ANTICIPATORY CARE AND THE ROLE OF DUTCH GENERAL-PRACTICE IN HEALTH PROMOTION - A CRITICAL REFLECTION

The Dutch GP is in a unique (potential) position within the health car e system with regard to clinical health promotion. An essential featur e is the integration in the regular consultation. The concept of antic ipatory care seems fit to understand this integration. Because of the GP's (anticipatory) knowledge of the patient's medical history, lifest yle, risk factors, living conditions, health perceptions and family co ntext, he has the opportunity to include during the consultation, aspe cts of health promotion and disease prevention. The production of evid ence-based guidelines by the Dutch College of General Practitioners gr eatly enhances the integration of health promotion within the consulta tion. Strategies for the implementation are needed on three different levels: encouragement of the patient to ask questions, training of the GP and organization of the practice. An important aspect of the last strategy concerns systematic delegation of health promotion tasks, usu ally related to the guidelines, to the practice assistant or practice nurse. Recent legislation in the Netherlands underlines and advances t he above mentioned trends.