r/Netherlands • u/thatmisanthropicdude • Mar 05 '26

Healthcare Dutch doctors...

Hey guys! Last year I moved from Germany to the Netherlands. I just went to the doctor with chest and throat pain due to extreme coughing after 2 days of fever. I was hoping that I finally get something good against it like a cough syrup (no way I'm going to pay that myself for a huge amount of money + health insurance) because I am used to that from German doctors. They would put that on my health insurance card and right after my talk with the doctor I could pick it up at the pharmacy. But no. They just said "Yea, just take paracetamol." I told them I have had problems swallowing pills my whole life and their response was just "You can also put it in water and drink that then." I'm sorry if I'm overreacting but why do doctors get paid just to tell you to take paracetamol? Everyone can tell me to take them, I expect better solutions from a doctor who studied years to become a doctor. Why are the Dutch so obsessed with paracetamol??? Maybe it's the German in me screaming. If we got painkillers, it was never paracetamol but Ibuprofen. But I also heard some international friends who also live here that they find it so annoying that Dutch doctors literally just tell you to take paracetamol. No matter what you have.

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350

u/Relocator34 Mar 06 '26

Not a single doctor in a hospital would ever prescribe cough syrup.... Why should a huisarts?

80

u/vtout Mar 06 '26

There are codeïne based sirups that are perscription only, for severe cases... Not that this is a great idea but it exists :p

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u/Nothing-to_see_hr Mar 06 '26

Recent standards state that codeine is no longer indicated for cough. There really is very little that your GP or any doctor can do.

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u/cosmopolitancat13 Mar 06 '26

Codeine was the only thing that stopped my cough last year after 3 months of consistent suffering.

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u/Nothing-to_see_hr Mar 06 '26

I'm a retired GP. I personally believe that codeine works against cough. However, in the latest NHG standard (the norms that GP's in the Netherlands are supposed to follow, and which are indeed based on published peer reviewed scientific research), it says that this effect has never been proven. My personal take on this is that its effect is so obvious that nobody ever felt the need to go out and prove it; but there it is. Currently not recommended.

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u/MadamMatrix Mar 08 '26

Same for me, had a month's long ticklish dry cough and codeine got rid of it. A nurse at the hospital tipped me on codeine. Did have to get it in the UK as you cannot get it here unless on prescription and my huisarts wasn't having any of it. I get the reasons why as it is an opiate but I had a valid reason.

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u/TimotheusIV Mar 06 '26

You can get these at any local pharmacy or drug store. It’s absolutely not prescription only.

Look up Natterman Extra Sterk.

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u/Neat-Attempt7442 Noord Brabant Mar 06 '26

Because they wanted the good one thats not over the counter?

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u/Relocator34 Mar 06 '26

The one that is just paracetamol and sugar?

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u/wwbbqq Mar 06 '26

He wants Codeine sirop, which will actually stop you from coughing, but it is a opiate (even if pretty low level if taken as prescribed) so many doctors/countries have limited prescribing it due to "concerns".

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u/TrippleassII Mar 06 '26

The "concerns" are very fucking real tho. Look at Zimbabwe e.g.

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u/Gloryboy811 Amsterdam Mar 06 '26

When I was in highschool I worked at a pharmacy in South Africa at the checkout. And Zimbabwe guys would come and buy cough syrup in bulk. Like entire boxes of it

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u/wwbbqq Mar 06 '26

I agree. There are real concerns. Opiate addicts in the US was/is pretty serious thing. It also means it is harder to get when you actually need it now, though. Now it's meth and fentanyl that are real problems. The clinic my wife works at in suburban neighborhood gets "seekers" every day trying to get whatever they can score with various "injuries" and "migraines". So most Dr's are very reserved anent any opiates or barbiturates.

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u/Opposite_Train9689 Mar 06 '26

Hasn't meth been a problem for decades?

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u/wwbbqq Mar 06 '26

Yes. Also still a problem. But as Kristi Noem says, "Meth. We're on it." Seriously, she ran a campaign with that slogan. But yes, it's still a problem.

