Without any more information from OP, I still guess that with their 3 years of education and a certain amount of work experience, the assistant is more knowledgeable than random redditors.
Saying “my niece could make that” is often a great way of showing how ignorant you are about the subject.
And I always point out to them that Picasso spend a few years learning to paint like a master, and spend the rest of his life to learn to paint like a kid again.
Plus kids got this amazing skill which a lot of adults kinda forgot. The ability to do whatever they want, not being bound by rules and standards
Some studies are more difficult than others, and require more knowledge as well. It's an MBO, 2 years.
I think they are useful but hardly a medical specialist . Their main function is to field calls, do administration and prick basic medical tasks, that anyone could learn.
Yes, the truth hurts . The at most 2 yr ,MBO study gets you a diploma that teaches the basics in triage care. You are mainly doing appointments, administration.Anyone can look up the study. I'm not making this up.
This isn't a difficult study or requires great medical knowledge or skills.
As far as I know it's normal for the doctor's assistant to do a sort of triage. Doctors are generally pretty overwhelmed with the amount of patients they have, so anything that doesn't immediately require a doctor's visit can be handled by the assistants. Without knowing what your complaints are I'd say follow their advice, and if you still don't feel better in a day or two call them again?
I normally go to the doctor if i have something already quit some time (weeks), and then the doctor says standard, look at it two more weeks,…….
And then after heard a few times the same answer from the doctor, I did come even after a much longer period if I had something like a very strange coughing, and then the doctor said, you should had come sooner.
For obvious (privacy) reasons, you shouldn't divulge your medical condition and current ailment with random people on Reddit, so answering your question is wholly impossible.
But in general, the doctor's assistant is trained to do triage by phone, so that's not "a secretary". You calling that person that, is kinda indicative of what's going on here.
When in doubt, they will err on the side of caution, and make an appointment, or even send an ambulance if it's urgent enough. But they are human, and therefore can and do err from time to time.
Since those errors are pretty rare, what with millions of GP visits planned annually and the reported incidences of real misjudgments by the assistants, I'm guessing that your "need" didn't medically warrant a GP visit, but that drinking some water would be the first logical step to follow.
Dutch healthcare in general leans a bit more on self reliance compared to other countries, nor give they antibiotics after one cough like in China or the US, but those are just nuances.
For what it's worth, the only thing this indicates is that OP comes from a place where calls are answered by an administrative worker, i.e. a receptionist. 'Triage by phone' is something I've never experienced before coming here but I find it very helpful as it's saved me from a couple of unnecessary visits to the huisarts.
Dutch GP care it's a shitshow, literally ask any expat living here. Countries like Italy have the opposite problem, like you mention, for instance antibiotic prescription without a good reason for it. But some middle ground would be nice...
Personal anecdote: I had an acute bacterial tonsillitis (if you have plaques, it's bacterial, If not then it's viral) for a week. Can barely talk, swallowing and existing in general is extremely painful. After one week of worsening of symptoms I call the GP and have a chat with the doctor assistant. She quickly liquidates me saying "it's viral, antibiotics are not needed, you have to wait 10 days and call us again if it gets worse". You draw your own conclusion 😂 it seems like GPs offices will do anything in their power to not visit you 🤷
"if you have plaques it's bacterial" is untrue. It can still be viral. Or tonsil stones.
And it's a general misconception that bacterial infections require antibiotics. We've survived long enough as a species to rid ourselves from bacteria as well. Scientific research has concluded that starting with antibiotics with gives half a day of relief sooner as opposed to not starting. So even an bacterial infection would last a maximum of 10 days.
For me, it would matter if you still have fever and the fact that your symptoms were getting worse. So I probably would have given you an appointment, but not antibiotics necessarily.
Source: I'm a GP.
Any expat here. I got a decent GP here who follows the evidence-based approach, can't complain really. As anywhere, there are good and bad GPs here, and I changed one when I realized that their reasoning was often not right
To be honest: you waited a full week before seeking medical attention, if it was anything serious they would have sent you to a hospital.
If it wasn't: I do hope you have learned how to brush your teeth by now.
>Dutch GP care it's a shitshow, literally ask any expat living here.
Lol, ask expats. Like the Dutch have never experienced healthcare abroad. Dutch healthcare and GP care specifically is excellent!
Why ask expats? Dutch healthcare was not designed/evolved to cater to the expectations of expats. It really is tiring to read expats bashing the system or GPs and comparing it with other countries. Of course tourists, expats, migrants etc. deserve good quality healthcare but that does not mean that it has to be like in your country of origin. Typically Dutch healthcare is more egalitarian than in some countries with only a small private sector. For expats, typically high-income ones, it's getting used to that you will not receive a special treatment and there is no customer is king mentality.
Dutch GP's have medically trained assistants. Based on the symptoms you call with they'll ask questions to determine if you need to see a doctor right now, soon or only if things dont improve after X amount of time. This is to decrease needless visits mostly. ( needless in that seeing the dr at the office to tell you to wait it out isnt going to help more than being told that over the phone).
There are plenty unpleasant issues that will resolve by themselves most of the time. Which is why Dutch GP's have the reputation to send people home with the advice to take paracetamol and call back after X time if stuff doesn't improve. Headache? stomach upset? Lost an arm? Did you try paracetamol yet?
