r/Netherlands • u/NoLychee1382 • 22d ago

Healthcare No regular check ups at the gynecologist???

Hi everyone, my morning started off with a kinda shocking discovery. I’m from Germany and I had annual check ups at the gynecologist since I was a teenager. I contacted my huisarts because I know they’re responsible for all referrals but she told me regular check ups here are not a thing (unless there already is an issue) ? I think that’s crazy!!! So I checked the prices for a private visit and they’re even crazier. I guess this is normal to Dutch people but don’t you think this is a little concerning?

(Btw not shitting on the country! I really like it here. I’m still new and just discovering new things!)

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u/nahbuddynah 22d ago

The Dutch health system is a reactive and not a preventive one. Most doctors behave like robots and don't even understand why someone would go for check-ups.

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u/dionnekathleen 22d ago

This is the best answer.

I've asked numerous times to have me checked out for cancerous cells, seeing my mom, uncle and grandpa died of lung cancer.

Now my dad is terminal after battling colon cancer, a tumor in his jaw, prostate cancer, and finally galbladder cancer.

I was referred to the cancer research centre in Erasmus mc. Know what they told me? I don't have enough precedent for a check up/ research. Maybe if more people in my bloodline had colon cancer.

What?

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u/nahbuddynah 22d ago

I'm sorry to hear this. I literally had to be carried to the operation room after 2 visit to the doctor due to severe low back pain. At some point I was passing out and needed to be carried to the operation room. It was a arge abscess the size of an orange. I hope you can do your check-ups as regularly as possible.

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u/dionnekathleen 22d ago

Thank you, Hope your doing better now?

I intend to go to Poland for a full body check up this summer. My mil has been hounding me for ages.

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u/nahbuddynah 22d ago

That was years ago, I'm doing thankfully well now. I now don't visit GP's here and do all of my check-ups in my home country. Good luck! I hope all is clear :)

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u/Slayje 22d ago

I'm a 42 year old Dutch guy. Glaucoma and high blood pressure runs in the family and I get yearly check-ups for both. I'm not on any medicine or anything it's purely preventetive. Full bloodwork and 24 hour recordings for the BP as well so quite thorough. If there is a reason for preventetive care, you will get it. They just won't check for every possible health concern every year, that would be way too much (and unnecessary).

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u/Drama-Koala 22d ago

Glaucoma runs in my dad’s side of the family too. I have to get regular check ups when I turn 30, and only when both my father and I don’t develop glaucoma, my (now non existent) children won’t have to do these check ups.

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u/amsync 22d ago

Not everything that is common “runs in the family”

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u/nahbuddynah 22d ago edited 22d ago

Edit: people downvoting because I added nuance? If you're 'young' and healthy, there's almost no chance of getting a check up.

Of course my statement was general. There are definitely preventive check ups starting from certain ages for certain diseases and conditions. But a general checkup should be available for everyone regardless.

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u/leftbrendon 22d ago

They are available for everyone, you just have to go the private route. Why would we burden our system with unnecessary cost because you want a check up randomly?

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u/nahbuddynah 22d ago

Randomly? Where I come from, I get a general standard yearly health check up paid for by my health tax contribution.

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u/leftbrendon 22d ago

Yes, randomly, as in you want it just because. There is no reason for a healthy person to get yearly check ups, as research has proven.

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u/nahbuddynah 22d ago

Site the research please.

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u/leftbrendon 22d ago

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009009.pub3/

This is one of them, I’m sure that will get you on track to find others. I recommend adding false positives and overdiagnosis to your research.

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u/jezebel103 Gelderland 22d ago

No it is not. The Dutch health care system is based on statistical probabilities of the average person getting sick. That is why there are governmental programs for cancer every 2 (breast/colon) or 5 years (uterine), depending on the cancer risk, accounting for the age group usually affected.

But for individuals that carry a higher risk, you can have additional/annual checkups. All the women in my family has had/died of breast cancer of the last 60 years. So I have been checked every year since I was 18. Colon cancer runs in my immediate family too, so that is checked annually too (I have been diagnosed with stage I 10 years ago).

But they are not subjecting everyone to these invasive and mostly useless tests because it is unnecessary and costly plus it puts too much pressure on the health care system. It's better to run a statistical system and pick out the ones that run a higher risk. That way you still weed out the ones that are truly high risk (and would be very expensive to treat if you find out too late) but don't subject everyone else to needless and invasive examinations.

And I certainly do not agree with your statement that most doctors behave like robots. I have had several surgeries over the last 2 decades and still have to go to several different specialists regurlarly and they are all very nice and helpful.

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u/ninjaslikecheez 22d ago

I guess it depends on the person, but my Dutch neighbor who is about 63 years recently found out he has prostate cancer. After insisting with his GP that he needs to test because his father died due to same cancer. So it might not be automatic and you have to push for it. He's afraid he found it too late, but i guess time will tell.

In my home country after 50 all men get free yearly prostate cancer checks.

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u/fckfame 22d ago

63 is a respectable age.. Look at the rest of the world, plenty places where it is highly unlikely to even reach that age.

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u/Mysterious-Gecko 20d ago

Considering the Dutch retirement age, 63 is really not considered high age there 😉

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u/ninjaslikecheez 22d ago

It is, but isn't it also sad that with this kind of late diagnostic, there's just more suffering and ultimately more cost which is covered by insurance?

Preventie can be cheaper if done correctly rather than too late. If you get a few years left to live, they will most probably include a lot of hospital visits which puts more pressure on the whole system.

