The "alchemists" is a group of medical experts that has set itself up over the past year as an unofficial umbrella body of general practitioners, medical specialists and paramedics such as pelvic physiotherapists. The goal is to be able to consult each other through short lines of communication for specific questions regarding pelvic pain. They use a digitally secured chat system, Siilo, and can give each other advice at very short notice. Right now, all the specialists in the group are focused on (chronic) pelvic pain, but they can imagine that the method can be used in a much broader area.

Fetske Hogen Esch, pelvic physiotherapist, and Grietje Vander Mijnsbrugge, colorectal surgeon, took the initiative. Soon the group grew, now consisting of eight specialists from various disciplines. This time not multidisciplinary within one healthcare facility, but interdisciplinary spread across the country. They speak with one voice. They are all about blending their collective knowledge and expertise to help the patient move forward. They use the Siilo app, which medics use to exchange information securely, to consult each other about patients with complex complaints. Prisma is a similar system for general practitioners to ask questions of gynecologists. A study by ZonMw is underway to determine whether it is cost-effective. For both apps, a healthcare provider must be BIG-registered.

"We are a transdisciplinary and cross-center group. We sought each other out because of the specific expertise, regardless of where the other works. Often one person has just the specific knowledge you need. Even without having the whole team there, you can look each other up and question each other. Even though everyone likes to learn from each other.


Our goal is to be able to help patients quickly without having to go through many stages. We also have knowledge about the presence of professionals in our own region, so that we can refer to each other more quickly. This is partly because we have short lines of communication and it does not run through secretariats. We send an app and there is an answer. We also try, for example, to form a network with clear lines of communication, such as between the UMC Groningen and the Antonius Hospital in Sneek. We are also trying that in Enkhuizen. You can consult with each other more easily and avoid duplication of effort. This way we can refer patients quickly and they are helped faster and better.


We are all passionate about helping patients move forward and question each other with equality and respect. That is a very pleasant way of working together. We have a safe team that communicates in a low-threshold manner and that definitely benefits the quality of care. What we also do: if someone has been to a congress and we hear something interesting there, or we read a good article, we share that in the group. That way we share knowledge and help each other grow. For complex problems, we try together to create a safe place for the patient without having to go from one hospital to another. We don't have to deal with all kinds of rules and hurdles to overcome. The evaluation with the patient is essential. You can consult with each other, but decisions are made together with the patient.'


The Alchemists were created to quickly connect with other disciplines, share expertise, and we do that to help patients quickly. The patients we serve in the

group discuss often have already come a long way and, despite this, it is unclear where the complaint comes from. Then we start puzzling: I've seen this and I'm not really sure what to do, would you like to look with me? You can also share something unusual that you experienced to illustrate what you may encounter so that others are more likely to recognize that issue. You sometimes encounter unusual problems and here you can safely exchange views and get advice from different perspectives. From each other's insights you learn and grow. Because of that advice, that patient does not have to see another doctor, saving travel, time and healthcare costs, and above all, the patient is better served. We hope to get to the point where general practitioners and other colleagues can also ask questions within the team, so that we can be consulted as a kind of four-line advisory group by other care providers or by a patient organization with a specific question.


We now have a network for the complex pelvic floor pain and it is really puzzling what we should or should not investigate. Patient organizations such as Pelvic Floor4All can also call on the Alchemists. Of course, there are info lines, carousel clinics and multidisciplinary consultations. But there is often a lot of time involved. We are people who do not like rules, nor do we like unnecessary administration. The group is cross-disciplinary and goal-oriented. If a doctor can't figure it out in the local carousels or multidisciplinary consultations then you can approach the alchemists. That's the future. Maybe at some point it would be nice to involve someone from the B4A Foundation. But I think we first need to further define who we are and what we stand for. Then there could possibly be a patient organization involved. For now, some of us only know each other through the app group and through ZOOM. Still, we feel like a unit. We speak each other's language and do so with one voice.'

Alchemy is an ancient natural philosophy found in various cultures. Alchemists attempted to produce gold and other precious metals and searched for the philosopher's stone. Other alchemists saw these practices as a byproduct in the search for their own inner change.