Although there are a multitude of pluses to living in the Netherlands, the one thing many foreigners agree on is their universal dislike of visiting Dutch doctors. Amongst the expat community, there’s a common joke that goes something like this: “I had a sucking chest wound and my left leg had been severed below the knee. My huisarts [general practitioner] told me to take a paracetamol and call her back if I’m not better in two weeks.” In other words, no matter the ailment - large or small - many foreigners complain that they feel under-cared-for in the Dutch medical system. Medicines aren’t prescribed as often in Holland as in other countries and requesting a referral to a specialist is almost a sure-fire way to elicit a dismissive chuckle from your otherwise reserved doctor.

Timothy Noel is an assistant professor in the Department of Chemical Engineering and Chemistry. And though he does have Dutch insurance (indeed every resident of the Netherlands is required by law to have it), he much prefers to head home when he’s ill. “The doctors in Belgium immediately explain what it is and you feel much better from that explanation. It comforts you. I really appreciate the psychological help that you get from a doctor in Belgium.”

Barrier or enabler?

Despite the complaints, the Dutch must be doing something right. According to the 2014 Euro Health Consumer Index, the Netherlands tops the list of quality healthcare systems. The research ranked 37 countries according to several factors: patient rights and information disclosure; accessibility and waiting times for treatment; outcomes; the range of services offered; illness prevention and access to pharmaceuticals. The top score possible was 1,000 points, and the Netherlands earned an impressive 898. (Switzerland came second, followed by Norway, Finland and Denmark.) In fact, the Netherlands has been in the top three countries in each report published since 2005 and the latest one noted that the Netherlands has addressed a weak spot - accessibility - by setting up 160 primary care centers that stay open 24 hours a day, seven days a week.

Why is it, then, that so many foreigners don’t feel comfortable with Dutch healthcare? For internationals like Timothy Noel it may come down to, ironically enough, a lack of gezelligheid between doctor and patient. “I would describe the Belgian system as social and warm. I feel more secure because every time you go there, you feel like you’ve been helped. I once had severe headaches during the night and I was scared of a tumor. I’d never had such massive headaches in my life. I couldn’t sleep and I was a wreck. I jumped in my car and went to the doctor in Belgium. They gave me something for the pain and I immediately felt better. In Belgium, you don’t get the cold hardness that you have here. It’s even dramatic enough that I don’t even want to see a doctor in the Netherlands.”

Lorenzo Giunta dislikes the “wait and see” approach he experiences in the Netherlands. “If I go to a doctor in Italy, they’ll help me. But here they want to investigate to see if I’m really sick. One time I went to Morocco and I felt very ill when I got back. I went to the doctor but they didn’t really bother with checking anything. The healthcare here is very good but I feel like the GP is more of a barrier than an enabler. They try to convince you that you’re not sick. The Italian philosophy of healthcare is focused on making sure everyone is taken care of. No matter how minor the problem might be, the idea is that everyone feels they have the full attention of their doctor.” However, Giunta does compliment the streamlined efficiency of the Dutch medical system. “Practitioners in Italy triple check things because they’re afraid they’ll get sued. And that does clog up the system because people are getting tested for even minor things.”

The Dutch perspective

Arguably, the medical system here is a reflection of an over-arching Dutch mentality of life. Doe maar gewoon [be normal], naturalness and authenticity are important elements of Dutch culture. For instance, doctors stress that pregnancy is a natural event and the process is medicalized as little as possible, with midwives - not obstetricians - providing all or the majority of care. And unique to the Netherlands (at least in the West), home births are strongly encouraged, with some 30% of first babies and 65% of second babies born at home. And as many internationals have already experienced, most Dutch GPs prefer to let minor illnesses run their normal, natural course rather than intervene with medicines.

However, the Eindhoven region is working to alleviate foreigners’ concerns with their healthcare. SGE International is a healthcare provider that was created to cater to the needs of the many internationals living, working and studying here. Services are offered in English, consultations last 20 minutes - twice the normal consultation time as a normal practice - and they offer an initial intake of 40 minutes in order to explain the ins and outs of the Dutch healthcare system. The newly-opened practice already serves about 250 patients from many different countries. 

Dr. Hebe Rullman is the GP for the practice at Strip-S and explains the impetus for the clinic’s creation: “There was a clear question from the Eindhoven city council and the Holland Expat Center South to have a provider who cared for internationals because they want to improve the climate for people to immigrate to Eindhoven. And they noticed that there was a lot of dissatisfaction about the Dutch system.” Prior to their opening, SGE organized an international and age-diverse panel to discover what foreigners experience as the main problems with the Dutch medical system and their ideas for tackling them. Rullman: “Most people are unhappy because they don’t trust their general practitioner. And it’s probably because the Dutch system works differently than most people are used to. The GP has a key role in the Dutch system. We’re trained for three years to recognize and treat the most common problems and symptoms. And because of that training, we do more. And that’s why you don’t get referred to a specialist that often.” Dr. Rullman says that once her patients learn more about the philosophy behind the Dutch approach to healthcare and exactly how it works, it boosts their confidence in the medical care they receive here.

Do you also want to know more about what you can expect when you visit a Dutch doctor? Go check out SGE’s English-language information page. Arming yourself with a bit more information could go a long way in helping you feel comfortable with your Dutch doctor the next time you’re under the weather. But don’t throw away that box of paracetamol just yet. You’re going to need it.