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Hippokrates programme	Contents
NATIONAL PRESENTATION: Denmark

General Practice - the Danish Model
By Dr. Ivar Østergaard, general practitioner, specialist of family medicine & senior lecturer

Health care structure
Denmark is just a small country of 5.2 million inhabitants. Doctors make a total of about 18,000 with 6,000 in training in the 30+ different specialties - and 3.300 GPs. Doctor-population ratio is 1:300 and GP-population ratio 1:1500.

General practice is a strong tradition for more than a century, and the GP is the central figure in the health care system, representing the point of first encounter for >95% of people suffering health problems. The current system was launched in 1973; Danish GPs are independent professionals working on a contractual base with the government (county). The population register on a list with a specific GP and gets primary medical care without private cost of service besides part of cost of medicine (50%) 98% (of the population are registered, the remaining 2%) are "private" patients paying a part of fees for service and getting the right to visit any GP and specialist service. Registered patients must have a referral to visit a specialist and hospital service without personal cost. Patients register with their GP for many years, less than 3% making a change per year.

Tasks in general practice
Danish GPs deliver 30 million contacts to the population per year. 30% as telephone contacts, 70% face-to-face consultations and home visits. 4% of patients seen are referred to hospitals, 2% to community specialist care, and 2-3% to auxiliary services (physiotherapist etc.). GPs take care of people from (before) birth (pregnancy care) to (after) death (bereavement care). Daily work in the practice includes prevention of any kind, sorting minor complaints from major, sorting the sick from the well, diagnosing, referring, curing and caring the sick, palliative care for the incurable, follow-up, caring for children, youngsters, adults, and 01(1 people, men & women. General practice in Denmark is aware of a context including somatic, psychological, social and humanistic dimensions, a holistic or comprehensive approach and model for patient-doctor relationships.

Medical education
Medical school 6 to 6 1/2 years, obligatory general practice in 5th and 6th year, consisting of a clinical period of 1 month and 24 hours of lectures, and included in final exams.
Internship (or basic clinical training) for all candidates no matter future specialty: 1/2 year surgery + 1/2 year internal medicine + 1/2 year general practice.
Specific general practice training includes the internship and runs for 3 1/2 years more, in total a training period of 5 years. The last period of 3 1/2 years is composed of various hospital posts 2 1/2 to 3 years + general practice 1/2 to 1 year + a theoretical course of 200 hours

Country coordinator for Denmark:
Per Kallestrup
Department of General Practice,
University of Aarhus,
Vennelyst Boulevard 6
DK-8000 Aarhus C, Denmark
E-mail: kallestrup@dadlnet.dk

Denmark - HOST PRACTICE

Skødstrup Lægepraksis
Stationsstien 24, DK - 8541 Skødstrup.
Phone:+ 45 8699 1655 and fax: + 45 8699 3588

Welcome to our general practice in Skødstrup!

Geography:
Our clinic is placed in a mixed rural/village area in the eastern part of the Danish mainland -close to the sea and nice country-side - and close to "civilization" with lust 15 kin to the university city of Aarhus with 250.000 inhabitants. We have just 30 kilometers to a domestic airport (also one international route from London Stansted to this airport).

Doctors:
We are 6 GP's (2 female and 4 male) working in the clinic - and one young doctor during his or her training in family medicine. For shorter periods we also have a medical student in the clinic.
Apart from the daily work with the patients the doctors are engaged in education in family medicine in many respects - allowing you to be invited to these educational sessions.

Staff:
In Denmark staff in general practice clinics is very limited. We have three full-time secretaries -you can understand they have to be efficient!

Clinic:
We run a well-equipped modern clinic with a fully computerized filing system. Our clinic (650 square meter in total) is placed in a separate building lying in a little garden.
We have 9800 patients registered at our clinic - and we service an area with a diameter of approx. ~ 5 km.

Special:
We absolutely prefer that you combine your visit to our clinic with a visit to another general practice in our area. We suggest one week at our clinic and one week in another clinic (we will help to arrange this). This will allow you to broaden your view of Danish general practice.