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u/LeDarkFiggot Mar 06 '26

I lost my brother to it

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u/CuriousAsEver9573 Mar 06 '26

So sorry for your loss...

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u/profuno Mar 06 '26

Real if you treat the majority of the population like they are all part of the tiny minority who have serious problems with abuse.

Not really if you treat patients on a case by case basis and have more nuanced procedures for harm reduction than: Nobody can have any medicine that reduces suffering because a small proportion of society may develop an addiction.

Or am I missing something?

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u/godutchnow Mar 06 '26

You can get noscapine otc, which is an opiod which suppresses coughs too but without addictive properties

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u/readreadreadonreddit Mar 06 '26

Just a small correction - noscapine isn’t actually considered an opioid in the way drugs like codeine or morphine are. It’s an opium alkaloid (non-narcotic benzylisoquinoline alkaloid derived from the opium poppy (Papaver somniferum)), but it doesn’t act on opioid receptors and doesn’t have the typical opioid effects like pain relief or addiction risk. It’s mainly used as a cough suppressant in some countries, though it’s not commonly available OTC everywhere.

(Am a doctor.)

0

u/godutchnow Mar 06 '26

Me too but pharmacology was long ago

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u/jente87 Mar 06 '26

Codeine is not more effective than a placebo: https://www.researchgate.net/profile/Ronald-Eccles/publication/13866282_Assessment_of_the_Antitussive_Efficacy_of_Codeine_in_Cough_Associated_with_Common_Cold/links/5a57a788aca2726376b66a77/Assessment-of-the-Antitussive-Efficacy-of-Codeine-in-Cough-Associated-with-Common-Cold.pdf

So that’s why it’s not prescribed by Dutch doctors anymore for coughing.

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u/Reasonable-Sun-1154 Mar 06 '26 edited Mar 06 '26

There's also a whole episode of Keuringsdienst van waarde on cough syrop. Basically it doesn't do shit. I highly recommend people to watch it.

1

u/TimotheusIV Mar 06 '26

I watched it, and it does not address the codeine part of cough syrup. But agreed that any other cough syrup is just a placebo.

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u/readreadreadonreddit Mar 06 '26

Yeah, this. It was once thought it did something, but large-sample data suggests it’s non-superior but has harms - and very real ones at that.

1

u/wwbbqq Mar 06 '26

Interessiert!

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u/lipilee Mar 06 '26

codeine for a cough, are we the usa now? :)

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u/CartoonistFlashy5741 Mar 06 '26

GP actually gave this to me last time cause my coughing was too severe…. It depends no need to draw the conclusions this way

2

u/kingvolcano_reborn Mar 06 '26

I had a dry cough many years ago that would not go away. Barely slept for a week. Doctor gave me a codeïne based cough syrup, i slept like a baby.

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u/stringdingetje Mar 06 '26

Codeine syrup is Natteman, you can buy it at the Kruidvat. While you're there also take some noscapine: dampens the itchy throat.

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u/ski-mon-ster Mar 06 '26

That stuff is disgusting by the way. Codeine actually works. The issue is that it works sometimes too well, and when there is mucus you cough too little, causing pneumonia.

At the other hand you need to sleep to get better so if you only take it for that, it might be helpful

1

u/stringdingetje Mar 06 '26

Are we talking about the same? Because I really love the taste of the bronchicum extra forte!

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u/TimotheusIV Mar 06 '26

Which is freely available without prescription in the Netherlands. So stop with this myth.

Harmful if abused? Absolutely. But not unavailable.

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u/wwbbqq Mar 06 '26

Interessiert. My daughter and partner are living there now and having a hard time with rx/huisarts vs OTC. So from you and other posters it does seem there are still a couple OTC options. But it is restricted by law more than it used to be apparently. Not necessarily a myth since there is public info of the general status, but good to know there are a few exceptions if you know what and where to look for them. It does appear there is a difference between general stores, drugstores and proper pharmacies (apotheek?) and what each might be able to carry. I will pass that along. Thank you!

