Understanding the Dutch Healthcare system

Hi again.

Yeah, the Dutch system is a bit different to others I've encountered; you just met the Doctors receptionist, don't think that's a one-off, it's the norm in the Netherlands; I wouldn't worry too much about it, it seems to work just fine, just we need to ween ourselves off the need to see a doctor on demand.

If it happens out of hours, you call the out of hours service who will arrange for you to see the on-call doctor if they think it necessary, he/she will refer you to A&E if they can't deal with it.  If you turn up at A&E without a GP or emergency referral, they will send you away.

Hope this helps.

Cynic
Expat Team

Thanks for the quick reply.

So I guess there are no places that you can just turn up and get seen by a doctor?

In that case I will need to be convincing on phone to get seen by a GP I suppose, during work hours or after hours.

What about a scenario where they give you a date for the appointment but you really need one earlier? Do you have a choice at all or simply have to wait?

Hi again.

No, there are no walk-in clinics like in other countries; A&E is there for genuine emergencies, but these can only be decided by an emergency paramedic or a GP.  You have to accept that the medical professionals know more about illness than we Dr Google trained experts.

There is no such scenario in the Dutch health system where you know better than the healthcare professionals, If they don't think you're ill enough to see a Doctor urgently, then you have to accept it.

They've given you appropriate advice that should see you through till you see the doctor; if the nasal spray doesn't work, after 24 hours call them back and tell them and see if they can find recommend something else for you.

Probably not the answer you were hoping for, but it is what it is.

Cynic
Expat Team

The doctor here doesn't really immediately prescribed antibiotics medicine. I had once infection with a fus  in my arm from a scratch i made, the GP looked at it and said to just kept it clean blah blah blah but no medicines were given.

Till the infection or the pimples looked like appeard in some parts of my body. When i came to the Philippines the doctor immediately prescribed me antibiotics and it was eventually gone.  If i was only given the appropriate medicine the infection would not spread more . I was really disappointed. 😕😑

Antibiotics are another subject; many healthcare professionals worldwide are trying to actively reduce the prescribing of antibiotics; my wife gets a lot of grief from her patients who think she is trying to make them feel worse by refusing to give them antibiotics unless they are absolutely required.  Many people think they are a suitable treatment for a cold.

As a Dutchman I really don't get your story. Why do you want to see a doctor straight away for just a little thing?
You now have your appointment and if your symptoms get worse you can call your doctor for an earlier appointment. When it get really really bad you can go to the "dokterspost" in your neighbourhood.
When you really have something life threatining you can call 112.

In the Netherlands nobody dies because of this.

Don't expect to get antibiotics either, you will only get it if there's no other way. They will advise you to take an paracetamol. It's how are our system works.

Every country no matter how advanced is has always good and bad. As what i observed and experienced in the Philippines doctor at least  they always take basic procedures like taking the bp, weight, temperature of the patient on a record.  That is not what i had  here and the check up is really very quick. .another illness is another appointment.

In my opinion don't expect too much. No matter how advanced the country is there's always negative side.

Dutch medical system is murderer for 4 months I’m coughing up black phlegm’s losing nearly 20pounds still they ain’t do nothing

Dutch medical system is murderer for 4 months I’m coughing up black phlegm’s losing nearly 20pounds still they ain’t do nothing
-@ppiatros

Have you been to a Doctor?

I made this account just to reply to this topic, but I agree with what's being said here. I'm Dutch and can confirm that the Dutch healthcare is worthless (yeah, I know it can always be worse, but for a supposedly rich country, our healthcare system is not a good system at all). It used to be good some 20 years ago, but it has been on the decline ever since our government decided to privatize our healthcare back in the early 2000s. Now you have burned-out GPs who don't give a fxck about their patients and will throw every ailment on mental or emotional stress (even though it's obviously something physical) or think paracetamol is the answer to everything without even doing a proper diagnosis.

The refusal to do proper physical examination is the most horrible part of the system. I understand the need to be cautious with prescription of medicine, especially with the increase of antibiotic resistance, but the least a GP ought to do is give a full physical check-up in order to provide the patient with a proper diagnosis and have the decency to refer any patient that they can't make a proper diagnosis of to a professional instead of refusing the patient proper aid by throwing all the symptoms on "stress" in order to maintain their own ego.

Our healthcare system, since the privatization scam, is increasingly more unaffordable and providing lower and lower quality service for the huge amount of money thrown into it. It's been slowly, incrementally hollowed out by all the neo-liberal policies that have been implemented since the 80s and 90s. People who still say that our system is good are those suffering from nostalgia. They're wearing the rose-tinted glasses of what healthcare was like 30 years in the past.

As for Dutch healthcare consistently ranking number 1 or 2 in various studies — well, I would not be surprised if the researchers have been paid off to make our system score higher than it actually does or have an alternative agenda to promote privatization of healthcare.

