Hello ..
I would like to ask our American citizens about their experience with Dutch healthcare.
Will 14 million Dutch health system work with 280 million Americans comprising over 180 different ethnic groups?

Did you have to wait long queues for treatments in NL ?

is how well NL does at taking care of people with the most serious diseases — particularly cancer ?


Doctors in the US need a firm or secretary to deal with insurance and provide a full and complete cost , but in netherlands , the service is missing, are you able to get the copayment?


Do you like your Home Doctor and do you have other choices ?

Today news ..Dutch healthcare system rated Europe’s best
http://www.ehealtheurope.net/News/4332/dut...%E2%80%99s_best


VS
the old news
http://www.youtube.com/watch?v=9ArpzcbrhJ0...feature=related


K..

I have not really had to wait too long to see a doctor here, though if you have not been ill over a week, they will sometimes try to discourage you from making an appointment - they will also be hesitant to prescribe any medication to help you and tell you to go home and let the body heal itself or "wait and see". Though it sounds like a good idea, many GPs here are not qualified enough to make these calls, and there are endless stories of catastrophic results (some in my own family, I'm sad to say).

There is a daily "spreekuur", where you can go in without an appointment to see the doc, and you can wait anywhere from 5 minutes to an hour and a half, depending on how busy they are. There are waiting times for some thing -for example, my wife just waited A YEAR to get surgery - it was non-life threatening, but still, that's quite a wait! (she needed that surgery as a result of the GPs telling her to "wait and see" about a previous condition, resulting in a lifelong problem which probably could have been avoided with a simple medicine which is standardly prescribed in most western countries within 48 hours of outbreak - but not here according to several Dutch GPs - the specialists would have prescribed it, but it took a month to see them and by then it was too late for the medicine to be effective) - She also needed a small surgery for an ingrown toenail, and they made an appointment for 2 weeks - after a few days, she couldn't take the pain anymore and went to the emergency room, where they performed the surgery within an hour.

I had a friend with cancer and another with Sudden Arrhythmia Death Syndrome, both young - they received the proper treatment and are doing well - on the other hand, my colleagues mother, who had a lump on her body, was told by her GP that it was "nothing" and there was no reason to do any tests at all - she died 6 months later of a very treatable form of cancer....

The problem with healthcare in NL, in my opinion, is more to do with the dismissive attitude of the GPs - I can't tell if this is more to do with Calvinism or whether it is an attempt to keep as many people away from specialists as possible, so the system isn't as overloaded - the GPs, however, who are the "gatekeepers", can be very difficult - they seem more interested in keeping you away from specialists than in truly helping you - for example, I once had a very irritated throat and wanted to see the throat specialist - I had to go back to the GP 3 times over a month before I was finally given a referral - when I finally saw the specialist, he gave me some tests and said "Oh, I see this all the time" - and he gave me a prescription which cured me within an hour! They also do no real preventative care here - they don't even take your blood pressure unless you request it.

The system on paper seems OK, especially when compared to the US - and apart from the monthly payments to the insurance company, there are no co-pays and I never have to have cash when going to the doctor, the hospital or the pharmacy. My two friends with the cancer and death syndrome would probably not have had insurance in the US - and the one who needed a pacemaker corresponded with Americans who had the disease and was shocked to learn that many had to sell their businesses or homes to get what he was given for "free" here.

However, there is a slowness to react here which can be deadly - I do not feel safe or confident with the GPs here - they're fine for small things, but I feel in much safer hands with doctors in the US....the irony there, of course, is that US doctors are more thorough in part to avoid lawsuits, which of course means lots of unnnecessary testing, driving prices up...

