“…In the Netherlands and many other Western-European countries such as Denmark, Norway, Sweden, and the United Kingdom, family physicians usually serve as gatekeepers to specialist medical care. The family physician also traditionally chooses the medical specialist provider, usually without much involvement from patients themselves (Earwicker & Whynes, 1998;Victoor et al, 2013;Vrangbaek, Østergren, Birk, & Winblad, 2007). Since the late 1990s, health care reforms have been gradually introduced in the Netherlands and most other Western-European countries that aim to facilitate increased competition between health care providers (Helderman, Schut, van der Grinten, & van de Ven, 2005;Martinsen & Vrangbaek, 2008).…”