19th NCGP

Nordic GP 2015

Keynote Speakers

Prof Simon Griffin

Simon Griffin is Professor of General Practice at the University of Cambridge, Group Leader in the Medical Research Council Epidemiology Unit (www.mrc-epid.cam.ac.uk) and CEDAR (the UKCRC Public Health Centre of Excellence for Diet and Activity Research, http://www.cedar.iph.cam.ac.uk/), Honorary Professor of General


Medical Practice at Aarhus University Denmark, Honorary Consultant at Cambridge University Hospitals NHS Foundation Trust and NHS England and an assistant General Practitioner at Lensfield Medical Practice. He qualified from the London Hospital Medical College in 1986 and trained in Clinical Epidemiology and Public Health at the University of Southampton and the London School of Hygiene and Tropical Medicine prior to his appointment to the University of Cambridge. He leads a research programme which contributes to efforts aimed at preventing the growing burden of diabetes, obesity and related metabolic disorders by translating epidemiological knowledge into preventive action, and evaluating the effectiveness of a range of preventive approaches in randomised trials. He has been awarded over £36M in extramural research grants and authored over 230 publications. Away from work Simon plays soccer and surfs.

Missed oppotunities and too much medicine: discovering 'lagom' in primary care
At a time of growing recognition that strong primary care is associated with better and more equitable health outcomes, general practice is facing unprecedented challenges. Demand from patients and policymakers is rising inexorably while simultaneously general practitioners are being blamed for over-investigation and treating people with ‘too much medicine’. Sustainable health care requires evidence –informed judgments about what constitutes the right amount of medicine in primary care.

Prof Linn Getz

Linn Getz (b. 1962) is a Norwegian MD with clinical experience from general practice, psychiatry and occupational medicine in Norway and Iceland. Her Phd titled Sustainable and responsible preventive medicine (2006) deals with ethical dilemmas emerging from implementation of advancing medical technology.  Linn has taken active part in development of the ideological base for general practice in the Nordic region. In this context she has devoted considerable time and thought to the rapidly increasing body of evidence which links human existential experience to biological function and disease development. She is involved in projects focusing on multimorbidity, the patient as a person, as well as potentials and pitfalls related to the rapidly increasing interest in systems biology as some sort of a new scientific paradigm in medicine. Linn works as a professor at the Department of Public Health and general Practice at the Norwegian University of Science and Technology (NTNU) in Trondheim.

How to care for the whole person in general practice: a million dollar question with a billion pixel answer?
All across medicine, it is becoming increasingly fashionable to speak about “the whole person.” In fact, two person-movements are on the rise: The first is Person-Centered Healthcare (PCH), the second Personalized Medicine (PM). Both movements are rooted in what I see as an imminent crisis in evidence-based thought and practice (EBM). What is striking and profoundly challenging, however, is that PCH and PM propose fundamentally different ways forward. PCH is a humanistic and value-based movement, whilst PM is based in hi-tech molecular science. How will the resulting tension affect the role of the GP? I believe the EBM-crisis opens “a dangerous opportunity” for general practice. But surfing the waves is not going to be easy. Hold on to your hat, and get ready for a spin!

Margrét Ólafía Tómasdóttir

Margrét Ólafía Tómasdóttir (born 1981) graduated as a medical doctor from the University of Iceland in 2007. She finished her speciality training in general practice in Iceland in July 2014. She is a PhD candidate in General Practice. Her research project is a collaboration between the University of Iceland and the General Practice Research Unit, Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim. Her scientific topic is Multimorbidity with reference to the concept of allostatic load. She was also the chief resident in general practice training in Iceland from 2010-2014.

Multimorbidity and more pressing matters – a young GPs view on the future of general practice:
I recently qualified as a specialist in general practice in Iceland. The path has been tortuous, but from where I stand now, our discipline´s future looks bright and challenging. As a part-time researcher, I have chosen to work with questions that are truly pressing for medicine as a whole and relevant for me in every-day clinical practice. My topic is multimorbidity. It has been termed one of the biggest medical challenges of the 21st century, and it is a challenge mainly managed by general practitioners. Its management requires a different approach to the patient, the diseases and the consultation and could widen the gap even further between the work of GPs and other specialities. Furthermore the management of multimorbidity challenges conventional medical thinking with its constantly increasing deconstruction of the body and mind, demanding the GPs holistic view as a cornerstone of medical practice. How does this affect the future of general practice? – And even more importantly – what effect could the multimorbidity “epidemic” have on the future of medical theory in general? Has the time come for general practice to finally take the lead?

Prof Merete Mazzarella

Merete Mazzarella is professor emerita in Nordic literature at The University of Helsinki and has written twenty-five books, mostly autobiographical essays. She has taught literature and creative writing to medical students and doctors, she has an honorary doctorate in medicine at Uppsala University and is an honorary member of SFAM.


General Practice more important than ever
Why is General Practice more important than ever?
I will be speaking not only as an academic and writer with a long-standing interest in medical humanities but also much more personally as an ageing woman in an ageing society. I will have something to say about communication between doctor and patient and about the difference between authority and authoritarianism, and I will have a lot to say about the importance of trust. I will also be talking about how doctors and patients should be seen as allies in the battle against economic cuts and structural problems.