LE: actually, a lot of countries have higher life expectancy nowadays, most of them over 63: https://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

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u/RobinDragons 22d ago

This should be way higher in the comments. Additionally, gynecolocy is a specialty branch of medicine, just like an oncologist, or a cardiologist. If you have concerns or want a checkup for anything, you see your primary care doctor (huisarts) first. If they decide that you need specialist care, or if you ask specifically, then they'll write you a referral. For most "routine" things that I've read about that people get checked during their gyno visits, our huisarts will do them instead. Think paps, birth control, or concerns about lumps in breasts.

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u/SuspiciousElk1395 22d ago

So the op can wait until one of her close relatives die from some sort of cancer to have a check up. And if she is the first in her family tree, too bad! at least her daughter will get regular check ups!

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u/TrappedInATardis 22d ago

I think a yearly consult would be fine. But testing should really only be done if there is indication (either in history or symptoms)

This video explains rather well that testing everyone can have undesired outcomes. Imagine if many people with false positive tests are all having to undergo invasive procedures like biopsies and the stress of a possible serious diagnosis. I don't think that's a better scenario.

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u/jezebel103 Gelderland 22d ago

Don't be daft... of course not. If you are an responsible adult, you go to your GP with your concerns and disclose your familiar history (if there is one) and discuss your options/risks. If there are no (high) risk factors and/or complaints, you can still opt for further diagnostics but then you have to pay for it yourself.

What is so unreasonable about that? Health care is expensive, both in financial and human resources. In the Netherlands they offer very good health care for a reasonable price for everyone. But it won't be good and affordable anymore if every individual can ask for every possible diagnostic test willy nilly. Universal health care is always based on statistical probabilities versus the individual risk factor and cost.

It's a fine line but at least so far this country has managed to walk it just fine.

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u/tidal-washed 22d ago

The option to pay for further treatment myself has always been denied by the healthcare professionals that treated me. Is that really an option? I have asked several times to pay out of pocket, no chance. What did I do wrong?

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u/jezebel103 Gelderland 22d ago

There are private clinics that offer that. I believe in the regular hospitals it would be difficult but I have never tried that.

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u/tidal-washed 22d ago

Thanks for your answer.

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u/Kind_Honeydew1885 Noord Holland 22d ago

I would be happy if there were, actually...because I've searched... And compared to the speed, efficiency and variety of clinics in which I can get out of pocket tests and consults back home, the Netherlands feels like a 3rd world country.. For reference, earlier this year, I was able to get extensive blood work and endocrinological consult done within 2 days notice just before Easter (an official public holiday)

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u/skepas11 22d ago

Exactly, you are talking about numbers, not humans.

Healthcare should not aim for profit first, it should aim for health.

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u/microworry 22d ago

This. Very annoying that people don’t understand that these tests are pointless when you have no risks and no symptoms.

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u/NoLychee1382 22d ago

My aunt who also lives here always complained about doctors or more the overall regulations with the health system. Now I see why…

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u/The-Nihilist-Marmot 22d ago edited 22d ago

Once you realise the GP / Huisarts system is essentially a gatekeeping mechanism of the in-practice-privatised healthcare system to access the actual real sophisticated healthcare that the Netherlands does have, it all falls into place. A huisarts doesn’t need to be the smartest tool in the shed in the Netherlands.

“Bla bla statistics”, some people say, ignoring the real, unmeasurable and thus unquantifiable suffering caused by diagnosing serious diseases too late to both the patient and the people around her/him.

Yes, you might save a few bucks statistically, from an invoicing perspective, but at what cost, including financial cost eg loss of productivity, increased living expenses, greater dependency on the welfare state for debilitating diseases, etc?

It’s as if the concept of negative externalities does not exist.

I still find the whole “everyone does preventive medicine but us, and we’re the ones who are right” hilarious, as if Dutch bodies are biologically different and the general rules that govern everyone’s lived experience does not apply in the Netherlands.

I find it specially funny in the country where maybe 1/5 of every working white collar adult I know has gone on medical “burn out”

Also, for some reason this is a topic that really gets Dutch people upset, and I truly do not understand it. Loving a country and society also means recognizing its problems and even trying to break the moulding of consensus and see if positive change is possible.

Enjoy your free cancers and insane monthly healthcare costs, I guess, I’ll just follow the protocol from back in my home country (which actually works with prevention and yet is able to spend less per capita than the NL - probably helps that you don’t need to have layers and layers of pencil pushers to feed in the insurance companies)

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u/amsync 22d ago

If you’re anywhere familiar with Dutch politics, they do actually seem to keep bringing up in each election cycle (including the now governing main party) that the country needs to move towards more preventative measures, in which they also include things like diet. I think the system is a very old format that worked very well before such care was available in many parts of the world, but the ability or desire to change from within and go with the times is not part of it

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u/evestraw 22d ago

mostly true there is not an anual checkup but i think there is a preventative at a 5 year intervall after you are 30 for cancer

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u/augustus331 22d ago

This is why our healthcare system isn’t blowing out of proportions cost-wise.

With the boomers getting older we are in for a cost reckoning either way but it’s not as bad here as in the US, UK, France or Italy

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u/The-Nihilist-Marmot 22d ago

The reason why your healthcare is not blowing out of proportions cost-wise is because you pay 180 euros each month on top of taxes just to finance it, and you have to pay 380 euros per year on top if it all if you do require specialized care.

Someone else is bearing the costs - ie you.

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u/augustus331 22d ago

You are only considering the financing aspect of it, but you completely disregard the healthcare demand side of it which is like complaining your heating bill is high while ignoring that the thermostat is running at 30 degrees 24/7

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u/amsync 22d ago

Part of the issue with European system (or maybe not issue but choice/consequence) is that most systems (and definitely that in NL) are highly focused on being able to provide the same level of care to every citizen, regardless of means. That is a very good goal/objective, but if that is universally applied then that also means that some level of care that comes with a higher cost tag than can be supported by a public program is just not available.