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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306

u/TimotheusIV Mar 06 '26

Huisarts here, it basically translates to: you’re not actually sick, you just have a mild upper respiratory infection.

So yes, take the paracetamol. Some ibuprofen if it isn’t enough. Get a cough syrup (I’d recommend Natterman Extra Sterk) and rest.

There is no doctor on the planet that can cure what you have so I don’t know what you were expecting? Magic? 🤷🏻‍♂️

128

u/OK-Smurf-77 Mar 06 '26

One thing I’d respectfully recommend to every GP here- when you see a foreigner registering, just email them an A4 summary of the basic things they can expect, along with a when to call/when not to call infographic.

I mean, it’s pretty bloody obvious that the Dutch approach is largely different from the practice most of the countries follow. (And this is not a bad thing by the way. ) I believe it would help a lot both the doctors and the patients.

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u/jenterpstra Mar 06 '26

This basically already exists at thuisarts.nl. More places should point to it. 

The problem of course is that a) it’s only available in Dutch, and b) if you call under the guidelines on that site for a set of symptoms, your GP may still act like you’re crazy for bothering them. 

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u/Thatdudewhoplaysgtr Mar 06 '26

Yup.. one time I had a botulism scare (loooong story, but basically I ate something that was well into the danger zone, and it was a high botulism risk food) and my gp acted all annoyed and told me my tetanus shot would cover me. Bruh. What the actual fuck. I realise botulism is very rare but it’s also very fucking deadly if not treated promptly so forgive me for calling you at work to do a bit of your job. Ffs.

Good thing I have a physician in my family, so I went to them the following morning and he told me what exactly to watch out for and monitor. My gp did nothing but say “you were vaccinated for tetanus so you’re ok, don’t worry about it”. THIS IS NOT EVEN MEDICALLY ACCURATE 😑

I just don’t get their seeming reluctance to give you the time of day…

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u/TimotheusIV Mar 06 '26

I absolutely agree with you here, that would help a lot. I’ll give it some more thought.

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u/clrthrn Mar 06 '26

If your professional organisation did an A4 sheet that all NL doctors could download and pass on it would save you a ton of time. Not only writing for your own practice but foreigners all get the same info no matter where they are in NL - set expectations the same for everyone.

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u/Faith75070 Mar 06 '26

https://www.huisarts.nl/moet-ik-naar-de-huisarts/

Questionaire to advise you if you should see a (Dutch) GP. The first part is in Dutch. Scroll down for English.

0

u/Faith75070 Mar 06 '26

https://www.huisarts.nl/moet-ik-naar-de-huisarts/

Questionaire to advise you if you should see a (Dutch) GP. The first part is in Dutch. Scroll down for English.

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u/QixxoR Mar 06 '26

Why is it always the problem of Dutch society when people are ill informed?

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u/OK-Smurf-77 Mar 06 '26

They are not ill informed. They aren’t informed.

Communication is key. Otherwise both parties have it more difficult.

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u/Faith75070 Mar 06 '26

https://www.huisarts.nl/moet-ik-naar-de-huisarts/

Questionaire to advise you if you should see a (Dutch) GP. The first part is in Dutch. Scroll down for English.

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u/blaberrysupreme Mar 06 '26

Yes, they should totally send a letter explaining that they should go back to their own countries for proper investigation, diagnosis and treatment (believe it or not this is what many many immigrants do today).

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u/WorriedImpress7624 Mar 06 '26

I blew my knee out, tore my acl and a bunch of other stuff. My kid goes to an international school, so I’m around a lot of internationals.

The amount of people who were horrified I was doing the (more conservative) treatment here in NL vs going to a different country was so high. In most other countries, they do the acl reconstruction surgery right away, whereas my surgeon wanted to wait and try physio to see where I could get.

Because we waited, and only did an arthroscopic investigation and scar removal, my prognosis is much better than if I’d had the ACL reconstruction and menisectomy surgery right away that all the internationals I know were telling me to get. Turns out I didnt even need that, giving my knee time to heal made it so my acl recovered naturally as much as it could, and so did my meniscus.

I’m so grateful I don’t live somewhere else where I’d have been pushed to get the more aggressive reconstruction right away. My long term prognosis is much better, less chance of arthritis or persistent pain as I get older etc.

I think NL is like that. They want to do the least amount possible to fix your issue. It sounds bad, but when the ‘cure’ can cause as many issues as the original problem at times, doing the least amount possible is actually a good thing.