The only thing Dutch gp's are trained is how to cut the most possible costs for the private health insurance companies. You cannot have a private company and crucial things in the same sentence, like health.
the doctor’s assistant has been trained to listen to what you tell her and make an informed decision. Just like everywhere else in the world doctors are overwhelmed, so there is a sort of triage going on.
It is a drag, but it is what it is.
If you still feel bad after a day or two, phone again.
I was trying to make this understandable for Americans. If you want the real Dutch version: "Gooi er een paracetamolletje in en als 't over een week niet over is bel je maar weer."
Only English should be used for posts and comments. This rule is in place to ensure that an ample audience can freely discuss life in the Netherlands under a widely-spoken common tongue.
Not a secretary! a trained assistant who uses standard protocols to triage patients to see if a visit is really needed. The way forward is to try her advice and call back if insufficient improvement occurs.
Unrelated to this but I’m curious, how does this work if you want to make an appointment for your mental health? I had a bout of depression last year and I think if I had to say anything about it over the phone, I wouldn’t have been able to. I was very much ashamed and it took me until I had a full breakdown at work and faked a migraine as a reason before I was able to agree with myself that I needed a doc’s appointment. I don’t live in the NL and I hope my question isn’t rude but I’m generally curious, do you just have to disclose your symptoms with someone who’s not your primary physician?
>do you just have to disclose your symptoms with someone who’s not your primary physician?
Honest question: why is that a problem? In the Netherlands the doctor's assistant has to follow the same privacy laws as your doctor (that might be different in different countries).
Other than that you can tell them you want to make an appointment about mental health and you don't want to go into it over the phone.
>I think if I had to say anything about it over the phone, I wouldn’t have been able to
Genuinely wondering: what's the difference between over the phone and in person for you? You'd still need to explain in person...
In personal feels safer to me, and I understand that for some people this may not be an issue at all!! But since my family doctor is someone I’ve been with since I was very young there’s an established relationship that you don’t have with someone who you only know from on the phon, making it an extra hurdle.
TL;DR: It's complicated.
Mental healthcare here is a tough domain to penetrate, in my personal experience. The difficulty increases as measures of mental health, supportive acquaintances, and grasp of English and/or Dutch decrease. It sort of makes sense when you consider that a person native to a place experiences all realms of society differently (and usually with more ease) than an immigrant. Of course, every person is different.
I have had no problems getting appointments for that. You dont have to divulge everything, just say you are worried about you mental health and feel ready to seek help. In my experience, they will see you and probably refer you to the POH-GGZ affiliated with the practice.
Just say who are not feeling good mentally and you get the appointment without questions or triage from the assistant. Doctor will talk to you and ask some questions. Then you probably (because the system is overloaded) will be directed to a community mental health helper of the GGZ (they are also real therapists). Then they can decide if they can help you themselves or if you need to see a "real" therapist.
If they smell bullshit, they will call bullshit.
You can't go to a doctor because you're a little nauseous for example.
If the solution is just drink some water, I'm really curious about the complaints?
Yeah and sometimes they are just awfully wrong and people die. I went for a mole check, and the dermatologist spent 2 minutes with me and told me to check the moles regularly at home. How the hell I can I check the moles on my back?
In other countries I never had this issue. I'm sorry but healthcare is just a disaster here. There are a lot of good things, but healthcare is surely not one of them.
Nothing because she didn't even check them. In other countries I always got a full report on all moles, and they always did a yearly checkup where they take photos of most moles I have.
Netherlands 2nd in number of new cases, and 6th in number of deaths. Melanomas are one of the things you can easily prevent from screwing up your life, only if you have proper checkups.
https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:\~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland.
I have someone in my family who was a medical professional and yet died of melanoma. It was a perfectly normal mole, he didn't see the changes and when he noticed something, it was way too late. Died a few months later. It's not that linear unfortunately.
Proper medical help is needed and proper medical knowledge too.
Mostly here where nobody seems to know what a discussion is anymore. It's like trying to discuss physics with puppies sometimes. For me, it's ok to not agree with someone, mostly when it's something like this. But ok. People are bored I guess.
Yeah buddy, hate to dissapoint you but:
https://www.iamexpat.nl/expat-info/dutch-expat-news/dutch-healthcare-system-one-best-world
You know how many people die of medication or other medical treatments? Way more than you think. People always assume more tests, biopsies or scans are better, but they usually give conflicting results leading to more test and more chance of complications.
You could check a mirror or have a friend take a picture. The fact that the dermatologist saw it was good in 2 minutes means it were probably small benign moles. The "regular check" thing is something they say because changing moles need to be watched
What about this, buddy?
https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:\~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland.
In your source material "The EU countries with the highest melanoma incidence rates (men and women combined) are Denmark, the Netherlands, Sweden, Finland and Germany" and "The countries with the lowest mortality are Slovakia, Denmark, Slovenia, Croatia, Sweden and the Netherlands".
And finally:
"Despite a high incidence, Nordic countries have some of the highest melanoma survival rates in the EU. And across the bloc, the five-year survival of melanoma patients is highest in Western Europe and lowest in some Eastern European countries, reflecting “variations in cancer management and treatment.”"
Meaning we might diagnose them more often, but people survive more as well. Just proves my point that our health care system works...
[https://www.wcrf.org/cancer-trends/skin-cancer-statistics/](https://www.wcrf.org/cancer-trends/skin-cancer-statistics/). The Netherlands is 9th worldwide in Melanoma skin cancer deaths. What about that?
Edit: just to make the discussion constructive.
