Opinion

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Family doctors: A surgery is not a bakery

Tuesday 10 January 2012

Competition body NMa has fined the family doctor’s association LHV €7.7m for limiting doctors’ rights to set up business where they like. The Volkskrant asks if the NMa was right to stick its nose in.

‘If family doctors are really in cahoots when it comes to admitting colleagues onto the market, the Nma definitely has a point’, says economist Marcel Canoy of research bureau Ecorys. ‘Doctors can’t prevent other doctors from setting up shop in the same way that bakers can’t. The established bakers would have an interest in limiting the competition.’

Dangerous

But most doctors don’t think the baker comparison holds and feel that competition does not have a place in their particular branch of health care. Chairman of family doctors’ association VPH Wouter van den Berg argues that too much competition would be a dangerous thing. ‘In areas with a surplus of surgeries people could say: if you don’t give me the antibiotics I’ll go next door.’

The NMa doesn’t divulge the number of complaints it has received. But it’s the principle that counts, it says. The problem is unlikely to be huge, however. Tim Linssen, chairman of the national organisation of young family doctors LOVAH, says he’s never heard of anyone being blocked from starting a practice. ‘There is a shortage of family doctors. Most start out in locum jobs and then work towards a contract that way. It’s not usual for doctors to start a practice from scratch.’

Patients

Nevertheless Canoy thinks the NMa was right to act. ‘Providers shouldn’t determine among themselves who gets in and who doesn’t. Patients won’t benefit if young doctors don’t get a chance to work.’

Patients don’t tend to change their family doctors. But that, says Canoy, doesn’t mean they should be prevented from going elsewhere.