Het werk van de huisarts

Osselen, Esther van; Helsloot, Ron; Werf, Ger van der; Zalinge, Emma van

doi:10.1007/s12445-016-0077-1

Cited by 2 publications

(2 citation statements)

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“…To address this problem, in 1974, the Dutch Government decided to invest in primary care. The healthcare system was reorganised around two echelons, with the GPs given the key position of gatekeeper (Hendriks, 1974;van Osselen, Helsloot, van der Werf, & van Zalinge, 2016c). The government's 'conservative' stance was reflected in MNC in efforts in favour of midwives' position.…”

Section: Unexpected Alliances and Transprofessional Coalitions In Promentioning

confidence: 99%

“…Retaining jurisdiction as gatekeeper would have been in their professional interest. In the end, however, the GPs' stance against the increasing medicalisation in healthcare (van Osselen, Helsloot, van der Werf, & van Zalinge, 2016a;van Osselen et al, 2016c), their strong belief in the gatekeeper system as a brake on medicalisation (van Osselen, Helsloot, van der Werf, & van Zalinge, 2016b), and their declining interest in, and skills for, providing midwifery care (Aulbers & Bremer, 1995;van Alten & Treffers, 1981), led them to support midwives as the gatekeeper in MNC, supporting the 'conservative' stance in the SGKL.…”

Section: Unexpected Alliances and Transprofessional Coalitions In Promentioning

confidence: 99%

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Risk and the politics of boundary work: preserving autonomous midwifery in the Netherlands

Goodarzi

Holten

et al. 2018

Health, Risk & Society

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Midwives' position in maternal and newborn care (MNC) in the Netherlands is unique: unlike many other countries, they have retained the authority over risk assessment and referral. We studied why and how midwives formally gained their position as gatekeepers, a role formally granted in 1987 by the Study Group for the Revision of the Kloosterman List (SGKL), a group of representatives from all professions and organisations involved in Dutch MNC. We analysed the minutes of the SGKL's meetings and conducted interviews with eight key-informants who were involved in the SGKL's decision process. We used theories of professional boundary work and cultural theories of risk to analyse the negotiations regarding the authority over risk assessment and referral in MNC that occurred between the representatives of midwives, general practitioners, and obstetricians in the SGKL. Our study offers new insights into professional boundary demarcation and the contest for control of risk management that occur at the political level of MNC. We show that beliefs regarding risks associated with childbirth and concern with the protection of professional interests can differ not only between but also within professions that seek to police and extend their boundaries. Negotiations are shaped by a dynamic interaction between these beliefs and interests, creating the possibility for otherwise unexpected transprofessional coalitions and redefining boundaries in unexpected ways. Our findings offer the possibility to view disputes in MNC as occurring between beliefs and interests, instead of between professional groups. These insights can reframe policy discussions in MNC and point to the need for further analysis of the boundary work that occurs in political and regulatory arenas.

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Section: Unexpected Alliances and Transprofessional Coalitions In Promentioning

confidence: 99%