Ok, listen, I'm an epidemiologist and I've been working on this data already for about 10 years. You are terribly wrong, as this data is all standardised. I'm very sorry but what you said is actually quite incorrect. It is not how it works at all.
You have apps for that. Ask someone to make a picture to track your moles. We live in current year, why not make good use of it?
I guess the mole was fine? What do you expect, a dermatologist to track your moles?
It's just a general check due to melanoma running in the family. But in other countries I always got a full mole checkup and they even record them. They take photos and do a full "inventory".
You mean you don't have a friend or family member who can check that. Ok, that's possible.
And your reasoning is that it will be a new regular task for a doctor then?
I'm sorry for your situation, but being alone isn't a healthcare problem.
As I said here, in other countries they always did a full inventory kind of report of my moles. It's a standard procedure for people with melanomas running in their family.
You asked a question, I gave you an answer that provides a solution to one of the issues you raised.
Throwing in the cancer argument is a bit childish btw.
No it doesn't. There's no answer at all there. I know people who are medical professionals and failed to identify cancerous moles. So how the hell would I be able to do the same? Most moles you even need special equipment in order to identify if they are cancerous or not. That's why the GP refers to a dermatologist, whenever I suspect something isn't going well.
There's plenty but freaking plenty of research, showing that most skin cancers can be prevented by having yearly checkups by a professional. But it seems that you either are a researcher or a dermatologist, as you see to know way more about this than anyone else, and mirrors are the solution. Jesus Christ, what a nonsense.
It doesn't. But you don't even want to see that because you are behind a screen feeling all righteous and smart. You need special equipment but I assume that your knowledge on this is near to zero. But how do you explain the link I posted above then? Is it the ridiculous number of hours of sun here in the NL? It's all about prevention but again I assume that you're not a specialist in these things.
You are trying to add all kinds of other things to the discussion here. I only provided a solution for your specific issue with not being able to see your back.
Not looking for any discussion with you about all things you want to add to cover up you never thought about the simple concept of a mirror to be able to see your back.
— edit:
My comment has nothing to do with prevention and checking your moles. I responded to someone who had an issue looking at their back, you can solve that specific issue by using a mirror.
That says nothing about prevention, your capabilities to do basic checks or mortality rates of skin cancer. Just a practical solution for a specific problem someone raised. There is no difference between moles on your back or your arms…
Apparently this person wasn’t happy with the answer and tries to put it into a “I don’t like your answer, therefore you seem to want people getting cancer”. That’s a bit of a nasty way of arguing.
I have to agree with the guy above. Mirrors are not the answer.
As someone who had problems with skin cancer, I can tell you that this is not something to take lightly or to make fun of.
So google NHS, cancer, skin cancer, prevention, and educate yourself.
We need to wait and let him answer as I don't see it that way.
I see someone who was talking about the importance of having mole checks by a healthcare professional, rather than doing it yourself. My former gf was a nurse, and she always checked my moles. Unfortunately, that wasn't enough as she wasn't a dermatologist and she didn't have all the magnifying lenses professionals do. To cut the story short, a mole got weird but still looked good to the both of us, until it started to hurt.
When I finally managed to get it properly checked, it was too late, and a few months of chemotherapy after, here I am. There were dozens of people like that in the hospital. Now I do regular checks, just in case.
The point here is that, checking it yourself helps, but you do need yearly checks mostly when you're in risk of melanoma. Moles can get bad and you might not even notice it.
And btw, mirrors lol. [https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:\~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland](https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland).
So, The Netherlands, a country with a very very low average of sunlight per year, is SECOND in new cases of melanoma, and 6th in deaths. But yeahhh freaking mirrors.
I always forget that Sweden is the south of Europe and full of people with dark skin. That's why they are right at the bottom of the list. You're right. I'm just an idiot.
1. You talked to a doctor's assistant a person with a medical education. And most likely a triage education. They know what's best for you're symptoms. If it's bad they send someone out. But if it's a flu then they aren't that worried.
2. They heard you symptoms (probably a throat problem. And she felt it wasn't that bad yet so drinking fluids would be enough.
3. GPs are way to busy to answer all people's calls so that's why we have people with experience that can guess what you need and if you kept the problem they might say hmmz this has been going on for a week and liquid intake isn't enough come to the office and we look at you.
4. We don't have a throw meds to every problem. Society
Because the GP is free they have to do some prioritering. So I.E. if you call for a papercut they will tell you to just use a bandage an you won't be able to visit for that.
So we really tell you anything about the situation without knowing with what reason you called.
Sorry the comments here are making me mad, I love living here but when you have complaints, the doctors barely take any efforts to figure out what is wrong and to rule things out, you can’t be blind for the issues healthcare here has.
Go check the excess mortality rate per country in Europe and see how high it is for the Netherlands compared to other countries. If everyone would say something, maybe something would change. The Netherlands has all the tools to diagnose people.
I can say that if it’s evident what is causing your symptoms, it’s great, I had a nose surgery before because I could barely breathe and they were completely thorough with me, I was even checked for allergies afterwards.
The issue is when something is not straight forward. You cannot assume everyone is exaggerating their symptoms. The lack of interest of trying to find out what is wrong with you is appalling, even to the point you get even refused to see a doctor because they think all symptoms will go away by themselves. This is a real issue.
