title: [E-health and the GP as gatekeeper; are the two compatible?].
abstract: Within the Dutch healthcare system the general practitioner functions as a "gatekeeper", deciding whether or not to refer the patient for specialist care. The introduction of e-health makes it easier for medical specialists to inform patients about their abilities in their own field. When they also offer to help the patient via e-health consultation they are, in practical terms, bypassing the gatekeeper. At the moment the Dutch healthcare system has no way of regulating payment for these services. Irrespective of the many advantages of e-health in the collaboration between primary and specialist care, we should carefully consider whether we want the gatekeeper to be bypassed in this way. This will be even more important if it results in extra costs for the healthcare system.
authors.affiliation: UMC Utrecht, Julius Centrum voor Gezondheidswetenschappen en Eerstelijns Geneeskunde, Utrecht.
authors.forename: Roger A M J
authors.initials: RA
authors.lastname: Damoiseaux
mesh_terms: D019033:Delivery of Health Care, Integrated; D006801:Humans; D020407:Internet; D012648:Self Care / Q000379:methods*; D012871:Skin Diseases / Q000175:diagnosis* / Q000628:therapy*