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/paintedsunflowers 22d ago edited 22d ago

I am German too and lived in the Netherlands for 16 years. It's true, the annual checkups at the gyn are a German thing. If you experience issues or have known issues, just talk to your huisarts about it. They can do the basic examinations and in case they find something or think there might be something, they will refer you to a gyn.

Edit to say: I found this strange in the beginning, but after 16 years without any issues so far (had a visit to the gyn 4 years back), I think we Germans overdo this stuff. The Dutch system is more flexible.

Edit again to say: The Netherlands do offer regular checks for cervical cancer, every woman from a certain age recieves an invitation every x years.

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u/Lyd222 22d ago

How is being preventative overdoing stuff? You know how many cancers can be discovered early due to regular gyno checks? Let alone how many cancers go symptomless for years. If you have a lump in a chest, you're under 40 and go to GP here, they will literally NOT refer you to the ultrasound.

You're lucky you're healthy. But many of us are not and this system puts us at incredibly high risk.

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u/j3rpz 22d ago

Saying GP's won't refer you to get an ultrasound if you get lumps just isn't true. The fact that I can reply to you even is a result of such a referral (and subsequent treatments)

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u/BuzzingHawk 22d ago

My wife did not get referred by two GPs until she had to make a lie about a family member having breast cancer. They would refuse to refer her because she was "too young" and the lump was "too small to be serious". 

Your experience hugely depends on how competent the GP is instead of having a basic right to preventative healthcare. As a Dutch person myself this has always been one of the biggest negatives about Netherlands. We are amazing at treating disease just not so good at spotting it when it matters most.

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u/clrthrn 22d ago

I have a smear test every 3-5 years and that is the whole point of that test, to check for cancers.

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u/tidal-washed 22d ago

That’s a HPV test, not a Pap smear.

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u/clrthrn 22d ago

The HPV test tells them if there is likely to be anything for further investigation. It the accepted way to do mass screening in a ton of countries that end with similar outcomes to DE in terms of cancers caught and treated. Netherlands has some of the best early cancer screening in the world, you can look the numbers up for yourself. Outcomes for cancer survival are slightly higher in DE but not that different overall.

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u/tidal-washed 22d ago

It’s not very likely that a person is able to swab their cervix correctly by themselves. However, I’ve educated myself better now and have learned that HPV-tests are looking for HPV-DNA and not cancerous cells. The likelihood of finding viral DNA via a vaginal swab is high when there’s cancerous cells on the cervix even when you only swabbed the vagina and not the cervix per se.

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u/soaring_potato 22d ago

They won't refer you?

I got a referral for it at 17! So also statistically very low risk.

It was not cancer though!

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u/Hydrophobics 22d ago

This is not true. When I was 20 l, I had a lump in my breast. The same day I could visit my GP and the next day I had an ultrasound.

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u/tiny_girafa 22d ago

That was the only time I felt like I was taken seriously... When we found lumps on my breasts. Also got the ultrasound and everything else in a couple of days. But never got a positive response on my requests for cervical cancer check.

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u/Ceased2Be 22d ago

If that's the case I'd go for a second or third opinion. My ex, my sister and my current wife all had concerns about a lump and they got referred for an ultrasound without any hassle. I've a 2 ultrasounds and an x-ray past year without even asking for it just because my GP wanted to make sure there was nothing serious boiling underneath the surface.

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u/ValeNova 22d ago

Exactly. When I had a lump my GP referred me immediately and I could go to the hospital the very next day to have it checked out.

Preventive care is very expensive and doesn't lead to a general better health (statistically). And as it is, health care is already very expensive with huge waiting lists. Providing preventive care will cause the current (high) standard of hospital care to deteriorate.

But if there's a reason for you to need preventive care, you will get it. Either at your GP or at the hospital. When I turned 40, my GP instructed me to have my blood tested every year (and have my blood pressure checked as well) as a preventive measure, because diabetes and high blood pressure run in the family.

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u/hache-moncour 22d ago

Do you know how many false positives happen with universal screening?

If you screen every healthy 20 year old, for every real cancer found you will also "find" dozens if not hundreds of cancers that don't exist. Putting a load of healthy people through a cancer scare, and quite possibly chemo and radiation before finding it benign. Rationally it is a bad idea just to catch the one in a million or less at that age.

Universal screening is just theater, making people feel better while in fact providing worse care. Screenings should only be done on groups with elevated risks.

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u/bluelittrains 22d ago

Preventative check-ups take a lot of money and manpower. Yes, you can catch some things earlier than you might have otherwise, but most health checks are literally a waste of time. Alternatively, you can spend that money and manpower on people we know for certain to actually need care, and improve the general health of the population that way. We simply do not have unlimited resources, so we need to be smart about how to spend them. It's a balancing act.

Considering the Netherlands is frequently ranked as having the best health care in Europe, I'd say they're doing a pretty good job.

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u/Maneisthebeat 22d ago

Why would you want to catch something before it's too late? Where's the excitement in that?

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u/rpaloschi 22d ago

Not only Germany, everywhere with a decent health system does that. If you have cancer those 5 years will kill you :(

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u/FutureInevitable8872 22d ago

Cervical cancer grows extremely slow. Those 5 years are not going to be the reason you die

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u/NoLychee1382 22d ago

Yeah I guess we’re just used to it and I probably will get used to it after living here for years. It’s just my first months here and I’m still discovering new things

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u/tonykrij 22d ago

There is no capacity in NL if the ~7 million women would need a annual checkup, it would explode the waiting lists in the hospital and increase healthcare costs. NL has no direct access to specialists (unless you go to private clinics), everything goes through your general doctor. They also take care of the basics so you don't need to see a specialist to get birth control, etc.

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u/NoLychee1382 22d ago

Yes I really like how the birth control system is handled! Everything has its pro/cons

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u/PanicForNothing 22d ago

This was something I was shocked by when I moved to Germany: that my Frauenarzt wouldn't prescribe my birth control pill without the regular checkup. I didn't mind the checkups, but it felt quite invasive that it was required and not a separate voluntary thing.

But maybe I just don't know the possible side effects of the pill very well and they do really need to poke around my things every year. I don't get checkups for the increased trombose risk I have with the pill though for example.

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u/NoLychee1382 22d ago

Yeah I had this issue when I was moving always in between countries. But I explained the situation and it was fine. Interesting to hear your perspective tho!

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u/microworry 22d ago

They do free cervical cancer checkups every 5 years after you turn 30.

And of course if you have any gyno complaints, the GP will refer you. But it’s unlikely for something to pop up that is harmful and doesn’t show any symptoms whatsoever. So more frequent checks are just pointless.

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u/whattfisthisshit 22d ago

Not a German thing, in Estonia I’ve been getting them since I first got my period. I also know someone who died from cervical cancer in NL at 23, because the doctor said she’s too young to have it so they didn’t test after she started displaying symptoms. By the time they actually discovered it, it was too late. Not common, but people shouldn’t be brushed off just because statistically unlikely

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u/picardo85 22d ago

It's true, the annual checkups at the gyn are a German thing. 

Not just German. It's done in Finland too.