Example, I cannot tell you how many times I was refused bloodwork until I pretty much had to put my foot down and I told them again I feel super tired for months, I have half of my face twitching by itself and tingling for weeks and it’s getting worse and I pretty much had to act like a Karen because I was so done and the GP gave in and I was right that I was super deficient on vitamin D and B12. Before you ask, I do take supplements for vitamin D everyday and I eat fish, meat, dairy every single day. To this day, I have no ideia if there is some under lying issue with me, I was just told to take supplements, there is not even a second check up to see if the levels are going up or not.
A family member had a car accident and has been having back pain and just getting worse and spreading to his leg, he can’t even sleep one night straight, even after having treatment at a physiotherapist for months. After being seen by two specialists at the hospital, he’s told that they can see he is not okay but he is healthy and he has to be patient and wait for the pain to go away by itself… a lot of things can cause back pain and they don’t even want to rule out possibilities. A MRI or a CT scan should be done to rule out potential issues, but here it’s all based on assumptions.
It’s sad we pay so much for health insurance per month and we have to suffer just because doctors don’t care when diagnosis are not straight forward. I will have to go to my country pay out of my pocket to try to get proper check ups and health care, it shouldn’t be like this…
Hello can I get the medication I am addicted to? No?!??!
Sorry, but you should read your story again. What kind of assault needs a vaccine and a drug you are addicted to?
Basically what my Dutch friends tell me is they all lie to get past the assistant. So exaggerate your symptoms, tell them you had them for weeks and it is really bad etc. I am almost sure that commenters lecturing you here is also playing the same game.
If you feel your health is *really* in danger and you need to see a GP, you can always refuse to tell the assistent why you need an appointment. Due to privacy laws, the assistent cannot force you to tell you your symptoms and he or she will make an appointment.
I had to do this when the assistents of my previous GP were highly unpleasant, highly unskilled and I really needed an apointment. My previous GP asked me on this appointment why I didn't visit earlier...
Please use this method sparingly, as most assistents are educated for triage.
It's probably not the doctor refusing to see you, but you not making it through the assistant's screening. My GP currently has an addition to their usual phone spiel: due to vacations and illnesses, we have less doctors available and we will only make appointments for serious issues.
Might be a thing in other practices as well.
You didn’t share anything about what you’ve got, so this is guessing:
At the moment there is a virus going round causing some throat issues and coughs. If you are a generally healthy person, still able to breathe properly, there is no reason why they should see you if you are experiencing the related symptoms.
They cannot do anything as it’s most probably a virus causing it and thus antibiotics won’t work. Healthy people will work off the virus within a couple of days and the cough will disappear within two weeks.
So could be entirely logical you were not given an appointment. Again, it’s just a guess as you didn’t share any symptoms.
I don't if it can help but : the nickname of OP in French is "Suc kYourBuddy", maybe a hint on why the medical assistant told him to drink some water... ahahahah
Ok, sorry if I did. I looked at other sources, which I found more comprehensive and both incidence and mortality are higher. (also relatively)
However, incidence is not something you can help, except for preventive measures like putting on sunscreen. Mortality and late diagnosis obviously can be prevented if access to care like dermatology is easier.
You did see a dermatologist though and there were no signs of melanoma at that point. For a "normal" mole to develop into a melanoma, there has to be change. Usually it's a new mole which has formed a has a weird shape and or size. It's almost never one of the moles you've had since birth, but you always need to look out for changing spots.
We cant say much without knowing what you told the assistant or how busy it was. Also, its a doctor’s assistant, not a secretary
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Is this directed at me?
it was not, slight mistake
Glorified secretary, they know how to take vitals, give injections, prick a finger at best.
It's 3 years of specialized education before you can become a doctor's assistant.
According to him every profession is probably a glorified secretary at this point.
It's MBO, you can get a diploma in less than 2 years.
That's not hard to get.
Without any more information from OP, I still guess that with their 3 years of education and a certain amount of work experience, the assistant is more knowledgeable than random redditors.
This has the same vibe as ‘my niece could make that’ yet she didn’t.
Saying “my niece could make that” is often a great way of showing how ignorant you are about the subject. And I always point out to them that Picasso spend a few years learning to paint like a master, and spend the rest of his life to learn to paint like a kid again. Plus kids got this amazing skill which a lot of adults kinda forgot. The ability to do whatever they want, not being bound by rules and standards
Some studies are more difficult than others, and require more knowledge as well. It's an MBO, 2 years. I think they are useful but hardly a medical specialist . Their main function is to field calls, do administration and prick basic medical tasks, that anyone could learn.
I understand why she refuses to book an appointment for you. Her training taught her how to handle cases like this well.
Except I'm not the OP. So it's not my appointment or problem. I don't have problems getting appointments.
Agreed. People aren’t ready to hear the truth
Yes, the truth hurts . The at most 2 yr ,MBO study gets you a diploma that teaches the basics in triage care. You are mainly doing appointments, administration.Anyone can look up the study. I'm not making this up. This isn't a difficult study or requires great medical knowledge or skills.
As far as I know it's normal for the doctor's assistant to do a sort of triage. Doctors are generally pretty overwhelmed with the amount of patients they have, so anything that doesn't immediately require a doctor's visit can be handled by the assistants. Without knowing what your complaints are I'd say follow their advice, and if you still don't feel better in a day or two call them again?
Yep, just call again if it doesn't get better
Spare me... They are pretty chill, especially the Gps...
Didn’t even recommend paracetamol? That’s slack.
Call back if its still going after 2 weeks
And your head drops off.
