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204 Independence, freedom, individual responsibility and self successful as it was claimed to be. New techniques, like realisation were the popular notions. PBL fit perfectly in these intensive care, kidney dialysis and cardiac catheterisation, were new points of view and offered an acceptable alternative to prominent and proud signs of progress in medicine, but around existing medical education, which for a long time had been a 1970 progress seemed to falter. It proved difficult to find stronghold of traditional teaching according to the master- medical answers to new diseases, like chronic fatigue apprentice model of the old guilds. syndrome, which were not well understood. The increase in By giving priority to primary health care the basic complaints from the worried well, were interpreted as a sign of philosophy was in alignment with an increasingly critical undesirable and expensive medicalisation. Le Franu described attitude toward traditional medical practice. After the Second this with uncanning precision in Rise and fall of modern World War there had been an explosion of knowledge in medicine (2000). The doctor and consequently medical medicine. This had important consequences. The ever education had to pay much more attention to societal aspects of increasing role of medical technology, increasing health care. The doctor had to change. subspecialisation and the size, organisation and climate in Specialist and technical health care in the Netherlands hospitals had made medicine expensive, industrial and cold. had grown explosively and become too expensive. Among Foucault had written about the coercive system of medicine in politicians, progressive circles in the medical profession and Naissance de la clinique (1963) and in The role of medicine, health scientists the conviction gained ground that, based on dream, mirage or nemesis (1976), McKeown had posed the considerations of costs and in order not to burden patients critical question whether modern medicine was really as unnecessarily, primary care should take precedence and more


Geneeskundeboek-Opmaak Binnenwerk-ENG.indd
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