The year of reflection
For me, 2015 was the year of indicators for acute care, but also a year of reflection. Just before the end of the year, the Dutch National Health Care Institute (Zorginstituut Nederland) drew up indicators for emergency care.
It is certainly a good thing that we now have such indicators, but it is a shame that they had to be drawn up by an external body. For years, we have been debating ways of organizing emergency care, and I think it is a missed opportunity that we, as professionals, have not solved this challenge together. If we could have taken that step ourselves, we would have remained in charge. The same applies to the organization of Intensive Care in the Netherlands. Again, the National Health Care Institute takes control and professionals are mere spectators.
How this will develop in the coming years remains to be seen, but it is a big change. We as professionals must accept a bureaucratic body's interference in our work in cases when we fail to agree among ourselves. This development is a continuation of a growing trend of ever more recording and controlling. The space for professional autonomy is becoming smaller, and it appears that professionals are allowing official bodies to fill the vacuum. At the same time, professionals also experience a growing need for control and regulation within their profession, as reflected by increasing protocolization, rules, and decision-making by consensus.
A positive development in my opinion is that, when it comes to providing acute care, we take into account more and more the wishes of patients who do not want treatment. Only a few years ago we did not take their wishes into account. We consult more and more with patients and increasingly decide to take time for reflection. As a result, we often decide together against treatment, believing this to be a better choice.
2016 will show how the indicators will work in practice. I expect that the cooperation will continue to develop, but also that there will be fewer traditional hospitals. There will therefore be less and less choice for the patient, which will put pressure on free competition. There will be fewer providers and fewer insurers to choose from. There are many brands on the market, but they are almost all from the same big companies.
A new year also means good resolutions, of course. Which I also have. I am going to focus even more on improving collaboration between care givers, supply chain partners and healthcare providers. This is where untapped opportunities lie.