With its high negative predictive value, MRI is of great value to the general practitioner’s (GP) unequivocal task of excluding pathology in a large proportion of their patient population. While GPs prefer open access to MRI, insurance companies prefer to limit or discourage GP use of MRI, the main fear being unlimited unnecessary requests. Studies have shown these fears to be unfounded. Dutch Health Care Insurance Board (CVZ) regulations stipulate that GPs should have access to MRI on specific indications that are described in the Dutch College of General Practitioners’ (NHG) practiceguidelines. In the Netherlands, Alkmaar Medical Center (MCA) has offered open access to MRI since 1993 (knee) and 2006 (hernia nuclei pulposi), with excellent results. The percentage of normal report rates and of pathological findings of GPs is comparable to that of both neurologists and orthopaedic surgeons. Open access to MRI helps to speed up the diagnostic process, reduce outpatient waiting lists and limit unnecessary consultations. International publications have reported the cost-effectiveness of MRI. Experience both outside the Netherlands and at MCA has shown that open access to MRI results in reduced waiting lists and enhanced cost-effectiveness. This is best practice and should be incorporated into NHG practice guidelines.
Conflict of interest: none declared. Financial support: none declared.