Preferred visiting periods:
Avoid in general the months of July, August and December. Because of our engagement in many fields some other periods might be inconvenient, too. Therefore we prefer your contact as early as possible allowing us to plan a good exchange visit for you.

Accommodation:
It might be possible to stay in turn with some of the GP's or the trainee-doctor. In other
periods where this is impossible low-cost accommodation is available at the Youth Hostel in
Aarhus.

Contact:
Please make contact as soon as possible to either:
Dr. Gitta Nørgaard
private phone: +45 8699 1997

Dr. Roar Maagaard
private phone: + 45 8699 3929
e-mail: roarmaag@post7.tele.dk

Denmark - HOST PRACTICE

The Doctors Kjær, Lundh & Møller
Gammel Strandvej 9
DK 2990 Nivå, Denmark
Telephone:+45 49147232
Fax: +45 49181152
E-mail: Lundh@dadlnet.dk
WWW: www.laegehusetnivaa.dk

Our practice is situated in the municipality of Karlebo in the old part of the village of Nivå 30 kilometres north of Copenhagen. The practice has 3 partners and has been a practice for medical training for more than 15 years. The number of patients is 5.380 (from the age of 0 upwards).

The practice was started by Claes Kjær in 1969. At that time there were no general practitioners in Nivå. The place was only a small town with a railway station where the only workplace was a brickyard. Now it has 8600 inhabitants and 6 general practitioners. The other general practitioners are respectively working in a one-man-practice and a practice with two partners.

Ulla Møller (50) became a partner in 1983 and has recently worked part time as a doctor at the employees health service. Jesper Lundh (53) began as a partner in 1978 and has a number of consultancies beside the Practice. He works as a General Practitioner Hospital Adviser, as secretary for the Committee for Quality Improvement in General Practice and finally as a co-ordinator of specialist training in general medicine. Therefore Dr. Lundh only works four days a week in the practice. Dr. Kjær (65) works full-time in the practice. For more than 15 years he worked as an adviser in the Secretariat of Education at the Danish Medical Association.

Trainees and registrars have been part of practice for at least 15 years.

The staff in the clinic includes secretary Anni Nørgård, who has been employed since 1987 and the nurses Gitte Weeke and Heidi Dyrberg. Gitte has worked in the practice since 1996 and Heidi since 1998.

Every week we spend two hours on supervising the younger doctor and discussing different educational activities, research projects and projects for quality development.

During the stay in Nivå which should preferably be in the period from August till May food and lodging can be arranged in the home of one of the doctors who lives four kilometres from the practice.

The Doctors
Kjær, Lundh & Møller

Denmark - HOST PRACTICE

Lægerne Kanaltorvet 8
Kanaltorvet 8
2620 Albertslund, Denmark.
Telephone: +45 4364 1008
Fax: +45 4364 4212

Our general practice which has existed since 1982 is situated in Albertslund, a suburb to Copenhagen 20 km from the center of Copenhagen. Albertslund has about 30,000 inhabitants. It is an area characterised by a majority of young families with children and only few elderly people, a fact which, naturally, is reflected in our group of patients: out of 5,700 patients, about 1,700 of these are children beneath the age of sixteen.

The practice consists of four permanently employed doctors, two women and two men, all of us at the age around fifty. We all take part in other functions beside the practice and work therefore only 3/4 of our time in the clinic. These functions are for example: giving lectures for students or for colleagues who are specialising in family medicine, arranging courses in supplementary training for colleagues, and working as facilitators at Glostrup hospital etc.

Beside doctors the staff includes two secretaries, Pia Glennild and Trunte Lindstrøm, who work fulltime, one nurse, Ann Sindal, and one locum tenens, dr. Marianne Pedersen, who work two to three days a week.

The clinic is on the second floor of an apartment building in the centre of Albertslund. The actual clinic consists of five large and bright, well-equipped consulting rooms and one smaller laboratory. The job is quite varying and gives among other things the possibility of minor surgical operations.