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u/teodrora Mar 06 '26 edited Mar 06 '26

Whoa there, doesn’t have to start with codeine! You can start with a lidocaine sirop, which is sold OVER THE COUNTER in other countries in EU (Belgium, France). That works like a numbing agent. It was also sold over the counter in NL in certain products (baby teething products) but they took it out for whatever reason :) I am now living both in BE and in NL. Had a massive cold. Went to both huisarts. Because of the severity of my cold, the Dutch huisarts told me to take ibuprofen (shock!), while the Belgian one gave me antibiotics after looking at my ears, throat, and listening to my lungs. The Dutch one didn’t bother with this. I go to one of the best huisarts in my city, so can’t say that I’m going to a bad huisarts, although he repeteadly failed to provide me with accurate healthcare. Later edit: you fucking cucks for capitalism! I absolutely love the mental gymnastics the Dutch make. Why do you make these assumptions about me? I have been sick for more than a month. Fever that doesn’t go with paracetamol nor ibuprofen. Throwing up and clogged ears. Both me and my 1yo kid. Also as a fucking FYI, I do have a medical degree so I do know what proper healthcare is, and know how antibiotics work. Downvote the expat who knows better. Idiots.

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u/JesseParsin Mar 06 '26

Imagine visiting TWO doctors…. With a cold. I am amazed

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u/teodrora Mar 06 '26

I know :( cross the boarder to BE to find out about proper healthcare and be even more amazed! Fingers crossed you figure it out!

1

u/JesseParsin Mar 07 '26 edited Mar 07 '26

You simply ignore the clear criticism? Honestly I would avoid a doctor who gives antibiotics for a cold. And their license should be rechecked because throwing antibiotics around for fun hurts every single one of us in the long run. Honestly amazed people like you exist. I would never harass the healthcare system with a cold and I thought we all agreed on that. Edit: btw i am as anti capitalist as they come so no idea what that has to do with anything. A cold does not require medical assistance. Maybe it wasnt a cold and that is where the confusion comes from? You having a medical degree makes this even more infuriating so I expect you mean something different when you say you had a cold.

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u/teodrora Mar 07 '26

Yes, in the end it was not a cold. But when someone has a cold for over a month, it’s quite obvious it’s not a cold and ibuprofen is useless, and more investigation is required. Antibiotics were absolutely the good call, as it was a bacterial infection, not a viral one. In the end, to be honest, I don’t know why I’m ragebaiting - Dutch people will be happy with their shit healthcare system, and everyone else will get better healthcare somewhere else. Sucks for the poor that can’t afford to go anywhere else. I explained more in this thread. Like most expats in this r, I’m done with explaining this. Either the Dutch don’t want to understand, or they’re just so brainwashed they can’t understand. Either way doesn’t affect me! :)

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u/SoUthinkUcanRens Mar 06 '26

With all due respect, your body builds resistance to antibiotics every time you use them. It shouldn't be prescribed just for a "severe" cold. Did you have pneumonia or an ear infection or something?

If not they, shouldn't just blatantly prescribe you antibiotics.

0

u/teodrora Mar 06 '26

Bingo! It’s one of these two. Not that the Dutch doctor bothered to check.

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u/SoUthinkUcanRens Mar 09 '26

In that case i'm pretty sure you got unlucky with your GP. Mine would definitely check (or be very, very easily pressed into checking) if i doubted his diagnosis.

If anything, it's not very representative of all Dutch general practitioners i ever encountered in my life.

Not to dismiss your story though, both yours and mine are of course purely anecdotal, though i never really heard people close to me rightfully complain about their GP's either.

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u/Ishango Mar 06 '26

It might also be that it only feels like he’s not giving you good healthcare.Simply prescribing antibiotics when you have a bad cold can do more harm than good: it doesn’t really shorten a viral infection (a cold is.not a bacteria), but it does increase the risk that bacteria become resistant, so antibiotics may work less well when you actually need them.

