Geen huisarts nodig op de SEH:daar werkt de SEH-arts

In the Netherlands, general practitioners (GPs) are known as ‘gatekeepers’ for patients requiring acute or emergency care, because all referrals should be made via them. Despite this role, many patients visit the accident and emergency (A&E) department as self-referrals. Different organisational models have been implemented in order to deflect self referred patients from the A&E departments. One example of a model is to have a GP working in the A&E department; a study indicated that this would be more efficient and just as effective as general A&E physicians treating self-referring patients. In this commentary the study is analysed and the advantages and disadvantages of having a GP work in the A&E department are discussed. The author pleads for having trained accident and emergency physicians working in the A&E department, with GPs in an adjoining post. A joint triage system could then ensure that the patient is treated in the correct place. Collaboration between a GP post and the A&E department but with physicians working in their own environment is promoted.

Conflict of interest: none declared. Financial support: none declared.