Triage medicine appears to have become the default across many countries; to the extent that you will not get to see a doctor unless you have been triaged by a nurse; the same policy is in place with Emergency medicine in the Netherlands where if you walk into the Emergency Department without first being referred by your GP or a paramedic, you'll be sent away.

Triage has been around since the Korean War when it was the only way to cope with the mass casualty situation they found themselves in.  One of the issues caused by freedom of movement is that social support (healthcare, education, housing) just did not keep up with it and no country is planning to invest in these areas to bring things back to how they were.

@goten

Refreshing to see a Dutch person actually realising the state of the Dutch health system. In my experience general practitionners in this country have a very low general knowledge, more college level than university level. There is a fundamental lack of understanding of interconnected systems, no interest whatsoever in knowing the casues of a sympton (even when severe), inappropriate use of medical equipment and scientific procedures. The list could go on. It seems the health system is more of an industry than an actual service to society. It makes some people very rich, it gives jobs to many people but patients are unwelcome clients. There should be a radical reform in the system but sadly many Dutch people do not realise how inappropriate their health system is.

No, the healthcare system is not trying to kill you. I've been living in this country more than a decade and all of my complaints were sufficiently attended and I've always received the treatment needed, after consulting with a specialist. But I do not call GP for any small thing, do not expect to get an appointment the same or next day and stay away from medicine as much as possible.

One thing I should mention is that, in case a friend or relative from abroad visits you and they need to go to a hospital, please be aware that the standard travel insurance coverages are NOT accepted by Dutch hospitals. They ask for a European Health Insurance Card. Visitors are advised to see a GP (your own GP may accept to see them for urgent complaints) or a private specialist first and if they refer them to emergency or to a hospital, they should be prepared to pay everything upfront and then if they are lucky, their insurance will reimburse these costs. Just keep all the paperwork, test results, invoices etc. ready and if you have a chance, first contact your insurance provider and ask what else they may ask.

I have limited knowledge of how the healthcare system works in general, in the Netherlands anymore.  I can say this though.  It's a great place to die (and I mean this in the best way).  My sister was dx with end stage neuroendocrine cancer in December 2023.  We, her siblings, came to the Netherlands at that time and stayed with her for the last three weeks of her life.  Her GP came to the house 2-3 times a week.  He would sit by her bed and talk to her, keeping her informed of her illness.  Whenever we called he would either come or speak to us by phone and give her medications to manage her symptoms.  We were offered home health help and when we accepted they came the same day and did an evaluation.  They started the next morning and came twice a day, 7 days a week.   When my sister needed fluid to be removed (ascites) it was arranged for by the MD and an ambulance picked her up and brought her home, this happened multiple times.  My siter was able to die in a dignified way without pain. And, no, it did not cost anything.  Just to say that to us this was remarkable and it was a gift to her and us.   

The Dutch health system is a most absolute rubish. To the Dutch people that keep reapeating the inane thing that this is one of the best systems in the world, I have to say this: go live abroad for a stint. If you to Brazil, for instance, and have a health insurance, you will see that the figure of the GP doesn’t exist. Your insurance will have an extensive list of all the specialists registered with them. You pick one that is proper to your problem, schedule an appointment (which is mostly done within 24h) and go. They, by their turn, will focus on finding the cause of your ailment before they do anything: so you are sent to undergo the appropriate exams. Then they do whatever needs to be done (the proper medicine or any other intervention). And then they schedule a follow up appointment to see if it worked. Here, when you finally see a GP, all you get is guesswork, tea, rest and freaking paracetamol…  this is the treatment they give for anythig you may have. If what you have doesnt go away by itself, you may endure weeks or months of hell before you can see someone who seems to have a proper medical degree. It is medicine on the cheap. If the problem is money, I’d say that I’d prefer to have Belgian roads and more funding for the medical system instead… but course, first the Dutch have to stop flattering themselves and recognize how amazingly bad the system here is.

The fact that Brazil does not have GP's is definetely not a positive thing.  We are living in Brazil for 4 years now and yes I can see specialists although the wait time can be weeks.  The problem is that not one MD oversees your care so everything is fragmented.  They only take care of one system/organ and don't see the whole picture.  In the US you can see a GP who does many things and takes care of you as a total person.  We have not had the best experiences with MD's here.  They run a ridiculous amount of tests but their diagnostic skills are not always the best.  Brazilians go to the hospital for everything so yes this is in total contrast with NL.  My husband went to the hospital and was prescribed a penicilin based antibiotic and he has a penicillin allergy which was clearly stated on his medical form from the hospital.  This would never happen in the US.  When I told a Brazilian friend she said that sometimes you have to see multiple doctors to get the treatment you want.  That is not a good standard of care.  My son lives in NL and initially he had a hard time getting used to the dutch healthcare system (and the paracetemol ) but with time he is more than satisfied and he has had good care over the years.  I love the fact that Brazil has universal healthcare but honestly I travel back to the US to see MD's unless it is an emergency.