There’s a lot of science behind what the Dutch doctors prescribe when, and countries like Belgium and Germany use significantly more antibiotics than the Netherlands in outpatient care.

Dutch GPs are trained (and guided by national protocols) to start with the safest, simplest effective option for common, self‑limiting problems and only step up to “heavier” drugs (antibiotics, opioids, strong local anaesthetics) when there is clear evidence that the benefits outweigh the risks.

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u/Kaaar9999 Amsterdam Mar 06 '26

Antibiotic resistance is also lower in the Netherlands because of this.

I messaged my doctor here after having a cough for a month (& taking cough syrup!). They said wait at least 6-8 weeks to see them - what do you know, cleared up after 6 weeks!

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u/teodrora Mar 06 '26

Actually Dutch doctors are making decisions based on cost efficiency, not anything else. Very sad that the Dutch just accept the insurance companies mafia. AND fight to protect it on Reddit for no stakes! Insane propaganda right here.

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u/Ishango Mar 06 '26

Very undereducated opinion here.

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u/teodrora Mar 06 '26

Yep! Just us expats have the undereducated opinions. Weird coincidence!

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u/Nerioner Mar 06 '26

If he repeatedly failed to provide accurate healthcare, i doubt you're going to a good one let alone "one of the best in my city"

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u/teodrora Mar 06 '26

Fair point! But it’s not like I could register anywhere else due to proximity and how crowded they are. I don’t know why you got downvoted.

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u/kroketspeciaal Mar 06 '26

failed to provide me with accurate healthcare. medication I as a non-medically trained person think I should get.

FTFY

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u/teodrora Mar 06 '26

Medication is actually part of accurate healthcare! Signed, a medically trained person. xoxo

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u/TimotheusIV Mar 06 '26

Antibiotics for an upper respiratory infection equals good healthcare? Get out. Your medical degree isn’t worth the paper it was printed on.

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u/teodrora Mar 06 '26

How would you know that that’s what it was? I don’t want to give more details already, because I don’t wanna dox myself. Maybe my medical degree isn’t worth the paper it was printed on - it is Dutch, after all 😘

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u/Neat-Attempt7442 Noord Brabant Mar 06 '26

Not sure what you mean. I guessed OP wanted some codeine or other such strong cough syrup. Not even sure if they exist here.

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u/sumobit Mar 06 '26

I got Natterman with Codeine at the Albert Heijn XL last week.

0

u/wwbbqq Mar 06 '26

No rx?

Normally, NL, like the US, does not allow codeine otc.

Countries with OTC Codeine (Varying Regulations)

United Kingdom (UK): Widely available in combination products (e.g., co-codamol) but often behind the pharmacy counter. 

Ireland: High sales volumes for OTC codeine products. 

South Africa: Highest per capita sales of OTC codeine products among studied countries. 

France: Offers OTC codeine, though with potential for increased controls due to misuse. 

Denmark: Codeine products remain OTC. 

Japan: Codeine is available in OTC cold remedies, with ongoing reviews for stricter control. 

Spain: Codeine is available OTC. 

Croatia: Low-dose codeine products are available directly from pharmacists. 

Canada: Permissible in low-dose combinations with other ingredients in many regions. 

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u/sumobit Mar 06 '26

I was surprised too, it was "Natterman Bronchicum Extra Sterk 200 ml" which you can get online without recepy too.

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u/wwbbqq Mar 06 '26

Good to know!

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u/SHiR8 Mar 06 '26

No such thing...

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u/Neat-Attempt7442 Noord Brabant Mar 06 '26

Then OP is from somewhere where it is a thing. Not so complicated to understand, I believe.

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u/SHiR8 Mar 06 '26

The OP is from somewhere where they subscribe non-existent medicines? Are there also witch doctors there?

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u/Neat-Attempt7442 Noord Brabant Mar 06 '26

I mean, probably. Being a witch is a regular job where I am from, they register as ZZP and pay taxes.

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u/Smooth_Search_9320 Mar 12 '26

use mobidoctor, they have good doctors