Nexøe, Jørgen

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Syddansk Universitets Forskerportal

       University of Southern DenmarkDeveloping Danish general practiceNexøe, JørgenPublished in:Scandinavian Journal of Primary Health CareDOI:10.3109/02813432.2013.815989Publication date:2013Document version:Final published versionDocument license:CC BYCitation for pulished version (APA):Nexøe, J. (2013). Developing Danish general practice. Scandinavian Journal of Primary Health Care, 31(3), 129-130. https://doi.org/10.3109/02813432.2013.815989Go to publication entry in University of Southern Denmark's Research PortalTerms of useThis work is brought to you by the University of Southern Denmark.Unless otherwise specified it has been shared according to the terms for self-archiving.If no other license is stated, these terms apply:            • You may download this work for personal use only.            • You may not further distribute the material or use it for any profit-making activity or commercial gain            • You may freely distribute the URL identifying this open access versionIf you believe that this document breaches copyright please contact us providing details and we will investigate your claim.Please direct all enquiries to puresupport@bib.sdu.dkDownload date: 22. Oct. 2025Scandinavian Journal of Primary Health Care, 2013; 31: 129–130ISSN 0281-3432 print/ISSN 1502-7724 online © 2013 Informa HealthcareDOI: 10.3109/02813432.2013.815989 EDITORIAL  Developing Danish general practice nurses and other staff. Their main source of income is reimbursement. GPs are paid by a mixture of per capita payment and fees for services. Privately paid fees from patients or other services outside the National Health Service account for only a modest turnover  [ 6 ] .  GP offi ces are contracted to be open on all week-days from 8:00 a.m. to 4:00 p.m., with the fi rst hour reserved for telephone consultations. On one weekday, opening hours run to 6 p.m. or 7 p.m. The Regions now want longer hours to provide accessibil-ity outside normal working hours without supplying any additional fi nancing. The GPs are supposed to make effi ciency gains as has been done in the  hospitals, even though these effi ciency gains are at least in part attained by transferring tasks to general practice. Furthermore, GPs will be forced to take over public health and preventive health tasks from the municipalities with no extra payment and with-out prior negotiations. It is proposed that patient care data from general practice, including diagnoses, prescriptions, laboratory tests, and information from hospitals, which until now have been used for quality improvement and research, will now also be used to monitor the individual GP.  The anticipated confl ict may have a great impact not only on health care for patients. Devel-opment may be slowed down and research in pri-mary health care may be halted for a period. In a situation with no agreement between the GPs and Danish Regions, data from the GPs ’ electronic record system cannot be expected to be forwarded to the joint unit for quality development between the Organisation of General Practitioners and the Danish Regions. The risk of losing valuable data is substantial.  Negotiation rather than legislation is the solution, if we want to preserve effective primary health care in Denmark. Latest: on 29 June 2013 the Organisa-tion of General Practitioners decided that the Danish general practitioners should not collectively give up their provider number. The chairman Henrik  Confl ict of interests  The Association of Health Authorities, Danish Regions, has refused to renew the current collective bargaining agreement after nine months of failed talks with the Organisation of General Practitioners. Sub-sequently, the Government announced a law that would force GPs to accept new working conditions if they wish to remain suppliers within the public health-care system. In response the GPs have collectively decided to give up their provider number. A labour confl ict with effect from September 2013 seems very likely. Thus the Danes may from  September 2013 be denied free access to primary health care and Danish primary health care is at risk of collapsing.  General practice is in many ways the backbone or cornerstone of the Danish healthcare system, forming the front line of the healthcare system  [ 1,2 ] . Nearly all Danish citizens (98%) are listed with a general practice  [ 2 ] . The Danish healthcare system favours an interpersonal doctor – patient relationship and continuity of care, which are highly valued by the patients  [ 3 ] . During the course of one year about 85% of all citizens are in contact with their general practitioner (GP)  [ 4 ] .  The current structure and position of Danish pri-mary health care have developed over more than 100 years  [ 5 ] . The ability to adapt to changing circum-stances and challenges has ensured general practice an important position in the Danish healthcare sys-tem, providing cost-effi cient, fi rst-line services and careful gatekeeping  [ 6 ] .  Approximately 3600 GPs serve the Danish popu-lation and they make up about 20% of the physician workforce. The GPs are distributed across approxi-mately 2200 practice units with one or two GPs in most practices. In principle, any doctor with a spe-cialty in general practice can set up a surgery, but to receive reimbursement from the public authority a GP provider number must be granted for services to be free to patients. With few exceptions doctors own the practice units in which they work, meaning the doctors are self-employed. The GPs employ and pay 130  Editorial  Dibbern has resigned. New acting chairman is Bruno Meldgaard Jensen. Negotiations between the Organ-isation of General Practitioners and the Danish Regions are resumed.  Confl icts of interest  The author is a general practitioner in the Danish healthcare system.  J ø rgen Nex ø e  Associate Professor, General Practitioner  Research Unit of General Practice  University of Southern Denmark, Odense, Denmark  E-mail: jnexoe@health.sdu.dk  References  Moth  G ,  Olesen  F ,  Vedsted  P .  Reasons for encounter and [1]  disease patterns in Danish primary care: Changes over 16 years .  Scand J Prim Health Care  2012 ; 30 : 70 – 5 .  Christiansen  T .  Organization and fi nancing of the Danish [2] health care system .  Health Policy  2002 ; 59 : 107 – 18 .  Frederiksen  HB ,  Kragstrup  J ,  Dehlholm-Lambertsen  B .  Attach-[3] ment in the doctor – patient relationship in general practice: A qualitative study .  Scand J Prim Health Care  2010 ; 28 : 185 – 90 .  Vedsted  P ,  Olesen  F .  [The use of Danish day-time general prac-[4] tice: Status and perspectives] .  Ugeskr Laeger  2005 ; 167 : 3280 – 2 .  Nyland  N .  Alment praktiserende l æ ger i Danmark 1900 – 2000 : [5] en professionshistorie [General practitioners in Denmark 1900 – 2000: A history of the profession] .  Odense: Syddansk Universitet ;  2006 .  Pedersen  KM ,  Andersen  JS ,  Sondergaard  J .  General practice [6] and primary health care in Denmark .  J Am Board Fam Med  2012 ; 25(Suppl 1) : S34 – S38 . 

