AbstractThis thesis investigated which factors contributed to changes in the thinking and acting of general practitioners with regard to tobacco addiction in the post-war period. Extensive literature research has been carried out for this in various medical scientific publications and medical journals. In addition, a small-scale witness seminar was held with six retired GPs and an interview with two GPs still working.
It was important to include oral history in the study in order to record the perception of the general practitioners who had worked during this period. The perception of retired and still working GPs has placed the view on the GP's role in prevention and in particular the GP's role in smoking cessation in a more personal perspective. No new truth was pursued. Subjectivity and unreliability of the memory were therefore subordinate to the experience and personal involvement of the (former) general practitioners.
There were several factors influencing the changing job perception of general practitioners with regard to smoking. The social climate was thus a determining factor. In the post-war years, smoking was a popular addiction. In 1958 90% of Dutch men smoked! There was no difference in smoking behaviour between physicians and non-physicians. In a way, this legitimized doctors not to want to get involved in smoking too much. Scientific research brought up the dark side of smoking and showed the nicotine addiction. However, the participants of the witness seminar and interview indicated that this information had no place in medical education.
Another determining factor was the professionalization process of the general practitioners, which got off to a good start with the establishment of the NHG. The discipline itself was searching and was looking for a good interpretation of the duties of the GP. Prevention already seemed to be part of this when the NHG was founded in 1957. However, the support base of the new professional association was still too small and it took more than three decades before prevention was actually embedded in the GP's duties.
The role of the government was seen as the most important factor in tobacco discouragement by the participants of the witness seminar and interview. Making cigarettes more expensive, pack warnings, banning smoking in public places, and public campaigns, they said, would have had much more impact than any of the primary smoking interventions by GPs.
Finally, it was investigated whether the smoking patient also had an influence on the tasks of the GP. Patients were partly represented by emerging patient associations such as the Cancer Society, the Long Fund (formerly the Asthma Fund), the Dutch Heart Foundation. But in the consulting room, one-on-one conversations took place. The retired general practitioners confirmed Snelder and Meijman's conclusion that patients have always been autonomous, but they also struggled with the question of the extent to which the general practitioner was allowed to interfere with the patient's privacy. The still working doctors found that to be much less of a problem.
The experiences of these general practitioners form a beautiful, colourful and personal addition to the existing theory in medical history. Moreover, it makes a contribution to the oral history that is in full development in the Netherlands.
|Date of Award||13 Jul 2022|
|Supervisor||Gemma Blok (Supervisor) & Susan Hogervorst (Examiner)|
- Master Kunst en Cultuurwetenschappen