My personal experiences so far are generally fine enough. I found the huisarts to be a bit...cold and formal, but competent. They were reluctant to give me any explanation as to what they were prescribing or why, I had to push a bit for that information. I was also told this attitude might be because we live in an area where the general population suffers a lower level of education (that's a whole 'nother story though) and so the average person going to this particular practice doesn't ask the kinds of questions I might ask, they just do what they are told. Once I pushed I did get answers, though still a bit wishy-washy. I was able to speak in English, but was glad to have my Dutch partner with me to translate some of the more complicated things that the huisarts had issues explaining. I was in a great deal of pain at one point during the procedure, and though the bedside manner had been cold up until that point, once I was in pain the huisarts was reasonably empathetic.

I have never had to wait to make an appointment for a non-emergency. I have always been seen within the week of calling, with reasonable wait times once I arrived for my appointment.

I have had to call the emergency line, but never had to come in for an emergency (luckily, knock on wood.) They were polite and friendly, but I did get the general "take a paracetemol and call back if you still have problems" non-sense. This had the potential to be dangerous since one of those calls I could have been bleeding internally and taking paracetemol would have made things worse since it thins the blood. Duh. Don't tell someone to take any meds unless you really know what's going on.

One of our relatives is a huisarts and he views his job as being the barrier between the resources and people abusing the system....I found this to be rather disconcerting.

My partner's mother became ill many years ago and from his experience he found the doctor's to be competent, but socially inept at dealing with patients. They also needed to be pushed further to give clear answers about the treatments, ex. why they were prescribing xyz, why they weren't trying this other option, etc. They went to the VU Academic Medical Center, and he does feel that they did a good job and if he or I were to become ill he would prefer to go there instead of another hospital. I assume that means he feels confident in them since he's trusting our health to them :-)

I pay an amount for health insurance that we are comfortable with, and I know I am guarantied to see a doctor within a reasonable amount of time. The doctor's have been competent. For the security of knowing that if something happens to me or my partner we will receive adequate medical attention, I am happier here than I was in the US.

I always get the feeling that they are more interested in that than in listening to and helping the patients It's like a game "How To Keep This Person Away From The Resources As Long As Possible".....really odd as you'd think people who become doctors really want to help people....This is of course the "rationed care" that frightens many Americans when contemplating "universal health care"...

I completely agree that this is a very scary possibility, and it made me uncomfortable to hear it. But when compared to the treatment I have received, I do think I have been treated well, prescribed medications where necessary, given the options for treatment etc. I think in this case I wouldn't let the attitude of the one spoil the possibilities for the many since on a practical level I do get treatment when I need it.

Funny, but I've had the opposite expeerience of what many here describe, but then again I live in a small town far from the Randstad so maybe they're less busy. I can usually get in to see my huisarts the same or following day. If it's a small thing I can often have a telephone appointment. I'm not totally trusting of doctors in general and tend to do my research before and after seeing the huisarts and she often agrees with my assessment and has even prescribed meds that I thought I needed. Nasal spray for allergies, that type of thing.

A few years ago I had an operation and it took about 8 months from first complaint until surgery, but it was for a badly damaged disc and they wanted to try physiotherapy first, which didn't work. IIRC, it took perhaps a week or two to get in for an x-ray, a little longer for the MRI and I never had any problem getting a prescription for pain meds. When I eventually had surgery the disc was replaced by an artificial one, an operation which has only limited availability in the states and only recently and they let me stay in the hospital for a couple of extra days to wean me off the pain meds at my request.

A few months ago I had to have an MRI for tinnitis and it took me about 2-3 weeks to get in to see an ENT, another 2 weeks for the MRI.

Recently I was a bit annoyed by my huisarts but when I asked to see a specialist she said just to call the receptionist for the referral letter when I had time. So, I'd say that my overall experience with healthcare here has been far superior than what I experienced in the states. I'm sure it has to do with the fact that I don't earn a very large paycheck, although more than I did in the states. There, even ten years ago with insurance I struggled to be able to afford going to the doctor sometimes. Here I've never had that problem.