English

Developing Danish general practice

       University of Southern DenmarkDeveloping Danish general practiceNexøe, JørgenPublished in:Scandinavian Journal of Primary Health CareDOI:10.3109/02813432.2013.815989Publication date:2013Document version:Final published versionDocument license:CC BYCitation for pulished version (APA):Nexøe, J. (2013). Developing Danish general practice. Scandinavian Journal of Primary Health Care, 31(3), 129-130. https://doi.org/10.3109/02813432.2013.815989Go to publication entry in University of Southern Denmark's Research PortalTerms of useThis work is brought to you by the University of Southern Denmark.Unless otherwise specified it has been shared according to the terms for self-archiving.If no other license is stated, these terms apply:            • You may download this work for personal use only.            • You may not further distribute the material or use it for any profit-making activity or commercial gain            • You may freely distribute the URL identifying this open access versionIf you believe that this document breaches copyright please contact us providing details and we will investigate your claim.Please direct all enquiries to puresupport@bib.sdu.dkDownload date: 25. Oct. 2025Scandinavian Journal of Primary Health Care, 2013; 31: 129–130ISSN 0281-3432 print/ISSN 1502-7724 online © 2013 Informa HealthcareDOI: 10.3109/02813432.2013.815989 EDITORIAL  Developing Danish general practice nurses and other staff. Their main source of income is reimbursement. GPs are paid by a mixture of per capita payment and fees for services. Privately paid fees from patients or other services outside the National Health Service account for only a modest turnover  [ 6 ] .  GP offi ces are contracted to be open on all week-days from 8:00 a.m. to 4:00 p.m., with the fi rst hour reserved for telephone consultations. On one weekday, opening hours run to 6 p.m. or 7 p.m. The Regions now want longer hours to provide accessibil-ity outside normal working hours without supplying any additional fi nancing. The GPs are supposed to make effi ciency gains as has been done in the  hospitals, even though these effi ciency gains are at least in part attained by transferring tasks to general practice. Furthermore, GPs will be forced to take over public health and preventive health tasks from the municipalities with no extra payment and with-out prior negotiations. It is proposed that patient care data from general practice, including diagnoses, prescriptions, laboratory tests, and information from hospitals, which until now have been used for quality improvement and research, will now also be used to monitor the individual GP.  The anticipated confl ict may have a great impact not only on health care for patients. Devel-opment may be slowed down and research in pri-mary health care may be halted for a period. In a situation with no agreement between the GPs and Danish Regions, data from the GPs ’ electronic record system cannot be expected to be forwarded to the joint unit for quality development between the Organisation of General Practitioners and the Danish Regions. The risk of losing valuable data is substantial.  Negotiation rather than legislation is the solution, if we want to preserve effective primary health care in Denmark. Latest: on 29 June 2013 the Organisa-tion of General Practitioners decided that the Danish general practitioners should not collectively give up their provider number. The chairman Henrik  Confl ict of interests  The Association of Health Authorities, Danish Regions, has refused to renew the current collective bargaining agreement after nine months of failed talks with the Organisation of General Practitioners. Sub-sequently, the Government announced a law that would force GPs to accept new working conditions if they wish to remain suppliers within the public health-care system. In response the GPs have collectively decided to give up their provider number. A labour confl ict with effect from September 2013 seems very likely. Thus the Danes may from  September 2013 be denied free access to primary health care and Danish primary health care is at risk of collapsing.  General practice is in many ways the backbone or cornerstone of the Danish healthcare system, forming the front line of the healthcare system  [ 1,2 ] . Nearly all Danish citizens (98%) are listed with a general practice  [ 2 ] . The Danish healthcare system favours an interpersonal doctor – patient relationship and continuity of care, which are highly valued by the patients  [ 3 ] . During the course of one year about 85% of all citizens are in contact with their general practitioner (GP)  [ 4 ] .  The current structure and position of Danish pri-mary health care have developed over more than 100 years  [ 5 ] . The ability to adapt to changing circum-stances and challenges has ensured general practice an important position in the Danish healthcare sys-tem, providing cost-effi cient, fi rst-line services and careful gatekeeping  [ 6 ] .  Approximately 3600 GPs serve the Danish popu-lation and they make up about 20% of the physician workforce. The GPs are distributed across approxi-mately 2200 practice units with one or two GPs in most practices. In principle, any doctor with a spe-cialty in general practice can set up a surgery, but to receive reimbursement from the public authority a GP provider number must be granted for services to be free to patients. With few exceptions doctors own the practice units in which they work, meaning the doctors are self-employed. The GPs employ and pay 130  Editorial  Dibbern has resigned. New acting chairman is Bruno Meldgaard Jensen. Negotiations between the Organ-isation of General Practitioners and the Danish Regions are resumed.  Confl icts of interest  The author is a general practitioner in the Danish healthcare system.  J ø rgen Nex ø e  Associate Professor, General Practitioner  Research Unit of General Practice  University of Southern Denmark, Odense, Denmark  E-mail: jnexoe@health.sdu.dk  References  Moth  G ,  Olesen  F ,  Vedsted  P .  Reasons for encounter and [1]  disease patterns in Danish primary care: Changes over 16 years .  Scand J Prim Health Care  2012 ; 30 : 70 – 5 .  Christiansen  T .  Organization and fi nancing of the Danish [2] health care system .  Health Policy  2002 ; 59 : 107 – 18 .  Frederiksen  HB ,  Kragstrup  J ,  Dehlholm-Lambertsen  B .  Attach-[3] ment in the doctor – patient relationship in general practice: A qualitative study .  Scand J Prim Health Care  2010 ; 28 : 185 – 90 .  Vedsted  P ,  Olesen  F .  [The use of Danish day-time general prac-[4] tice: Status and perspectives] .  Ugeskr Laeger  2005 ; 167 : 3280 – 2 .  Nyland  N .  Alment praktiserende l æ ger i Danmark 1900 – 2000 : [5] en professionshistorie [General practitioners in Denmark 1900 – 2000: A history of the profession] .  Odense: Syddansk Universitet ;  2006 .  Pedersen  KM ,  Andersen  JS ,  Sondergaard  J .  General practice [6] and primary health care in Denmark .  J Am Board Fam Med  2012 ; 25(Suppl 1) : S34 – S38 . 

