First appeared in THEXPAT Journal Summer 2013 Publication
Healthcare: Demystifying myths, managing expectations
The Dutch Healthcare system is often presented as one of the best in the world. Regardless of how good (or bad) a medical healthcare system is though, at the end of the day this will be partially judged by what an individual expects of the services and care provided. And, since international patient’s come from too many countries to list it means that expectations are multiple. Each new patient brings with them – into the Doctors office or hospital, their own experiences and expectations – which may or may not be met by the attending health care provider.
Pieces of the puzzle
ACCESS has learnt over the years that it is virtually impossible to satisfy everyone, all of the time. We come from too many places, traditions, cultures etc., to even wish to attempt this. In providing information about how things work in the Netherlands, we hope to at the very least provide the tools for expectations to be managed in a realistic manner. In the case of healthcare it is perhaps worth noting what the building blocks of such a system look like, and dispel a few pervading myths.
To start with, the first and crucial building block of the Dutch healthcare system is the Family Doctor, the Huisarts, or General Practitioner. Family doctors in the Netherlands follow a training program after completing medical school, and as GPs are trained to perform a number of functions many of us from other countries may expect of other specialisations: such as, gynaelogical exams including PAP smears; basic care of children (with baby & young child care being done by the consultatie bureau) – and minor surgery. The GP is the gatekeeper of the Dutch healthcare system and your referral source when you need other medical services, such as hospitalisation, maternity care and specialists. One is of course free to make an appointment and see a specialist if you so desire, however, this may well result in longer wait-times or incomplete reimbursement from your insurance. This dispels one of the first myths regarding Dutch healthcare: that it is not possible to see a specialist on one’s own. It is possible, but there are consequences you should be aware of.
Another particularity of the Dutch healthcare system is the fact that it is, essentially non-interventionist. This is reflected in the reluctance of doctors (and some dentists) to prescribe drugs unless absolutely necessary, the general practice of giving birth without any pain relief (though this is possible, when and if requested) and the relative lack of preventive healthcare checks available in the Netherlands. Open dialogue with your own physician can overcome many of these factors, but one must be aware of the tendency.
Among some the more common myths ACCESS has had to dispel are: that of having to register your whole family, with one GP. Of course, it may make life easier to have one GP – but the fact of the matter is there is no requirement to do so. Nor in fact does your GP have to be in your postal code. What is highly recommended of course is that you find and register with a GP before you actually need one. This not only avoids unnecessary stressful situations – it sets the start of what is also recommended, that of dialogue. Being proactive about your health is certainly advised; though do keep in mind culture-based and system-based differences. Keeping the dialogue open means not only will you, as a patient, become more aware of how things work in the Netherlands, it also allows your GP to get to know you, as a patient, better. When you are dissatisfied with your GP, it is within your right to find and register with another, taking the courteous action of deregistering with the original one of course. As a result of recent surveys and discussions into what internationals expect from their medical caregivers, GPs and other care giver) can now be sourced and found on CheckNL [www.check-nl.com] according to location, languages and other criteria. When in doubt, the ACCESS Helpdesk and the ACCESS FAQ Health Guide can provide additional answers to your questions.
Two active health related networks at your disposal
There are two areas of ‘healthcare’ in which ACCESS has had a more direct involvement over the years. Not the least of these is the Counselling Services Network (CSN). This is a network of mental health professionals who, besides being qualified psychologists, are (or have been) themselves expats. They add to their professional qualifications and experience direct understanding of the particular circumstances and challenges facing people when they are far from home and in need of help. Every month two of the Counsellors are on call to refer clients to the care best suited for them. The on call numbers can be found on the ACCESS website or by calling the helpdesk.
The CSN is further supported by another, more specific support group, Cancerlink which is a support network, in English, for individuals with cancer or for those close to them – especially when they are far away.
A long standing and popular programme administered by ACCESS are the Childbirth Preparation Courses in The Hague, Amsterdam and Rotterdam. Run on a regular basis these courses again help manage new families’ expectations of the care they will receive during pregnancy, birth and early child-care. An added and often commented upon benefit, is also the ability to meet others in a similar situation – and many a playgroup has emerged among the participants. This too is important for ACCESS: providing opportunities for communities and groups to flourish. Without that, expatriation can be very trying indeed.