Prof Jan De Maeseneer

Jan De Maeseneer (b.1952) is a Belgian family physician, working in the Community Health Center "Botermarkt – Ledeberg", in one of the most deprived and multi-cultural neighborhoods in Gent (Belgium). He made a PhD on "Family Medicine: an exploration" in 1989 at Ghent University. His main research topics are: epidemiology, multi-morbidity, social inequities in health, health service delivery, health policy, medical education, training of family physicians worldwide. In the field of medical education, he was in charge of a fundamental reform from a traditional discipline-based medical curriculum towards an integrated contextual medical curriculum at Ghent University. He chairs the Medical Education Committee and is the Vice-Dean for Strategic Planning at the Faculty of Medicine and Health Sciences at Ghent University.

As far as health policy is concerned, Jan De Maeseneer is active at different levels of policy development: he chairs the Local Platform for Health and Welfare at the Community of Ledeberg. Moreover, he is the chairman of the City Health Council at the City of Ghent and chairs the Strategic Advisory Board for Welfare, Health and Family, advising the Flemish minister. He serves at different advisory boards at the Federal level in Belgium. He is actually the chairman of the European Forum for Primary Care (www.euprimarycare.org) and chairs the Expert Panel on Effective Ways of Investing in Health, advising the European Commission (http://ec.europa.eu/health/expert_panel/index_en.htm).

Jan De Maeseneer is the Secretary General of The Network: Towards Unity for Health, the oldest network of innovative training institutions in health (www.the-networktufh.org), an NGO in official relationship with WHO. He is a member of the Global Forum on Innovation of Health Professional Education at the Institute of Medicine in Washington. He is actually the director of the International Center for Primary Health Care and Family Medicine – Ghent University, a WHO Collaborating Centre on PHC. He is active in Latin-America and Africa, supporting the development of training programmes for primary health care professionals (www.primafamed.ugent.be).

Recently, together with the colleagues of the other departments of family medicine in Flanders, he wrote a Policy Paper: "Together we change", developing a blue-print for an innovative, sustainable health care system transformation in Belgium, based on a strong primary health care.


Primary care and equitable and sustainable health care delivery: the need for health systems transformation.
In December 2014, the 4 Flemish professors in Family Medicine and Primary Health Care in Belgium decided to write a book: "Together we change: primary health care now more than ever!". Why do academics want to be involved in the policy-debate on the future design of the health system?

The main reason is that actually we face a fundamental transition in health care delivery. Our health systems are facing the following challenges: a demographical and epidemiological transition: with an increase of multi-morbidity. An increasing social gradient in health. A changing position of the patient, becoming a well-informed actor in the health system, multiculturality and globalization. In combination with financial austerity due to the economic crisis, the strengthening of the primary health care system becomes mandatory.

Starting from the principles of relevance, equity (access), quality, cost-effectiveness, person- and people centeredness, sustainability and innovation, the organization of the health system at the nano (provider-person interaction), micro (the primary care team), meso (the region) and macro (a country, Europe,…) level needs a fundamental re-thinking.

The outline of the proposal formulated by the 4 Flemish professors will be documented and debated with the audience.


John Brodersen

MD and general practitioner with over ten years of experience in clinical practice. Dr. Brodersen has a PhD in public health and psychometrics. He is an associate research professor at the University of Copenhagen, Department of Public Health, Research Unit and Section of General Practice, where he works primarily within the areas of preventive medicine and medicalisation. Dr. Brodersen’s specific field of research is the development and validation of questionnaires to measure psychosocial consequences of false-positive screening results. He has employed qualitative and quantitative methods in order to objectify these subjective constructs. Dr. Brodersen’s expertise also lies within the areas of diagnostic test-performance, overdiagnosis, informed consent, and consequences that may arise when healthy people are clinically examined and tested. Furthermore, he teaches evidence-based medicine in Denmark and internationally. Dr. Brodersen has published widely in peer-reviewed journals.


Quaternary Prevention:  Doing More Good than Harm
‘First, do no harm’ (Primum non nocere) – is a precept in the Hippocratic Oath. However, any medical intervention runs the risk of doing harm. Preventive medicine is no exception. In primary prevention, we have recently witnessed how a large influenza vaccination campaign injured hundreds of children. For what turned out to be a rather harmless pandemic, these children will now suffer from narcolepsy caused by the vaccine. In secondary prevention, we have seen how healthy individuals have been harmed by false-positive screening results, overdiagnosis, and overtreatment. These harms are not only manifested physically, but also psychologically, socially, and economically. In tertiary prevention, we have unfortunately also seen serious cases where patients have been exposed to more harm than good, for example by hormone replacement therapy to menopausal women. When the healthcare system or we as GPs initiate preventive procedures, we are directly responsible if these procedures in fact do more good than harm. This is where quaternary prevention comes into play. Quaternary prevention is “Action taken to protect individuals (persons/patients) from medical interventions that are likely to cause more harm than good”. Quaternary prevention reminds us that there is evidence that medicine can also do harm, and that we must always consider non-intervention in order to avoid medicalisation of the individual and society. The principles of quaternary prevention should be included in the core curriculum of medical students, general practice trainees, and in the continuing medical education of GPs, in other words, in the culture of general practice. By doing this, we can transform preventive medicine in primary healthcare into an evidence-based sustainable practice of doing more good than harm.


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NordicGP 2017

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