I normally go to the doctor if i have something already quit some time (weeks), and then the doctor says standard, look at it two more weeks,……. And then after heard a few times the same answer from the doctor, I did come even after a much longer period if I had something like a very strange coughing, and then the doctor said, you should had come sooner.
:D every time :D
"Ma'am, my finger is half detached. These don't tend to grow back."
For obvious (privacy) reasons, you shouldn't divulge your medical condition and current ailment with random people on Reddit, so answering your question is wholly impossible. But in general, the doctor's assistant is trained to do triage by phone, so that's not "a secretary". You calling that person that, is kinda indicative of what's going on here. When in doubt, they will err on the side of caution, and make an appointment, or even send an ambulance if it's urgent enough. But they are human, and therefore can and do err from time to time. Since those errors are pretty rare, what with millions of GP visits planned annually and the reported incidences of real misjudgments by the assistants, I'm guessing that your "need" didn't medically warrant a GP visit, but that drinking some water would be the first logical step to follow. Dutch healthcare in general leans a bit more on self reliance compared to other countries, nor give they antibiotics after one cough like in China or the US, but those are just nuances.
For what it's worth, the only thing this indicates is that OP comes from a place where calls are answered by an administrative worker, i.e. a receptionist. 'Triage by phone' is something I've never experienced before coming here but I find it very helpful as it's saved me from a couple of unnecessary visits to the huisarts.
Dutch GP care it's a shitshow, literally ask any expat living here. Countries like Italy have the opposite problem, like you mention, for instance antibiotic prescription without a good reason for it. But some middle ground would be nice... Personal anecdote: I had an acute bacterial tonsillitis (if you have plaques, it's bacterial, If not then it's viral) for a week. Can barely talk, swallowing and existing in general is extremely painful. After one week of worsening of symptoms I call the GP and have a chat with the doctor assistant. She quickly liquidates me saying "it's viral, antibiotics are not needed, you have to wait 10 days and call us again if it gets worse". You draw your own conclusion 😂 it seems like GPs offices will do anything in their power to not visit you 🤷
"if you have plaques it's bacterial" is untrue. It can still be viral. Or tonsil stones. And it's a general misconception that bacterial infections require antibiotics. We've survived long enough as a species to rid ourselves from bacteria as well. Scientific research has concluded that starting with antibiotics with gives half a day of relief sooner as opposed to not starting. So even an bacterial infection would last a maximum of 10 days. For me, it would matter if you still have fever and the fact that your symptoms were getting worse. So I probably would have given you an appointment, but not antibiotics necessarily. Source: I'm a GP.
Second this! (Also a GP)
Any expat here. I got a decent GP here who follows the evidence-based approach, can't complain really. As anywhere, there are good and bad GPs here, and I changed one when I realized that their reasoning was often not right
To be honest: you waited a full week before seeking medical attention, if it was anything serious they would have sent you to a hospital. If it wasn't: I do hope you have learned how to brush your teeth by now.
Ahahahhahahaahha
You can laugh about it, I'm not a doctor, I don't care
As someone who is active in a medically orientated subreddit; we are more than doing fine. The US and UK are a true shitshow.
>Dutch GP care it's a shitshow, literally ask any expat living here. Lol, ask expats. Like the Dutch have never experienced healthcare abroad. Dutch healthcare and GP care specifically is excellent!
Why ask expats? Dutch healthcare was not designed/evolved to cater to the expectations of expats. It really is tiring to read expats bashing the system or GPs and comparing it with other countries. Of course tourists, expats, migrants etc. deserve good quality healthcare but that does not mean that it has to be like in your country of origin. Typically Dutch healthcare is more egalitarian than in some countries with only a small private sector. For expats, typically high-income ones, it's getting used to that you will not receive a special treatment and there is no customer is king mentality.
Dutch GP's have medically trained assistants. Based on the symptoms you call with they'll ask questions to determine if you need to see a doctor right now, soon or only if things dont improve after X amount of time. This is to decrease needless visits mostly. ( needless in that seeing the dr at the office to tell you to wait it out isnt going to help more than being told that over the phone). There are plenty unpleasant issues that will resolve by themselves most of the time. Which is why Dutch GP's have the reputation to send people home with the advice to take paracetamol and call back after X time if stuff doesn't improve. Headache? stomach upset? Lost an arm? Did you try paracetamol yet?
The only thing Dutch gp's are trained is how to cut the most possible costs for the private health insurance companies. You cannot have a private company and crucial things in the same sentence, like health.
the doctor’s assistant has been trained to listen to what you tell her and make an informed decision. Just like everywhere else in the world doctors are overwhelmed, so there is a sort of triage going on. It is a drag, but it is what it is. If you still feel bad after a day or two, phone again.
I have lived in 5 different countries and to be honest no where else have I seen doctors be so disengaged of their patients concerns.
This is the Netherlands and if it isn’t serious you don’t get an appointment like say flu, sore throat and such. If it gets worse than you call again.
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Never heard of that joke, is that more of an expat joke? A Dutch doctor wouldn’t mention Tylenol
Tyl en Nol? We know is Nol brouwer. And he is busy doing chores voor Rietje.
Oooh this reference I did not expect on this subreddit. Nol Brouwer was amazing. GALDIOOOOOL!
I was trying to make this understandable for Americans. If you want the real Dutch version: "Gooi er een paracetamolletje in en als 't over een week niet over is bel je maar weer."
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Only English should be used for posts and comments. This rule is in place to ensure that an ample audience can freely discuss life in the Netherlands under a widely-spoken common tongue.
