Annual reports 

And so annual reports for the years 1998, 1999 and 2000 were published from the dermatology department of the Carolus-Liduina hospital (now of course it has to be formal), location 's-Hertogenbosch. Recurring topics were: summary of the year, staffing, partnerships, brief description of the scope of the practice, production data (numbers of patients, numbers and nature of diagnostic and therapeutic procedures, clinical admissions), diagnoses (nature, codes and numbers), continuing education and further training, publications, accreditation, lectures, other activities, conference visits, and 'A look to the future'. In addition, each of the annual reports dealt with a number of topics that had been important in that year. For example, in 1998 I wrote about the visitation and recorded the protocols that would later be published. In 1999 I discussed my vision on patient information (with a large number of new leaflets), described the newly  acquired medical equipment and automation, and in 2000 attention was paid to emergency appointments (about

which I had published), the imminent collaboration with the Bosch Medicentrum, I told about my holiday letters to the GPs with all the cartoons and of course about the Leo Dermatology Award, which I had won that year.
I had fun publishing the annual reports very early in January of the following year (I know, a little boastful). This was possible because everything was ready and registered when I closed the outpatient clinic for the Christmas holidays, usually from December 19 or 20 until the first Monday in January. Because we never really went away during the holidays, I had plenty of time to collect the data, write an annual report (I now had 20 years of experience writing articles, chapters and books, so this was a piece of cake), make the necessary copies in the hospital and glue them in at home with a plastic cover around it. A cover with an image added extra cachet. All specialties in the hospital received a copy, of course the Board of Directors and the Supervisory Board, the Board of the Dutch Association for Dermatology and Venereology and all health insurance funds / health insurers. No one ever said so, but Vince once told me that a lot of colleagues at the hospital thought it was overkill. Well, it was a new development that everyone should eventually be forced to do, and change simply generates resistance.

I didn't blame my colleagues and understood their feelings. After all, you may wonder to what extent such exercises improve the quality of your medical practice, although the visitation committee of the Dutch Society for Dermatology and Venereology (NVDV) suggested that it did. It was therefore somewhat disappointing that the Board of the NVDV wrote to me about my annual report from 1999: 'It provides a clear and easily readable overview of all aspects of your practice. The preparation and distribution of such a thorough document can contribute to the profiling of our field and the exchange of knowledge and ideas about the practice of our profession'. Nice of course, but where is the aspect of quality improvement, isn't that what it was all about? Fortunately, CZ, the second largest health insurer in our region, appreciated my annual reports very much.


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