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Mar 26, 2012

First “More,” Then “Less”

Author Affiliations

Author Affiliation: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.

Arch Intern Med. 2012;172(6):465. doi:10.1001/archinternmed.2011.2252

As a family physician from the Netherlands, I work as a gatekeeper in a setting with a long-standing tradition of supporting strong primary care by both the public and policymakers. The concept that less can be more is one of the pillars of the cost-effectiveness of the Dutch health care organization.1

My experience with this concept is that before “less is more” comes into play, initially “more” is needed. This “more” deals with time invested in the patient-physician relationship.2 In this process, I will come to understand my patient in the context of his life (family, work, social activities, health behavior) and he can learn whether my practice is of good quality or not. If all works out well, we establish a relationship based on trust.