       University of Southern DenmarkDeveloping Danish general practiceNexøe, JørgenPublished in:Scandinavian Journal of Primary Health CareDOI:10.3109/02813432.2013.815989Publication date:2013Document version:Final published versionDocument license:CC BYCitation for pulished version (APA):Nexøe, J. (2013). Developing Danish general practice. Scandinavian Journal of Primary Health Care, 31(3), 129-130. https://doi.org/10.3109/02813432.2013.815989Go to publication entry in University of Southern Denmark's Research PortalTerms of useThis work is brought to you by the University of Southern Denmark.Unless otherwise specified it has been shared according to the terms for self-archiving.If no other license is stated, these terms apply:            • You may download this work for personal use only.            • You may not further distribute the material or use it for any profit-making activity or commercial gain            • You may freely distribute the URL identifying this open access versionIf you believe that this document breaches copyright please contact us providing details and we will investigate your claim.Please direct all enquiries to puresupport@bib.sdu.dkDownload date: 20. Oct. 2025Scandinavian Journal of Primary Health Care, 2013; 31: 129–130ISSN 0281-3432 print/ISSN 1502-7724 online © 2013 Informa HealthcareDOI: 10.3109/02813432.2013.815989 EDITORIAL  Developing Danish general practice nurses and other staff. Their main source of income is reimbursement. GPs are paid by a mixture of per capita payment and fees for services. Privately paid fees from patients or other services outside the National Health Service account for only a modest turnover  [ 6 ] .  GP offi ces are contracted to be open on all week-days from 8:00 a.m. to 4:00 p.m., with the fi rst hour reserved for telephone consultations. On one weekday, opening hours run to 6 p.m. or 7 p.m. The Regions now want longer hours to provide accessibil-ity outside normal working hours without supplying any additional fi nancing. The GPs are supposed to make effi ciency gains as has been done in the  hospitals, even though these effi ciency gains are at least in part attained by transferring tasks to general practice. Furthermore, GPs will be forced to take over public health and preventive health tasks from the municipalities with no extra payment and with-out prior negotiations. It is proposed that patient care data from general practice, including diagnoses, prescriptions, laboratory tests, and information from hospitals, which until now have been used for quality improvement and research, will now also be used to monitor the individual GP.  The anticipated confl ict may have a great impact not only on health care for patients. Devel-opment may be slowed down and research in pri-mary health care may be halted for a period. In a situation with no agreement between the GPs and Danish Regions, data from the GPs ’ electronic record system cannot be expected to be forwarded to the joint unit for quality development between the Organisation of General Practitioners and the Danish Regions. The risk of losing valuable data is substantial.  Negotiation rather than legislation is the solution, if we want to preserve effective primary health care in Denmark. Latest: on 29 June 2013 the Organisa-tion of General Practitioners decided that the Danish general practitioners should not collectively give up their provider number. The chairman Henrik  Confl ict of interests  The Association of Health Authorities, Danish Regions, has refused to renew the current collective bargaining agreement after nine months of failed talks with the Organisation of General Practitioners. Sub-sequently, the Government announced a law that would force GPs to accept new working conditions if they wish to remain suppliers within the public health-care system. In response the GPs have collectively decided to give up their provider number. A labour confl ict with effect from September 2013 seems very likely. Thus the Danes may from  September 2013 be denied free access to primary health care and Danish primary health care is at risk of collapsing.  