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ACM: If practices are full, GPs that are looking for a spot for switching patients do not violate competition rules

Following an investigation into reports filed by patients that were not able to switch to certain general practitioners (GPs), the Netherlands Authority for Consumers and Markets (ACM) announces that, if there is a shortage of GPs and GP practices are full, GPs are allowed to consult each other for finding a spot for patients that wish to switch doctors. The main principle is that patients are able to choose their own GPs. If a GP cannot accept a new patient, they must explain as to why not. If there is no shortage of GPs in a certain region, GPs cannot consult each other about sharing patients. Each year, ACM receives dozens of reports from patients that experience difficulties when switching GPs. These are both patients that have moved to a different district or municipality as well as patients that are looking for a different GP in the same district or municipality. ACM has investigated the reasons as to why new patients were refused, and has concluded that the current shortage of GPs is the biggest obstacle for patients that wish to switch. This shortage has led to GPs experiencing increasing work pressure, and to many practices being completely full. This is a problem over which ACM has no influence.

The freedom to choose one’s own GP cannot be curtailed unnecessarily

During the investigation, it was revealed that some GPs had possibly made permanent arrangements among themselves about not taking over each other’s patients. In addition, they may have coordinated ‘catchment areas’ among themselves, for example, on the basis of postal codes. These kinds of permanent arrangements are at odds with the patients’ freedom to choose, and are therefore, in general, not allowed. However, in discussions with several GPs involved, it became clear that the shortage of GPs played a key role. The arrangements were made with the intention to be able to offer at least a spot to patients that wished to switch.

ACM believes it is very important that GPs offer patients the opportunity to switch, even if practices in a region are full. That is why GPs are allowed to make arrangements among themselves to find a spot for individual patients. Further curtailing the patients’ freedom to choose their own GP is not allowed. ACM will only investigate new reports if there are concrete indications that permanent arrangements have been made with a purpose other than finding a spot for individual patients in a region where there is a shortage of GPs.

Patients that are looking for a new GP

The Dutch National Association of General Practitioners (LHV) has guidelines regarding the switching of GPs, both for patients as well as for GPs. In these guidelines, it is explained what is and what is not allowed. If patients are looking for a GP (because of a move or for any other reason), health insurers can also help find a new GP. See also the information (in Dutch) on the bottom of this page of the Dutch Healthcare Authority (NZa).

See also