being done to improve the provision of information. There is a lot of communication via the newsletter. Gerben also says that it is important to report things that stand out. This can be done with the medical managers, among others.  

Gerben thanks all those present for coming and he wishes them all the best in the new step they have taken.

The meeting was followed by a conversation with the retirees.
Present were Leny Van Klei, Wim Sleeuw and Abel Boels.

Leny van Kleij quit as a practice doctor a week ago. She is still a general practitioner at Issoria Hospice and she is a SCEN doctor.  

Wim Sleeuw is a former director of the doctor’s post. He found this an exciting time. Wim quit his job as a practice owner nine days ago. He still has a holiday feeling. Wim is also a SCEN doctor and he is the director of a small hospice in his village.  

Abel Boels also has a holiday feeling. One of the reasons he quit as a general practitioner is that he suffers from deterioration of his eyesight. He had planned to work as an observer but that is not possible for this reason.  

Gerben asks how the retirees look back on their lives as doctors. Abel says that an incredible amount has changed. In the beginning he only worked with an assistant and nowadays he works with seven general practitioners, six assistants and a number of practice nurses. He believes that better GP care is being provided than 30 years ago. The contact with the patient has remained the same and that is what he always liked the most.  

Leny doesn’t know if she would have become a GP again. She worked in the ER for a long time, which she loved too. When she had children, she chose to become a general practitioner.  She liked serving because she didn’t have to do it from home. Abel also remembers the time without a mobile phone when his wife was the back-up at home. He had a pager and always collected quarters to be able to call home during his visits.   

Wim’s wife was the back-up on weekends and Wim did the shopping.  

Wim hated going to the HAP, but once he was at the post, he liked it. Abel liked the fact that the frequency of service decreased with the arrival of the out-of-hours GP service. He can still remember a service during a Henny Huisman show and that the phone was down. Gerben recognizes this and says that this phenomenon was given a name, namely the “Henny Huisman effect” and that a lot has been learned from it. Wim thinks the professionalization over the years is great. His great ideal, that the general practitioner should have the function of gatekeeper in emergency care together with the ambulance service, has still not been realized. Gerben says that they work together with the care coordination center, where an ambulance care dispatcher also works. Wim says that GPs have a lot to offer in emergency care, the share is limited but the role remains important.  

Abel believes that the burden of the services is too high for the practice owner. He received about 35 services a year and he thinks that is too much. He lost his night shifts with difficulty. 

Leny thinks it is important that emergency care is provided and that you do not serve the people who do not feel like going to the doctor during the day. She believes that the best care should be provided in the day practice. Wim compliments the triage nurses who are increasingly aware of which patients should come to the post. They don’t know the patient and they can still distinguish between emergency and less urgent.  

Abel agrees, when his doctor’s assistant had to be quarantined, he answered the phone himself. This was an eye-opener for him. He was impressed by his assistant’s skills.  

Gerben thanks Leny, Wim and Abel for their participation and their stories. He wishes them a very good time and hopes to meet them again somewhere. 

Back to overview