3A.03. 90's

In the 1990s, patient education became more and more a natural part of primary-care consultations. This development was supported by legislation, on the one hand, and media attention, on the other. In the Netherlands, but also in most other western countries, patients' rights were firmly anchored in health laws [27], and the media paid ample attention to health and the healthcare system. Numerous programs were broadcast about health problems and the healthcare system, varying from educational programs about coping with illness, medical procedures, and the work of physicians to entertainment programs about patients' experiences and physicians' misconduct. Thus, the general public became more aware of their rights and became more critical about the care they received, which forced physicians to be more transparent about their work and achievements. Medical specialists, especially in oncology, also became more aware of the importance of patient education for secondary prevention and improvement in quality of life [28]. Medico-technical innovations played a role too. Patients were confronted with more complex and specialized procedures, patients faced more healthcare choices that were consequential, and patients with chronic conditions had to adhere to complex drug and lifestyle recommendations in order to achieve prolonged quality of life. Furthermore, patient-education research became a grown-up discipline with national and international research platforms, journals, and congresses [29]. However, research about patientspecialist communication was still in its infancy [30].