2. FAMILY DOCTOR
The family doctor, or general practitioner, is central to the Dutch health care organization.
There are three characteristics of Dutch family medicine that are the basis for this statement.
First of all, every person in the Netherlands is listed with his or her familv doctor. This doctor maintains a record of every patient, including medical history, risk factors, chronic diseases, medications, etcetera. This information is an important ingredient in giving personal care.
Dutch family doctors see three-quarters of their listed patients regularly, mostly four or five times a year. This characteristic of 'listing' guarantees patients continuity of care. The second characteristic is the gatekeeping function of the family doctor. This means that patients do not have free access to hospital specialists. Patients that are covered by the Sickness Fund require a referral card and the privately insured must have a referral letter written by the family doctor. Family doctors are real 'general' practitioners, because they are specialized in common and minor diseases and care for patients with chronic illnesses. The impact of the gatekeeping function is illustrated by the low referral rate to specialists: 90% of all complaints are treated by family doctors. There is, therefore, a big difference between specialists and general practitioners. The specialists only treat a very select and limited segment of the total spectrum of morbidity. The last characteristic is family orientation. It reflects the fact that family doctors in the Netherlands serve as personal physicians for the entire family, that is, all members of the family or household have the same family doctor. This family orientation is of importance, because family members share the same home, the same living circumstances, food and environmental conditions. Additionally, they also share a lot of important risk factors, they share hygiene and social level. Family doctors, therefore, are in a position to understand the essential link between disease and family factors. Every family doctor has