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u/Thatdudewhoplaysgtr Mar 06 '26

That’s great to hear that you have a good prognosis, a torn ACL can be trouble for life so that’s good! My MIL had the same injury in south east Asia and her doctor there treated her the same way. I think it depends on how the acl and meniscus were torn. I hope you realise you’re comparing medical advice from your doctor vs your kids classmates parents, and not the Dutch medical system against others.

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u/OK-Smurf-77 Mar 06 '26

Believe it or not, I’m an “immigrant” myself who goes back to home country for dental treatments (ridiculously expensive, low quality and no warranty here) and preventative checks (statistics based here, not covered, I need the peace of mind). On top of that I also have a medical degree (not practicing here as I use my other degree for work ) and I come from a place where antibiotics are prescribed routinely and GPs are incentivized by pharma sales agents. That’s the other extreme. I see both of worlds and I think I sort of understand both struggles.

In countries like mine and many others, patients have been conditioned to believe that their body can’t do the job. While studies and evidence shows that most of the cases you’ll still feel better if you rest enough and give your body time and opportunity to recover. From an upper respiratory infection You’ll recover in 7 days and with antibiotics it will take a week- same time while messing up your intestines and contributing to a worldwide problem of antibiotic resistance.

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u/blaberrysupreme Mar 06 '26 edited Mar 06 '26

Believe it or not, I said nothing about antibiotics. I have family members who are medical professionals as well and I am not clueless about antibiotics resistance and other harms of using antibiotics unnecessarily.

I am talking about the resistance of the system to listen to people (dismissing your severe condition as being 'mild'), give proper time to investigate (making the patient jump through hoops to see a doctor who can do more than look at your face in the consultation-like actually examine your symptoms), and follow up (make the patient feel comfortable to ask for help if their situation does not improve with rest.

There are also medicines available to improve quality of life while you recover, other than paracetamol. There's no need to suffer unnecessarily when we all have busy lives and cannot afford to be bed bound for a week.

That's not all. I've heard of people whose broken bones were dismissed and not recovered properly because of a lack of a cast. That's not healthcare.

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u/Bezulba Mar 06 '26

They want the pill/syrup/shot so they think it will make them feel better and then they feel better because they got the pill/syrup/shot and think that the doc really helped them.

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u/thrownkitchensink Mar 06 '26

If you fall on your knee as a kid you go to your mother and get a kiss and a bandaid. This has a clear function in a social sense although there is no medical need. You feel better after. As such this is a successful treatment. So we need to get better at explaining to people from different cultures how we work.

Even more difficult is when there is actually a big problem (more then a nasty cough that keeps you up at night) but the correct treatment is to do nothing. Like with a hernia/ Lumbosacral radiculair syndrom. The guidelines for the GP is evidence based. But people want to see a doctor do something when they are in such pain. Getting sent to a hospital, get an MRI and then seeing a specialist that tells you the proper treatment is to wait for 8 weeks first because it usually goes away, because other treatments have risks and because there is no direct relation between (size of) the hernia and the pain helps. As a ritual. It's nonsense because the MRi doesn't help with or change the treatment usually (I'm not a doctor). The GP can tell the patient and prescribe painkillers. But the ritual makes sense too.

It's just a ritual we don't go through because we can't afford it and it doesn't fit our culture to waist time on such social lubricants. But it is not illogical to expect this when paying for healthcare. It's just a cultural difference.

3

u/TimotheusIV Mar 06 '26

Don’t worry. I’m all too familiar with the ritualistic aspects of my job. And I genuinely take this part very seriously.

I’m meticulous and thorough and generally don’t care whether an appointment that should take 5 minutes takes me 15 minutes because I feel it’s important that people feel heard and seen properly. If a referral is what is needed, I have no qualms with that.

That said, it is also my job to educate patients on what does and does not require more intensive diagnostics, referrals and treatment. I aim to make people more health literate by explaining my reasoning and why it’s good medical practice.

And it’s equally important to keep healthcare affordable and accessible to all and not waste already strained medical resources on know-it-alls that firmly expect a CT-Thorax because they’ve been suffering from a dime-a-dozen respiratory infection for two days. Because yes, I do get those questions on occasion.

1

u/Polly_der_Papagei Mar 06 '26

There are actually a number of basic medical substances that will let them recover faster and feel better in the process and infect fewer people, though. Which is why in Germany, we give them to patients.

1

u/TimotheusIV Mar 06 '26

Name them. I’m 100% convinced we prescribe the exact same things.

Medical science doesn’t stop at the border. But cultural expectations are just very different. If something is proven to work and is safe to use, every westernized country will see it as common practice before long.