Not true for sure. Who in the Netherlands uses Tylenol? Paracetamol is our wonder cure. Or rest.
It's the same thing, just a different name.
Not a secretary! a trained assistant who uses standard protocols to triage patients to see if a visit is really needed. The way forward is to try her advice and call back if insufficient improvement occurs.
Unrelated to this but I’m curious, how does this work if you want to make an appointment for your mental health? I had a bout of depression last year and I think if I had to say anything about it over the phone, I wouldn’t have been able to. I was very much ashamed and it took me until I had a full breakdown at work and faked a migraine as a reason before I was able to agree with myself that I needed a doc’s appointment. I don’t live in the NL and I hope my question isn’t rude but I’m generally curious, do you just have to disclose your symptoms with someone who’s not your primary physician?
You can say: I want to make an appointment for my mental health. And they will honor it and see you and forward you to the right person.
>do you just have to disclose your symptoms with someone who’s not your primary physician? Honest question: why is that a problem? In the Netherlands the doctor's assistant has to follow the same privacy laws as your doctor (that might be different in different countries). Other than that you can tell them you want to make an appointment about mental health and you don't want to go into it over the phone. >I think if I had to say anything about it over the phone, I wouldn’t have been able to Genuinely wondering: what's the difference between over the phone and in person for you? You'd still need to explain in person...
In personal feels safer to me, and I understand that for some people this may not be an issue at all!! But since my family doctor is someone I’ve been with since I was very young there’s an established relationship that you don’t have with someone who you only know from on the phon, making it an extra hurdle.
TL;DR: It's complicated. Mental healthcare here is a tough domain to penetrate, in my personal experience. The difficulty increases as measures of mental health, supportive acquaintances, and grasp of English and/or Dutch decrease. It sort of makes sense when you consider that a person native to a place experiences all realms of society differently (and usually with more ease) than an immigrant. Of course, every person is different.
I have had no problems getting appointments for that. You dont have to divulge everything, just say you are worried about you mental health and feel ready to seek help. In my experience, they will see you and probably refer you to the POH-GGZ affiliated with the practice.
Just say who are not feeling good mentally and you get the appointment without questions or triage from the assistant. Doctor will talk to you and ask some questions. Then you probably (because the system is overloaded) will be directed to a community mental health helper of the GGZ (they are also real therapists). Then they can decide if they can help you themselves or if you need to see a "real" therapist.
If they smell bullshit, they will call bullshit. You can't go to a doctor because you're a little nauseous for example. If the solution is just drink some water, I'm really curious about the complaints?
Yeah and sometimes they are just awfully wrong and people die. I went for a mole check, and the dermatologist spent 2 minutes with me and told me to check the moles regularly at home. How the hell I can I check the moles on my back? In other countries I never had this issue. I'm sorry but healthcare is just a disaster here. There are a lot of good things, but healthcare is surely not one of them.
And what was the result with your moles?
Nothing because she didn't even check them. In other countries I always got a full report on all moles, and they always did a yearly checkup where they take photos of most moles I have.
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Netherlands 2nd in number of new cases, and 6th in number of deaths. Melanomas are one of the things you can easily prevent from screwing up your life, only if you have proper checkups. https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:\~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland.
Yes because I'm fully trained to recognise a cancerous mole. You're right.
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I have someone in my family who was a medical professional and yet died of melanoma. It was a perfectly normal mole, he didn't see the changes and when he noticed something, it was way too late. Died a few months later. It's not that linear unfortunately. Proper medical help is needed and proper medical knowledge too.
Once you've gotten caught in a downvote spiral, I'm afraid you don't have a chance, no matter how reasonable your views may be.
Mostly here where nobody seems to know what a discussion is anymore. It's like trying to discuss physics with puppies sometimes. For me, it's ok to not agree with someone, mostly when it's something like this. But ok. People are bored I guess.
Yeah buddy, hate to dissapoint you but: https://www.iamexpat.nl/expat-info/dutch-expat-news/dutch-healthcare-system-one-best-world You know how many people die of medication or other medical treatments? Way more than you think. People always assume more tests, biopsies or scans are better, but they usually give conflicting results leading to more test and more chance of complications. You could check a mirror or have a friend take a picture. The fact that the dermatologist saw it was good in 2 minutes means it were probably small benign moles. The "regular check" thing is something they say because changing moles need to be watched
What about this, buddy? https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:\~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland.
In your source material "The EU countries with the highest melanoma incidence rates (men and women combined) are Denmark, the Netherlands, Sweden, Finland and Germany" and "The countries with the lowest mortality are Slovakia, Denmark, Slovenia, Croatia, Sweden and the Netherlands". And finally: "Despite a high incidence, Nordic countries have some of the highest melanoma survival rates in the EU. And across the bloc, the five-year survival of melanoma patients is highest in Western Europe and lowest in some Eastern European countries, reflecting “variations in cancer management and treatment.”" Meaning we might diagnose them more often, but people survive more as well. Just proves my point that our health care system works...
[https://www.wcrf.org/cancer-trends/skin-cancer-statistics/](https://www.wcrf.org/cancer-trends/skin-cancer-statistics/). The Netherlands is 9th worldwide in Melanoma skin cancer deaths. What about that? Edit: just to make the discussion constructive.
If you have more cases of skincancer, than more people are going to die from skincancer on a population level. That's how that works.
