Hfjm. Crebolder et Fg. Vanderhorst, ANTICIPATORY CARE AND THE ROLE OF DUTCH GENERAL-PRACTICE IN HEALTH PROMOTION - A CRITICAL REFLECTION, Patient education and counseling, 28(1), 1996, pp. 51-55
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.