General practice is in many ways the backbone or cornerstone of the Danish healthcare system, forming the front line of the healthcare system  [ 1,2 ] . Nearly all Danish citizens (98%) are listed with a general practice  [ 2 ] . The Danish healthcare system favours an interpersonal doctor – patient relationship and continuity of care, which are highly valued by the patients  [ 3 ] . During the course of one year about 85% of all citizens are in contact with their general practitioner (GP)  [ 4 ] .  The current structure and position of Danish pri-mary health care have developed over more than 100 years  [ 5 ] . The ability to adapt to changing circum-stances and challenges has ensured general practice an important position in the Danish healthcare sys-tem, providing cost-effi cient, fi rst-line services and careful gatekeeping  [ 6 ] .  Approximately 3600 GPs serve the Danish popu-lation and they make up about 20% of the physician workforce. The GPs are distributed across approxi-mately 2200 practice units with one or two GPs in most practices. In principle, any doctor with a spe-cialty in general practice can set up a surgery, but to receive reimbursement from the public authority a GP provider number must be granted for services to be free to patients. With few exceptions doctors own the practice units in which they work, meaning the doctors are self-employed. The GPs employ and pay 130  Editorial  Dibbern has resigned. New acting chairman is Bruno Meldgaard Jensen. Negotiations between the Organ-isation of General Practitioners and the Danish Regions are resumed.  Confl icts of interest  The author is a general practitioner in the Danish healthcare system.  J ø rgen Nex ø e  Associate Professor, General Practitioner  Research Unit of General Practice  University of Southern Denmark, Odense, Denmark  E-mail: jnexoe@health.sdu.dk  References  Moth  G ,  Olesen  F ,  Vedsted  P .  Reasons for encounter and [1]  disease patterns in Danish primary care: Changes over 16 years .  Scand J Prim Health Care  2012 ; 30 : 70 – 5 .  Christiansen  T .  Organization and fi nancing of the Danish [2] health care system .  Health Policy  2002 ; 59 : 107 – 18 .  Frederiksen  HB ,  Kragstrup  J ,  Dehlholm-Lambertsen  B .  Attach-[3] ment in the doctor – patient relationship in general practice: A qualitative study .  Scand J Prim Health Care  2010 ; 28 : 185 – 90 .  Vedsted  P ,  Olesen  F .  [The use of Danish day-time general prac-[4] tice: Status and perspectives] .  Ugeskr Laeger  2005 ; 167 : 3280 – 2 .  Nyland  N .  Alment praktiserende l æ ger i Danmark 1900 – 2000 : [5] en professionshistorie [General practitioners in Denmark 1900 – 2000: A history of the profession] .  Odense: Syddansk Universitet ;  2006 .  Pedersen  KM ,  Andersen  JS ,  Sondergaard  J .  General practice [6] and primary health care in Denmark .  J Am Board Fam Med  2012 ; 25(Suppl 1) : S34 – S38 . 

Jørgen Nexøe

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Scandinavian Journal of Primary Health Care

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Developing Danish general practice

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