LAGRO-JANSSEN, Prof Toine
The Netherlands: gender and women's health expert
Toine Lagro-Janssen holds a PhD in medicine and is Professor of
Women’s Studies Medicine, at the Radboud university medical centre, the
Netherlands. In 2007 she received the Royal Honour as Officer of the Order of
Orange-Nassau, for profiling the role of women as patients and doctors,
especially in an international perspective. WONCA News September 2015 featured her comments about a publication called "Gender and Health Knowledge Agenda". She is a member of WONCA Working Party on Women and Family Medicine.
What work are you doing now?
Since 2012, we have been running the Nijmegen-based Centre for Sexual Abuse and Familial Violence, a collaboration of the Emergency Department, the Radboudumc, forensic medicine and the police for acute care and the Radboudumc’s GP practice for aftercare. I lead this centre and I am also available for consultation and advice to care workers, victims and relatives. I feel very committed to the Centre because care for victims is fragmented and often not personalized or good-quality care. GPs are very important because most victims have good relations with their GPs and appreciate their questions about violence and abuse. The medical and psychological consequences, moreover, can play a role in the victims’ lives for years.
The chair I held as a professor was in Gender and Women’s Health, and this reflects my interest in raising the gender awareness of medical students and doctors and teaching them about clinically relevant gender differences in diseases and complaints. In 2014, our unit of Gender Studies in the Medical Sciences was commissioned by the Ministry of Education, Culture and Science to implement gender in all medical faculties, a very successful project that will be running until the end of 2016. We have formulated gender-sensitive criteria and, in close collaboration with the faculties, we have screened and adjusted teaching programmes in gender-sensitive ways. Teaching materials are documented and listed in a digital knowledge centre, called Gender and Diversity in Medical Education. I am the head of this knowledge centre, and with our staff we aim to disseminate up-to-date gender education materials, some of which are also available in English.
In addition, I currently chair the scientific committee that is in charge of the annual conference of the Dutch College of General Practitioners, whose theme this year is on urogynaecological complaints and sexual health. An average of some 2,500 GPs each year attend this conference. This year it will take place in the Hague on 13 November. Finally, I am involved in supervising 15 PhD students who are expected to complete their projects in this or the next few years. Of course, I am also on various boards and have several advisory social roles to play, but that goes without saying.
What are your interests in medicine and outside medicine?
In medicine, I have always particularly valued the concept of integrated medicine, or the bio-psychosocial approach to complaints, paying a lot of attention to the narrative aspects. For more than 35 years, I enjoyed working with a steady practice population in an academic health centre in a medium-sized town. Several times I have served as a GP to three generations of patients and considered this a real privilege. As I was the first female GP when I started out in this town in 1977, many unhappy female patients came to my surgery, who felt they were not properly treated or helped by regular medicine. This aroused my interest in specifically female disorders and complaints: incest, sexual abuse, intimate partner violence, eating disorders, psychological problems and also physical pelvic floor issues, such as urinary incontinence, prolapse and sexual problems, and reproductive health issues, such as unwanted pregnancy, STDs and birth control. It is early medical termination of pregnancy by the GP that ranks high on the agenda now, as this is not yet legally permitted.
Outside medicine, I am a keen music lover and an avid reader, and I enjoy social gatherings (dinner parties with friends and family) and cultural events.
What other interesting things have you done?
I think it is very important for GPs to be sufficiently competent to deal with urological and gynaecological complaints appropriately. With the right approach, GPs can discuss and treat 90% of these complaints. Time and again, patients indicate that they greatly value the relationship with their GP, which is based on trust and low-threshold access. Our knowledge of the patients’ context means we can strike the right note, and because we also know their medical history, we can provide integrated care. These issues, in sum, more than deserve to be dealt with by the GP.
That is why I took the initiative in 2004 to develop a urogynaecological GP training programme, in collaboration with a working party of the Dutch College of General Practitioners. This programme was launched in 2008 and has meanwhile instructed over 60 GPs, who now take care of consultations and collaborative agreements with specialists and serve as an academic counterbalance to the pharmaceutical industry.
The Women and General Practice working party of the Dutch College of General Practitioners was founded in 2003, following the WONCA world conference in Dubai in 2001. This working party is still up and running and was an active participant in WONCA conferences up until 2010. The positions of female physicians and patients have always taken pride of place.
What have you enjoyed about your involvement in the WONCA Working Party on Women?
The 2002 Durban conference was something of a revelation for me: the enthusiasm of this global community of female physicians and of feminism was completely contagious. I felt I had come home. With my colleague Sylvie Lo Fo Wong I returned to the Netherlands full of a fighting spirit and we at once set about founding a Female Physicians working party of the Dutch College of General Practitioners. For the European WONCA conference in Amsterdam in 2014 (I was a member on the Conference Committee), we organized a pre-conference, a fantastic event with 100 participants, who shared their experiences on female leadership and on the position of female physicians internationally, attempting to find solutions to problems. This led to the European study Europe through the Glass Ceiling and Leadership within General Practice in Europe, which was funded by the Dutch College of General Practitioners. A great result of women’s international collaboration.