[Benign prostate hyperplasia; shared care reduces care load]

Specialist associations developing guidelines and the Dutch General Practice College (NHG) issuing standards make only little use of one another's knowledge and particularly one another's insight. Medical specialists see mostly patients with severe diseases. GPs mostly 'healthy' patients with symptoms. In practice, this leads to problems in arriving at mutual agreements. After publication of a guideline by the Netherlands College of Urologists in 1993 and of the NHG standards of 1994 concerning abnormalities of micturition in males, a joint team drew up a report titled 'Benign hyperplasia of the prostate, recommendations for transmural care'. Transmural recommendations and local practical agreements based on them may reduce patients being surprised by strikingly different and sometimes redundant approaches when visiting the GP and the specialist, respectively, and offer both categories the possibility to make the outside world know that much work is being done to achieve qualitatively adequate, efficient medical care.