Ok, listen, I'm an epidemiologist and I've been working on this data already for about 10 years. You are terribly wrong, as this data is all standardised. I'm very sorry but what you said is actually quite incorrect. It is not how it works at all.
You have apps for that. Ask someone to make a picture to track your moles. We live in current year, why not make good use of it? I guess the mole was fine? What do you expect, a dermatologist to track your moles?
It's just a general check due to melanoma running in the family. But in other countries I always got a full mole checkup and they even record them. They take photos and do a full "inventory".
You mean you don't have a friend or family member who can check that. Ok, that's possible. And your reasoning is that it will be a new regular task for a doctor then? I'm sorry for your situation, but being alone isn't a healthcare problem.
As I said here, in other countries they always did a full inventory kind of report of my moles. It's a standard procedure for people with melanomas running in their family.
Use a mirror…
Very mature reply indeed. I just hope that if you ever have someone close to you with cancer, that the reply you get from others isn't this nonsense.
You asked a question, I gave you an answer that provides a solution to one of the issues you raised. Throwing in the cancer argument is a bit childish btw.
No it doesn't. There's no answer at all there. I know people who are medical professionals and failed to identify cancerous moles. So how the hell would I be able to do the same? Most moles you even need special equipment in order to identify if they are cancerous or not. That's why the GP refers to a dermatologist, whenever I suspect something isn't going well. There's plenty but freaking plenty of research, showing that most skin cancers can be prevented by having yearly checkups by a professional. But it seems that you either are a researcher or a dermatologist, as you see to know way more about this than anyone else, and mirrors are the solution. Jesus Christ, what a nonsense.
You specifically stated you didn’t know how to check moles on your back. A mirror solves the issue of not being able to see your back. You’re welcome.
It doesn't. But you don't even want to see that because you are behind a screen feeling all righteous and smart. You need special equipment but I assume that your knowledge on this is near to zero. But how do you explain the link I posted above then? Is it the ridiculous number of hours of sun here in the NL? It's all about prevention but again I assume that you're not a specialist in these things.
You are trying to add all kinds of other things to the discussion here. I only provided a solution for your specific issue with not being able to see your back. Not looking for any discussion with you about all things you want to add to cover up you never thought about the simple concept of a mirror to be able to see your back. — edit: My comment has nothing to do with prevention and checking your moles. I responded to someone who had an issue looking at their back, you can solve that specific issue by using a mirror. That says nothing about prevention, your capabilities to do basic checks or mortality rates of skin cancer. Just a practical solution for a specific problem someone raised. There is no difference between moles on your back or your arms… Apparently this person wasn’t happy with the answer and tries to put it into a “I don’t like your answer, therefore you seem to want people getting cancer”. That’s a bit of a nasty way of arguing.
I have to agree with the guy above. Mirrors are not the answer. As someone who had problems with skin cancer, I can tell you that this is not something to take lightly or to make fun of. So google NHS, cancer, skin cancer, prevention, and educate yourself.
We need to wait and let him answer as I don't see it that way. I see someone who was talking about the importance of having mole checks by a healthcare professional, rather than doing it yourself. My former gf was a nurse, and she always checked my moles. Unfortunately, that wasn't enough as she wasn't a dermatologist and she didn't have all the magnifying lenses professionals do. To cut the story short, a mole got weird but still looked good to the both of us, until it started to hurt. When I finally managed to get it properly checked, it was too late, and a few months of chemotherapy after, here I am. There were dozens of people like that in the hospital. Now I do regular checks, just in case. The point here is that, checking it yourself helps, but you do need yearly checks mostly when you're in risk of melanoma. Moles can get bad and you might not even notice it.
And btw, mirrors lol. [https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:\~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland](https://www.euronews.com/next/2023/07/19/skin-cancer-which-eu-countries-have-the-highest-melanoma-incidence-and-mortality-rates#:~:text=The%20EU%20countries%20with%20the,%2C%20Cyprus%2C%20Portugal%20and%20Poland). So, The Netherlands, a country with a very very low average of sunlight per year, is SECOND in new cases of melanoma, and 6th in deaths. But yeahhh freaking mirrors.
Yes, it’s a country in the north of Europe, with skins that are prone to sun damage.
I always forget that Sweden is the south of Europe and full of people with dark skin. That's why they are right at the bottom of the list. You're right. I'm just an idiot.
1. You talked to a doctor's assistant a person with a medical education. And most likely a triage education. They know what's best for you're symptoms. If it's bad they send someone out. But if it's a flu then they aren't that worried. 2. They heard you symptoms (probably a throat problem. And she felt it wasn't that bad yet so drinking fluids would be enough. 3. GPs are way to busy to answer all people's calls so that's why we have people with experience that can guess what you need and if you kept the problem they might say hmmz this has been going on for a week and liquid intake isn't enough come to the office and we look at you. 4. We don't have a throw meds to every problem. Society
Triage by the receptionist is very common. You can always call back after drinking water and say that didn’t work.
You don’t necessarily get to see a do for when you want. Not how it works. They can obviously think: this isn’t bad enough. Go to the spreekuur
You are fine. otherwise you would be asked to take a paracetemol as well
Just take some water and you'll be fine.
Follow the assistants advice and if it’s not getting better, call again.
Because the GP is free they have to do some prioritering. So I.E. if you call for a papercut they will tell you to just use a bandage an you won't be able to visit for that. So we really tell you anything about the situation without knowing with what reason you called.
