We are getting older and living longer with disease, which is increasing the demand for healthcare. At the same time, new therapies offer opportunities, but also put pressure on affordability and raise expectations about how much life can be controlled. On April 23, Ewoud van Dijk, Professor of Neurology, delivered his inaugural lecture, “Neurology and Context.” In it, he explains why collaboration, continuous learning, and making deliberate choices between “doing and not doing” are essential.
“We know that if we do nothing, the healthcare system will reach a breaking point,” says Ewoud van Dijk in his lecture. “Currently, one in seven workers is employed in healthcare. With increasing demand, that would need to rise to one in four by 2040. Those people simply won’t be there.”
Demand for care is growing, and expectations are changing. New treatments offer hope and opportunities, but they also come with a price tag. “Without new funding models, these long-awaited therapies will either not become available or will be significantly delayed,” Ewoud states. “That would mean going from a promising treatment back to no treatment at all.”
“Not everything that can be done in healthcare is necessary or meaningful,” Ewoud emphasizes. “We therefore need to take a critical look at how it is currently organized and consider whether what we do is still truly needed.” This includes, for example, additional tests, hospital admissions, or follow-up visits. “Care you don’t provide has no side effects, does not require scarce staff, and is less polluting. If it is safe to stop, then the principle is: do, by not doing.”
He therefore advocates for more ‘less is more’ care. One example is the treatment of patients with an acute stroke who have only mild symptoms. “Together with the patient, we decide whether someone can go straight home from the emergency department instead of being admitted. The most important tests have already been completed and medication has been started. Further explanation is provided later at the outpatient clinic. About a quarter of patients chose this option. They were satisfied and experienced no complications.”
However, making different choices alone is not enough. Healthcare also requires a different way of working. “Healthcare professionals must not only have domain expertise, but also understand the broader context,” Ewoud emphasizes. “They need to work flexibly, collaboratively, and innovatively.”
That context goes beyond the disease itself. It includes the personal context: patients’ daily lives and their role in society. “We want people to participate in society as fully as possible. That can only be achieved if we collaborate, within and beyond healthcare, and understand what we can expect from one another.”
Continuous learning is therefore essential. “At UMC Utrecht, we do this in part through the New Utrecht School. Students from different disciplines learn together there. This allows them, from an early stage, to look beyond boundaries and collaborate—with each other, with patients, and with society.”
Ewoud summarizes his message in three words: together, learning, doing. “It’s not about doing more, but about being able to do things better together. We achieve this by creating time and space to keep learning and improving.”
He compares this to neurology: “Not only the nervous system consists of centers and connections—healthcare does as well. Those connections are just as important as the centers of expertise.” “It’s all about balance. Between content and context. Between doing and not doing. If we continue to learn and act on this together, we will be ready for the future,” he concludes.
Ewoud is Professor of Neurology and focuses on vascular and acute neurology. He primarily treats young patients with a cerebral infarction, brain hemorrhage, or cerebrovascular abnormality. His scientific research also centers on these neurovascular conditions.
Since April 1, 2025, he has served as Head of Department within the Brain theme. In this role, he is responsible for the Department of Neurology. In addition to patient care, he is committed to scientific research, the education of students and future neurologists, and holds several administrative roles.
