• Sword Verbison

  Economics Editor

• Roland Muller

  Economy Correspondent

“Thank you for your patience during these difficult times.” With these words, the director of Mediterranean cooperation, Guy Fromin, concludes an email to employees announcing that salaries will not be paid. Patience was indeed necessary: ​​for employees who still receive money, for patients who have not been able to reach their GP, and for the Inspectorate who has wanted to intervene several times.

Co-Med was presented as a solution for general practitioners in the Netherlands, not only by the founders, but also by health insurance companies. NOS spoke to thirteen employees of Co-Med: assistant practitioners, general practitioners, regional managers and board members. We also spoke to four general practitioners who did not work for the company but were faced with the shortage of doctors. Some wished to remain anonymous for fear of legal consequences.

Co-Med responds that it is “not right” for the company to be “taken for granted and pushed into the abyss at any given time.” The detailed response is at the bottom of this article.

In 2019, Co-Med was founded by three entrepreneurs from Limburg: Guy Vroemen, Guy Scholpen and Caro van Uden. Scholpen and van Uden have worked in the general practice world in Limburg for years. They have been toying with the idea of ​​Co-Med for some time. Vroemen has been appointed as business manager. He had previously sold his double-sided tape company to Americans.

The chain essentially buys practices from GPs who want to retire and cannot find a successor. Co-Med supplies doctors and assistants to each practice. The administrative part is managed centrally.

The organization is rapidly buying up practices across the country. The first are in Helmond and Breisand, making a total of twenty practices.

Soon there are problems in many practices. The schedules are not enough to cover their expenses, which means they are facing a tight staffing situation.

On July 1st last year, Co-Med took over the management of a clinic in Waalwijk. Here too, occupancy is not sufficient. “This problem arose “It’s a mark for other GPs in the area,” says Anne Oijen, a GP in Waalwijk who does not work at Co-Med. “We’ve been receiving more and more patients from Co-Med who need urgent care.”

The shortage of doctors is so acute that Van Ooijen proposes taking over the Co-Med clinic. If they can’t reach an agreement, Co-Med offers to hire Van Ooijen. That’s not an option for her, because she doesn’t agree with the company’s approach: “I didn’t think of it a hair on my head.”

The problems are so great that the practice must close. The doors will close on October 1, in four months.

A doctor from Zwolle who was temporarily working in the chain said he had not been transferred from caring for a terminally ill patient. The patient had last seen another GP at Co-Med two days earlier. “He told the patient he would be back in a few days. The man was dying. You should have at least a phone call the next day.”

When he wants to transfer the patient’s care back to the doctor the next day, it turns out that he is “working from home.” “That’s not possible at all. Then I was able to transfer him to the hospital doctor’s office.”

The doctor reports this to the practice manager. “He said he would work on it.” He doesn’t know what happened to the patient. Immediately after the incident, the doctor leaves the company.

There are also scheduling problems in The Hague, after Co-Med bought two clinics in a short time. “I have completely recovered from Co-Med,” says one freelance journalist. “It involved 8,000 patients. At one point, one of the trainees was all alone.”

Meanwhile, the Health and Youth Inspectorate (IGJ) has been receiving complaints for months. It will take until summer 2023 before the inspectorate takes action. Co-Med must provide monthly access to staffing levels.

In summary proceedings, the chain was found to be correct: the intervention generates media interest, makes doctors less willing to work for Co-Med and makes recruitment more urgent, the judge ruled. The inspectorate wants to intervene again in February 2024. The chain goes to court again, but this time it is not correct.

There is also pressure within Co-Med’s top management to intervene. Director Guy Schulpen told NOS he wanted to close the practice in Zwolle due to scheduling issues, but director Guy Vroemen doesn’t want to. Sources at the highest levels confirm that Vroemen wants to keep the practice open at all costs.

According to sources, director Fromen made the acquisitions without arranging the staff and without consulting his partners. “The acquisitions were often a fait accompli, and as a result you create your own negative image, because a good transfer cannot be made,” says medical director Schulpen.

Where does my money go? Many employees want to know. They still have months of unpaid wages. Other companies that have dealt with Co-Med will also get paid.

“Everything seemed good during the acquisition. The administrative burden would be reduced,” says one employee of the Hague practice. “Soon there were reminders from suppliers: cleaners, supermarkets. Freelancers were not paid or were paid too late.”

Creditors report to a subsidiary of Co-Med, a call center that accepts calls from practices. Creditors successfully filed for bankruptcy. Meanwhile, the company continues to maintain that it is “in a healthy financial position.”

A German investor will enter the company in mid-2023. He sees a future in the Co-Med plan and is investing €1.6 million in it. The founders are positive after the much-needed injection.

Sources inside the company, from doctors to management, say there is uncertainty about the finances. Guy Schulpin says there is also uncertainty within the board of directors, although he cannot provide any documents on the matter. “Nobody was incorrectly informed, so no complaints about this have ever been made,” Frumin, who was in charge of finance, said in response.

Guy Schulpen and Caro van Uden will leave at the beginning of this year. “The goal has clearly not been achieved,” says Schulpen. He believes there is still room for greater efficiency in GP care. According to Schulpen, the failure of Co-Med is mainly due to resistance in the GP world and negative publicity, which means that doctors no longer want to work there.

The signals from the inspection and the collapse of the subsidiary are worrying health insurers. The contingency plan must ensure that more than 50,000 patients are not left without a GP if the company collapses.

In mid-June, health insurance companies shut down the collaboration and turned off the cash tap. Co-Med could no longer be saved. The practice closed, and in an email to employees, Fromin said he was not paying salaries. Two days later, he declared bankruptcy.

The Co-Med programme, which declared itself a solution to the shortage of GPs, has only exacerbated the sector’s problems.