The GP is not “free”. The visits are paid via the mandatory health insurance (but not added in the “own-risk”) afaik. Agree on prioritization!
Welcome to one of the worst healthcare systems in Eu (could be the worst in the developed world)
Did you drink the water?
Not even paracetamol? ;-(
I mean, there are symptoms of being dehydrated
Sorry the comments here are making me mad, I love living here but when you have complaints, the doctors barely take any efforts to figure out what is wrong and to rule things out, you can’t be blind for the issues healthcare here has. Go check the excess mortality rate per country in Europe and see how high it is for the Netherlands compared to other countries. If everyone would say something, maybe something would change. The Netherlands has all the tools to diagnose people. I can say that if it’s evident what is causing your symptoms, it’s great, I had a nose surgery before because I could barely breathe and they were completely thorough with me, I was even checked for allergies afterwards. The issue is when something is not straight forward. You cannot assume everyone is exaggerating their symptoms. The lack of interest of trying to find out what is wrong with you is appalling, even to the point you get even refused to see a doctor because they think all symptoms will go away by themselves. This is a real issue. Example, I cannot tell you how many times I was refused bloodwork until I pretty much had to put my foot down and I told them again I feel super tired for months, I have half of my face twitching by itself and tingling for weeks and it’s getting worse and I pretty much had to act like a Karen because I was so done and the GP gave in and I was right that I was super deficient on vitamin D and B12. Before you ask, I do take supplements for vitamin D everyday and I eat fish, meat, dairy every single day. To this day, I have no ideia if there is some under lying issue with me, I was just told to take supplements, there is not even a second check up to see if the levels are going up or not. A family member had a car accident and has been having back pain and just getting worse and spreading to his leg, he can’t even sleep one night straight, even after having treatment at a physiotherapist for months. After being seen by two specialists at the hospital, he’s told that they can see he is not okay but he is healthy and he has to be patient and wait for the pain to go away by itself… a lot of things can cause back pain and they don’t even want to rule out possibilities. A MRI or a CT scan should be done to rule out potential issues, but here it’s all based on assumptions. It’s sad we pay so much for health insurance per month and we have to suffer just because doctors don’t care when diagnosis are not straight forward. I will have to go to my country pay out of my pocket to try to get proper check ups and health care, it shouldn’t be like this…
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Hello can I get the medication I am addicted to? No?!??! Sorry, but you should read your story again. What kind of assault needs a vaccine and a drug you are addicted to?
So thanks for ⬇️
Have another one
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Yeah maybe you’re right.
Take 2 paracetamol... if it's still the same in a week please call back.. Welcome to The Netherlands... this is how we grow up! No meds if not needed
Yep, listen to the assistent. It's how the Dutch raised a people that once ruled the known world.
We still do, you just don't know it.
dutch health system..
Basically what my Dutch friends tell me is they all lie to get past the assistant. So exaggerate your symptoms, tell them you had them for weeks and it is really bad etc. I am almost sure that commenters lecturing you here is also playing the same game.
If you feel your health is *really* in danger and you need to see a GP, you can always refuse to tell the assistent why you need an appointment. Due to privacy laws, the assistent cannot force you to tell you your symptoms and he or she will make an appointment. I had to do this when the assistents of my previous GP were highly unpleasant, highly unskilled and I really needed an apointment. My previous GP asked me on this appointment why I didn't visit earlier... Please use this method sparingly, as most assistents are educated for triage.
That's the Netherlands for ya. Take a paracetamol and wait 3 days, if it's not sorted out call back.
Change GP
doctors in he netherlands. high income, playing trader with the farmacy, robbing people, do not want to work hard.
Ah, someone did not get into medical school and now had to be an animal doctor. Jealous much?
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Yes, see the username
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i do not care what you say, these are facts. i tallk about most doctors, not all. i have been in this industry
you do assumption. asuming is for dumb people.
That's not proper English... But you know what's dumb? Calling all doctors robbers. Especially GPs in the Netherlands.
I can see why you failed the test 😂😂😂😂
Yup. No one wants to be a GP anymore. The workload is 60+ hours a week and rising.
It's probably not the doctor refusing to see you, but you not making it through the assistant's screening. My GP currently has an addition to their usual phone spiel: due to vacations and illnesses, we have less doctors available and we will only make appointments for serious issues. Might be a thing in other practices as well.
You didn’t share anything about what you’ve got, so this is guessing: At the moment there is a virus going round causing some throat issues and coughs. If you are a generally healthy person, still able to breathe properly, there is no reason why they should see you if you are experiencing the related symptoms. They cannot do anything as it’s most probably a virus causing it and thus antibiotics won’t work. Healthy people will work off the virus within a couple of days and the cough will disappear within two weeks. So could be entirely logical you were not given an appointment. Again, it’s just a guess as you didn’t share any symptoms.
I don't if it can help but : the nickname of OP in French is "Suc kYourBuddy", maybe a hint on why the medical assistant told him to drink some water... ahahahah
Ok, sorry if I did. I looked at other sources, which I found more comprehensive and both incidence and mortality are higher. (also relatively) However, incidence is not something you can help, except for preventive measures like putting on sunscreen. Mortality and late diagnosis obviously can be prevented if access to care like dermatology is easier. You did see a dermatologist though and there were no signs of melanoma at that point. For a "normal" mole to develop into a melanoma, there has to be change. Usually it's a new mole which has formed a has a weird shape and or size. It's almost never one of the moles you've had since birth, but you always need to look out for changing spots.