The clinic is open on week days from 8 a.m. till 4 p.m. (one exception: on Wednesdays we close at 6 p.m.). The exchange doctor will have the opportunity to join us at shifts outside of normal visitation hours and at visits to the county hospital in Glostrup.

At present we are not able to offer any accomodation, but will be of assistance in the search of such when it is needed.

If you are interested, please write or call us for further information.

Yours sincerely

Lene Jørgensen
Aase T. Jacobsen
Lars Rytter
Tom Simonsen

Denmark - HOST PRACTICE

Lægerne i Vestergade
Vestergade 17
3200 Helsinge, Denmark
Telephone: +45 4879 4004
Fax: +45 4879 5004

We are a practice with 5 part time working general practitioners, Arvid Frank Jørgensen, Niels Jørgen Christiansen, Anne Larsen, Mette Wanning and Ynse de Boer (a dutchman, living and working in Denmark since 1988). In addition, we almost continiously have employed doctors in some phase of their vocational training and in periods also students from the University of Copenhagen.
Besides the partners we employ a nurse (Jette) and 2 part time secretaries (Susanne and Lotte).
Two of the partners are engaged in CME and one in research. Some of the doctors have a special interest in the fields of allergic disorders and palliative medicine.

We are working in Helsinge, a small town approximately 50 kilometres Northwest of Copenhagen, situated in the beautiful North Sealand. Our patients (app. 5600) are a nice mixture of farmers, retired people enjoying their cottages near the forest and the sea, younger families, often working in Copenhagen, some fugitives from Africa and the Middle East and so on.
Our practice is situated in a beautiful house, built in the end of the 19th century for the first GP in town. One of the consulationrooms has been used as such from the beginning, whilst others have been used as living- dining-bedrooms, you still can see remains from children's inscriptions in their bedrooms.

Our practice is well equipped, we can make quite a lot near-patient investigations and we use a modern computerised patient filing system.

We have participated as a trainee-practice in 15 years, and have previous had guests from other countries. We think we can offer you a nice and hopefully enjoyable introduction to how general practice works in Denmark. If you would like to come, we suggest you to avoid visiting us during the summer-holiday period.
We will, off course, help you to find accomodation for your stay, probably at home with one of the partners.

If you are interested please contact:

Ynse de Boer
Practice: Vestergade 17, 3200 Helsinge, +45 48794004
home: Tvingsbakken 47, 3200 Helsinge, +45 4879 1309
e-mail: ynse.boer@dadlnet.dk

Denmark - HOST PRACTICE

Lægerne 1. sal
Sundhedscenteret
Sygehusvej 7
8660 Skanderborg

Geography:
Our clinic is located in the buildings of the former "Skanderborg Sygehus" in the village of Skanderborg approximately 15 miles south of Aarhus - the second city of Denmark. The village is beautifully located near forests and lakes.

Doctors:
In the clinic there are 5 GP`s and at most a young colleague in education. Only 4 of the GP`s is at work every day.
The GP`s are Jørgen Hobolth(62), Bjarke Skov (50), Kristian Flade (49), Peter Voss (40) and Claus Juul (39)

Staff:
These are "the girls" - our partly timed secretaries: Kirsten, Anne Sofie, Berit, Jette and Jytte. There are no educated nurses in the clinic.

Clinic:
The clinic is located on the first floor in an older building in which further GP-clinics are located. It is quite well equipped with a computerised filing system incl. communication links with hospitals and pharmacist.
There are 6000 registered patients at our clinic. The total count of the village is approximately 20.000.

Visiting periods:
The holiday months is June or July in which the clinic will be closed. Therefore you have to contact us to hear when it will be possible to visit us during the summer. During the rest of the year most periods are possible.

Accommodation:
There is a nice Youth Hostel in the village - a 10 min. walk from the clinic. In some periods it might be possible to live in one of the GP`s home

Contact:
Please make a contact to plan your visit to either:

The Clinic: Phone +45 86520133 or