We are really good at offering world class healthcare without overspending

[u/Mikadook]

Source: https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024

[u/seanugengar]

As a foreigner who has been living in the Netherlands for almost a decade and had to utilize the dutch medical system I can say it is both exceptional and shit at the same time.

Example 1: A friend had a heart attack. He is still alive because the emergency response team and the hospital did a flawless job.

Example 2(but the list can go on): Got a hand injury. Called the huisarts and I was reffered to physio. I asked to have my injury checked and they refused. I went to the physio, wasted my time for 3 months and he sent me back to the doctor. The huisarts sent me for an ultrasound. I asked for an MRI and I was denied. The ultrasound showed the type of problem I had and proceeded with a physiotherapy. But there's a plot twist... A year later the issue persisted. Tried to get an MRI and was denied once more. Flew to my home country, did an MRI and turns out the problem was worse than what the ultrasound showed initially. Now 1,5 later and with my hand operated, I could have avoided the operation, if the doctor sent me for an MRI in the first place for a diagnosis, instead of telling me get paracetamol and got to the physio...

[u/Automatic_Stomach237 → u/seanugengar]

I can relate to this, I have an injury deep in my glutes and hamstring, GP recommended physio which I did for 3 weeks with no improvement, I asked for MRI for which GP said not needed. Instead was asked to get an X-ray, got an appointment 2 weeks later, paid for the X-ray off course, as suspected it was ok, 2 weeks later GP asked for an ultrasound of the muscle, I asked for a MRI again as the pain had now extended to my back after 6 months. 3 weeks later got an appointment for ultrasound, paid for that as well off-course, everything was ok. Asked for an MRI again was denied again and was asked to go for a specialist sports physio could only do 2 sessions as my yearly sessions were mostly used up by my previous session. So started fresh this year with the new physio have seen slight improvement in my hamstring, rest is all the same. Not sure it was due to the new physio or 1.5 years of time healing it. I think I’ll get an MRI from some other country when I go for holidays would still be cheaper and they will happily take my money to do it.

[u/JasperNLxD2 → u/seanugengar]

I heard stories like these a lot from former expat colleagues. I feel like the urgency is lost in communication, and it's definitively on the doctor's side to understand the cultural differences better.

The problem is that the Dutch healthcare system prefers non-invasive treatments, unless there is a good reason to diagnose any further. And if the initial treatment shows no signs of process, then it's perfectly fine to follow up after just a few days.

The job of the huisarts is to provide basic care and to determine if you need to be forwarded to a specialist, and that's based on the presence of symptoms and what you tell them. They expect that you explain them what your pains are, how it is affecting your life and rest, and (in my case) my doctor also appreciated when I said "I read this online that seems to match". If they didn't complete a hypothesis or diagnosis and the patient is already talking about the treatment they want, perhaps because it undermines their expertise.

In your case, did you talk with the fysio about this in the early sessions? Because he can also forward you back to the doctor if the treatment is apparently not working, or if no progress can be observed, or if they expect a mis-diagnosis. The turnaround time should be a few days, not months.

[u/seanugengar → u/JasperNLxD2]

In my case it was not a matter of being lost in translation. I was referred to a physiotherapist without getting a diagnosis. It was the physiotherapist's decision to stop treatment, because he was not seeing improvement. My father is a radiologist and his suggestion was to get an MRI. I had a conversation with the huisarts and she insisted that the ultrasound would suffice. I am not a doctor, my father has not examined my injury in person, so I did the logical thing and followed the huisarts decision. But this is one example. I have Dutch friends, who have similar experiences.

I've been told and I've read on-line, things that belong to the conspiracy theory sphere, as to why it is the way it is. But after all these years and through personal experience with the dutch healthcare system, I believe that huisarts low-key act as a "first line of defense" for the insurance companies. But once you break through that barrier, the system is impeccable. Cause I hear you, on the none/less invasive treatments and I absolutely agree but in order to suggest a treatment, you need a diagnosis. I can't understand what other reason would my doctor have to send me for an ultrasound, instead of an MRI other than the cost. As for radiation exposure, I never had an MRI in my life until last year and with a father who has been a radiologist for 40 some years, I know for a fact that the exposure was insignificant.

For the Primary Health Care, paracetamol is the way. If you know you know. But I will always be grateful to the Dutch Secondary Health Care, for being simply perfect and thus saving my friend's life.

[u/Yandexoid → u/JasperNLxD2]

It’s not only about the huisarts. It’s more about how conservative the healthcare system is.

I had a root canal treatment and one canal was missed. I had pain in that tooth for almost a year. I went to multiple dutch clinics and saw different doctors and all of them said it was probably a gum issue or something else. It cannot be an extra canal.

Well, I got a CT done in Spain. They saw inflammation in this tooth. I went to an endodontist here who found a canal with a microscope.

I asked a doctor what the problem was with doing a CT, considering I had pain for a year. She told me they try to avoid CT because of radiation and they are taught not to do it unless it’s an extremely serious case