Did you have to wait long queues for treatments in NL ?
- There were never extremely long queues, the dentist being the only exception. What I liked about my GP in the NL is that they have a walk-in hour, so you can see the doc without appointment. What I didn't like with the GP in the NL is that you often have to convince the doc that you do have a health complaint and not just some difuse pain that will go away by itself within the next 2 weeks.
In the US I feel they take things more seriously but sometimes they exagerate, imho. What pisses me off is that I can't see a GP within a day. You need to make an appointment and will have to wait at least a week or two. Sometimes more.


Is how well NL does at taking care of people with the most serious diseases — particularly cancer ?
- I do think you can get excellent care in the NL for serious diseases. That is if you get past your GP. I would not be surprised if many serious diseases are diagnosed to late more often in the NL compared to other countries.


Doctors in the US need a firm or secretary to deal with insurance and provide a full and complete cost , but in netherlands , the service is missing, are you able to get the copayment?
- I never had any problems with that.

Do you like your Home Doctor and do you have other choices ?
- I'm having as many choices in the US as I had in the NL. In the US I chose one that works with the insurance. I've changed my GP in the NL twice until I found one I felt okay with.
Actually in the US I never get through to the doc. You see a 'nurse practitioner' - maybe it's cultural but I'm not happy about those NPs and would prefer the real doctor. However, it's very hard to get through and you have to wait for weeks to get an appointment. NP is quicker.

This attitude has to do with the pragmative approach that is so common in Dutch culture. Researchers in the NL have once found out that a certain percentage of patients who see a GP do not have any serious health complaint. In such and such many cases the complaints dissapeared by themselves within two weeks.
So the policies of the GPs were developed accordingly. They assume that the vast majority of their patients do not have any serious complaints. That's why you are often told to come back in 1-2 weeks.

Also, the pragmatic approach includes this attitude that if there is only a 5% chance a certain patient might have let's say cancer, the GP will go for the 95% that it is not.
In other cultures/countries a doctor will make sure you'll not one of the 5% instead of assuming you're in the 95%.

Although right before I moved the complaints about GPs not diagnosing or misdiagnosing were rising. It did start a discussion that GPs should be trained differently but I don't know how that has developed.

Indeed= http://www.expatica.com/nl/news/dutch-news...rage_56846.html

As I've recounted before, my colleague's mother had a lump and her GP refused to give any tests, completely dismissing it as "niks" - she died of a very treatable form of cancer later on - by the time they took it seriously, it was too late I honestly don't know how a GP could live with themself.....

Gawd that's awful. A Belgian colleague's mother just died of cancer that was caught too late after being dismissed.

Fortunately I've had good luck with my huisarts, she takes me pretty seriously and I've never had a problem being treated for something or getting referrals. If I thought something was that serious I would make a big stink until I was listened to though.

Yep, that's what you have to do - unfortunately for a lot of Dutch people, they don't really do that and are more prone to just accept the huisarts often dismissive opinion....we had a decent huisarts who took things seriously but she's gone away for 6 months leave! The replacement is pretty awful, so hopefully nothing too serious happens over the next 6 months .... I'm actually researching backup doctors abroad because i feel *very* uncomfortable with the Dutch anti-approach to medicine and healthcare....it's kind of sad we feel the need to do that... universal health care is kind of useless if you're dead because a GP can't be bothered to help you ...

Yeah, maybe it comes from being American, I tend to be kind of outspoken. Perhaps I drive my doctor nuts, not that I care. She's there to provide me a service. I'm polite about it but I'm informed. Not too long ago I went in after dealing with allergies for years and after researching my issue basically diagnosed myself. Printed off and highlighted what I had, what medicine I wanted. She said, "Sure, sure, no problem," she wrote me a prescription and that was it. Granted, it wasn't the most complicated thing in the world, but in those cases I discuss with her the possibilities and ask for a referral to a specialist. I have tinnitis in one ear, which is most likely caused by an injury during a flight, but I don't mess around with that kind of thing. I told her I'd been waiting it out and now wanted a referral to an ENT and an MRI. Not a problem. Maybe she does what I want because I'm a pain in the butt. Works for me.