How do I get through to a Dutch doctor?

All immigrants in this country know it: Dutch doctors mainly prescribe rest and aspirin to their patients. Whoever tried to convince a doctor in the Netherlands that they suffer from a serious disease and hence need a specialist or more medication, knows how hard that can be.

Female doctors seem even harder to convince than their male colleagues. With ‘only’ a flu or a simple digestion problem it’s out of the question that a doctor would prescribe something like antibiotics. Is this something to get used to or is it possible to see a specialist every once in a while or have ‘real, sound’ medicine prescribed in case you really need it?

Let’s first see why Dutch doctors aren’t accustomed to prescribing heavy medication. In the 80’s of the past century it became clear that e.g. antibiotics aren’t very good for the flora in our intestines. Since then it was used only in case of necessity. Actually this is a good sign, because you can fall much more ill if your intestine flora is ruined.

Many Dutch people don’t like taking chemical medication and they prefer going to an alternative doctor. Regular doctors don’t gain any popularity if they prescribe too many pills! In most cases a doctor will want to ‘see how it goes’ (in Dutch: hij wil het even aanzien) before prescribing anything heavy or sending you for a treatment.

But there is another reason, which is less sympathetic: specialists in the Netherlands receive the highest salary in the world. The other day it was again in the newspaper. So sending you to a specialist means that your insurance company will have to pay for it and … they only do that in case of utter necessity! This is the main (not the only though) reason why you have your baby with the help of a midwife and not with a gynaecologist and why you go to the ‘opticien’ (optician shop) and not to the ophthalmologist in case you need contact lenses or glasses.

In the Netherlands there are laws but there’s also a policy, called beleid. The policy used to be: send every patient to a specialist so they’ll be well cared for, but now changed into: see how it goes, you can always send the patient to a specialist later. In the old system a lot of money was paid to hospitals and specialists. In the new system sometimes things go wrong because a patient really needs more serious medication or treatment, but doesn’t have access to it. Hopefully there will be a main road between the two excesses.

For now what you can do if you really, really need a treatment or special medication, is SAY SO. In your country of origin you probably need to have a lot of respect for doctors and possibly you don’t have the right to tell a doctor what you think. Here not only you can, but you even have to. Tell the man or woman how you were treated in your own country – if you already had the same problem before you came here. If it’s a new problem: insist that you really need to see a specialist. Tell the doctor how your former treatment worked on you.

What you should definitely not do, is get mad. If you become upset in the Netherlands, nobody will listen to you and you will be sent home without anything. Exercise in front of the mirror so you stay calm and insist quietly but firmly on what you need.

We exercised this in a group of Dutch learners last year. They were refugees and lived in a camp. The only medical care they had, was a nurse that wasn’t too reluctant to send people to a dentist or to the hospital. One of the students, a young lady from Sierra Leone, wanted to become a nurse. She knew very well how to imitate the camp nurse and so we did a role playing. It was very hard for the students to convince her, but in the end they succeeded. This was a very valuable lesson of which the outcome was: yes, there is a way if you really need help.


©Sophia Vassiliou 2009

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