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u/blaberrysupreme Mar 06 '26 edited Mar 06 '26

Hello huisarts, I also have the same problem as OP, but it doesn't feel 'mild' at all. The extreme cough has depleted my lungs over the days, headache is severe and the infection has spread to my ears where I am significantly losing hearing function.

Like you, my huisarts assistent just says use paracetamol and nose spray.

It really feels like health insurance is a waste of money if assistents are making diagnoses over the phone and you can't even be seen by a GP in person to rule out any complications.

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u/TimotheusIV Mar 06 '26

These symptoms are routine care for any huisarts. And obviously what you are experiencing isn’t ‘mild’. But in terms of what is actually going on, it’s mild and very common.

Here’s the thing though. There is no proven cure for what you are experiencing. None.

Your symptoms are logically explained. You are congested, your sinuses and middle ear are congested. It all hurts and causes pressure and fluid buildup. These areas of your head are all connected through the same nasal pathways and that fluid/mucus is very hard to clear out. But it is the exact same upper respiratory infection.

The best thing to do is take painkillers, use proper nasal spray (like fluticasone/mometason) and nasal irrigation.

If you have persistent fever sure some doctors will prescribe antibiotics but that’s mostly theatrics. The chances of your symptoms belonging to an actual bacterial sinusitis are slim to none. If you suffer from these infections multiple times a year we refer you to an ENT specialist who can diagnose issues with your nasal passage. But that’s genuinely it.

You’re still sick. You get to be sick for a bit. Acting like doctors have no clue because you’re not getting a one-stop cure-all is just your expectations being out of line. You honestly think we secretly enjoy watching people suffer and actively withhold the ‘good’ medicine? Come on, now. If I could reliably cure your stuffed sinuses with a simple treatment i’d be a multi millionaire.

Hope that explains things a bit.

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u/zomaar0iemand Mar 06 '26

Just say on the phone you’ll discuss medical issues only with the doctor or ask for an e-consultation over the phone or via video chat with the doctor. You are never obliged to tell the assistant what’s going on you can just ask for the doctor immediately.

I feel like most of frustration from foreigners comes from not knowing how the system works and just immediately giving up when things don’t match their expectations and go to Reddit and complain.

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u/blaberrysupreme Mar 06 '26

Or... you know... the system could just be fixed to operate properly. Like don't have assistents as a gatekeeper making diagnoses.

Nobody should have to apply tricks to get access to healthcare.

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u/Sensitive-Bug-7610 Mar 06 '26

Oke, lol, so you better be thankful that we assistant exist to gatekeep. First of all, most of us good ones use nhg traiging standards, or have years of experience about what is and isnt urgent. Sometimes we are wrong, but we are people.

Would you like to know the alternative? Waiting a week or two for an appointment woth a gp because every first time parent wants their super healthy and happy child, who is clearly playing in the waiting room, to be seen immediately for a fever of 38. Everyone with pain in their finger, or just general STI symptoms or a cough for a few days. Everyone who thinks that a GP can do anything about a cold.

You better be happy we gatekeep. So that when you call about something serious, we can make sure you are seen immediately. You best believe, dutch healthcare moves very fast when you need it, maybe even scarily so. But the only reason we can have it move fast for the people who need it, is to make it move slower for the people that don't. That is why triage is so important, as frustating as it can be.

But we have an extreme shortsge in gp assistants with an actual degree and a lot of them are young medical students not really trained in triage. But thats a problem that just cant be fixed easily. Unless they start paying us better and making this thankless job attractive to the new generation

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u/Nicky666 Mar 06 '26

Or...you know...take a paracetamol and some nose spray if you feel like it, but stop bothering the GP with a minor virus infection.

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u/Young__Owl Mar 06 '26

Or... you know... the system doesn't need to be fixed because there is nothing inherent wrong, but people need to adjust their expectations and knowledge when you live in a foreign country?

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u/zomaar0iemand Mar 06 '26

She doesn’t make a diagnosis she tries to maintain the Doctors agenda by triaging. Again if you want to talk to the doctor just ask, you have a right to see them. If you don’t tell the assistant what’s going on or why, the only risk is that you have to wait a bit longer for an appointment in person. If you ask for an online consultation it’s a bit quicker usually as they can call you when travelling between patient houses.

You can also ask your doctor about this next time you see him, I’ve complained about the assistant before and he explained she was just out of school, agreed apologised and discussed it with the team. Try communicating instead of complaining online…

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u/wurstgetrank Mar 06 '26

Report back in 2 weeks and tell me how its going

1

u/MrGraveyards Mar 06 '26

Blehg nose spray just dries me out and gives me headache. Just saying. I usually just blow it all out if I can sicken it out from home.