De huisarts en de tijdgeest

Issues of Huisarts and Wetenschap from 1957 to 2008 were analysed to see whether the professional ethics of general practitioners have changed in response to changes in patient characteristics and changes in government policy. In addition, semi-structured interviews with three generations of GPs were carried out. Results showed that professional standards have changed over the years. In the 1950s and 1960s, GPs acted as ‘parents’ for their patients, determining what was appropriate for them. GPs still had this role in the 1970s, but it was no considered important to teach patients to be independent and to take responsibility for their health. This change, with emphasis on one’s own responsibility, was instigated by GPs and not by changes in patient characteristics. In the 1990s, restraint became a professional standard, but this policy proved difficult to communicate to patients. The introduction of market forces to health care has made it increasingly difficult for GPs to be restrained in the provision of care. How the professional ethics of GPs will change in the future depends on the solidarity among GPs and on government policy.