Three Keys to Reinventing the Future of General Practitioners in Belgium

The shortage of general practitioners in Belgium made headlines at the start of 2024. For Doctena, Dr. Lieve Vande Putte, a Dutch-speaking general practitioner in Brussels, shares her analysis of the situation and proposes three solutions for improvement. One of them? Better and more comprehensive digital support. “The shortage of general practitioners in Belgium has been a known issue for years, so the announcement wasn’t really news. However, it does not detract from its social relevance,” begins Dr. Lieve Vande Putte. She works at a health center in Brussels.

When she started her career as a general practitioner in 1985, the situation was entirely different. “Instead of a shortage, there was an excess of general practitioners. The idea of stopping patient intake was unknown to me and my colleagues. On the contrary, we lacked work…“

Setting and Protecting Healthy Boundaries

As the debate on the shortage of general practitioners resurfaces, she finds it important to share the lessons learned with her younger colleagues. “Occasionally, there’s criticism towards young general practitioners, accused of not working enough. But I absolutely disagree. On the contrary, I find the attitude of young doctors healthy.“

“My generation of doctors was conditioned by the system. Always work, work, work without learning to set boundaries. And thus, being available 24/7 became the norm for medical practice,” explains Dr. Vande Putte. “An unhealthy norm…“

Young general practitioners better protect their boundaries today. This is considered a notable progress by the Brussels doctor. This does not necessarily mean that patients have to wait longer for an appointment, she points out. “With proper practice organization, it’s possible to combine a good work-life balance for general practitioners with smooth accessibility for patients.“

Dr. Vande Putte suggests three solutions to explore:

• Establishing a Framework with Digital Support

A software program for general practitioners, electronic prescriptions, electronic certifications, etc.: “The use of the right digital tools simplifies the life of a general practitioner in many ways (…)” emphasizes Dr. Vande Putte.

She has also been using Doctena as an online booking system for appointments for several years. “I couldn’t do without it anymore. And I’m not the only one: nearly half of all my patients book their appointments this way,” she says. “The online calendar saves me a lot of administrative work. Moreover, I can often start an appointment better prepared, as many patients have already briefly described the reason for the consultation when booking.“

“I also find it very useful that patients can filter by language when searching for a general practitioner on Doctena. In Brussels, for example, there are few Dutch-speaking general practitioners. Thanks to the platform, Dutch-speaking patients still find their way to me.“

• Embracing Interdisciplinary Collaboration

Regarding the administration of flu vaccines, schedule management, ear cleaning, filling out certificates, taking blood samples, Dr. Lieve Vande Putte feels many general practitioners still do too much today. “My advice? Specifically surround yourself with other profiles in your practice. With a health promoter, a frontline psychologist, a nurse practitioner, a social worker…“

“Not only can you offer more care, but you can also improve the quality of care. Because each of these other profiles brings valuable knowledge and expertise that you do not have. Together, you can offer the patient much more than each individually.“

There are different ways to organize interdisciplinary. Think, for example, of an expanded primary care practice, a health center, or the new “New Deal” model around which a pilot project was launched on April 1st of this year. “Each approach has its own emphases. So, you can choose what best matches your vision.“

• Other Financial Incentives

With her third solution, Dr. Vande Putte addresses the government with the idea of different funding. “In Belgium, we have been rewarded for quantity for years, for the number of services and contacts with the patient. However, many colleagues, including myself, believe in a more proactive and preventative approach: we should be rewarded for keeping people healthy as long as possible and thus having as little contact as possible with their general practitioner.“

“As an individual general practitioner, you obviously can’t change the financing system alone – that’s a task for the government. But you can choose practice forms that focus on a proactive and preventative approach. Community health centers do this, for example: you receive an amount per patient and not per contact. And the new model under the New Deal also emphasizes a holistic approach to the patient through a combination of a flat rate per patient and a part of performance financing.“

Will we solve the shortage of general practitioners in Belgium with these three solutions? “Not immediately. But we’re definitely moving in the right direction. They help general practitioners find a healthier balance between work and private life. And they improve the quality and proactivity of care for the patient,” concludes Dr. Vande Putte.