In 1999, trauma surgeon Jan Luitse and pioneer physician in emergency practice Gos de Vries organized the conference ‘Emergency Medicine, who cares?’ in Amsterdam.
That same year, the Netherlands Society of Emergency Physicians (NSEP) was founded. The year 1999 can therefore be seen as a starting point for the new style of emergency medicine in the Netherlands.
Other links in the emergency medicine chain were already forming and developing during that time. Although the emergency medicine departments were becoming more complex, the training of specialized medical staff in these departments was being overlooked. At this time, physicians with little or no experience staffed Dutch EDs. There was no professional training or nationwide standard of care. Meanwhile, physicians, managers and politicians started to realise that through reorganising the provision of acute medical care, its delivery in the ED could be improved.
In 2000, four teaching hospitals started the first emergency medicine training in the Netherlands. Two years later, the first university hospital joined this group. In the following years, more hospitals joined and in 2004, the Stichting Opleiding Spoedeisende Geneeskunde, a foundation to secure and standardize the emergency medicine training programme, was founded. Since 2008, there has been a uniform, nationwide emergency medicine training programme, and since 2009, emergency medicine in the Netherlands has been recognized as an area of special interest by the Royal Dutch Medical Association (KNMG). Since then, the quality and uniformity of emergency medicine training has been overseen by the KNMG. The Stichting Opleiding Spoedeisende Geneeskunde had finally reached its goals and was therefore abolished. In 2011, the first professor in emergency medicine was appointed to the Erasmus University in Rotterdam.
Over the last 15 years, EM in the Netherlands has developed from scratch to an independent area of expertise. The professional association NSEP does unite all EPs and EM residents in the Netherlands and gives emergency medicine a public voice. It has taken responsibility for monitoring and improving the form and quality of training of EPs in the Netherlands. It is taking the lead in bridging the gap between the current Dutch training programme and international training standards. The NSEP participates actively in international umbrella organisations, such as the European Society for Emergency Medicine and the International Federation for Emergency Medicine. Representatives from the NSEP also sit on several national committees concerned with emergency medicine. Today 192 residents are being trained in 28 hospitals with a training program for emergency medicine. Over 300 EPs work in 83 out of 93 Dutch EDs and ten EDs have realized already 24/7/365 coverage with EP-staff. Nowadays, there are more and more Dutch EDs with an emergency physician as the medical manager and the same applies for the Emergency Medical Services. Most training programs have appointed an EP as training director.
Over the coming years, the NSEP and its members face new challenges. Quality of care, patient safety, cost reduction and accessibility are the main driving forces for regionalisation of healthcare in general, and therefore emergency care as an integral part of this process. Continuity of care delivered by specialty physicians. Improving and streamline EM residency programmes. Development of academic emergency medicine. Since 1999, much has been achieved, providing a solid foundation and a good starting point for these future challenges.
1. Emergency Medicine in the Netherlands: a short history provides a solid basis for future challenges, European Journal of Emergency Medicine 2012, 19: 131-135.
2. Emergency medicine training in the Netherlands, essential changes needed, International Journal of Emergency Medicine 2013, 6:19.
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