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19 wanted to take advantage of the support services of a hospital and the availability of other specialisms. At the same time, patients had become more critical and outspoken, united in patient organizations and supported by new healthcare legislation, so that the old authoritarian doctor-patient relationship gradually gave way to a more consultative model with an emphasis on participation, dialogue and choice. Because healthcare now took up an increasing share of total government expenditure, political entities, health insurers and hospitals started playing a more explicit role in judging eligibility for reimbursement. In this changing climate, dermatologists could no longer hold their own and opted to work within the precincts of the hospital, in partnership with their colleagues. Such cooperation could also be extended to other specialisms: for example, with gynaecologists in cases of vulvar patho- logy and surgeons with regard to phlebology. Thanks to increased regulation, peer review, the delegation of tasks to other health professionals, and through collaboration with specialists from other disciplines, a new formula for good quality dermatological care could begin to take shape. Fading of attention for venereal diseases The first Professor of Dermatology in the Netherlands, Chanfleury van IJsselstein was appointed in 1867 in Amsterdam in response to the venereal problem. Combating venereal diseases (VD’s), and scientific research of this group of disorders remained high on the agenda for decades, not only in Amsterdam, but also at the three academic departments of dermatology (Groningen, Utrecht and Leiden) that were established at the beginning of the twentieth century. This can be illustrated by the research agenda of the Department of Dermatology at the University of Utrecht, for example. Document establishing the founding of the Dutch Society for the Fight against Venereal Diseases (1915). BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:39 Pagina 19