What's Up, Doc?

As I mentioned in my previous Week at a Time post that, I recently went to the doctor for the first time since arriving in the Netherlands. I thought I'd share my experience since it differed so much from my experiences with doctors in the U.S. I'm not sure if the differences were due to the particular physician that I visited, or whether these differences are standard, but at least they make for some interesting reflections (at least in my mind).

Before we left for the Netherlands, my doctor had given me a sample of a prescription that would last me about 9 months.  I realized it would run out before I got home, but I only recently started to research the process of having the prescription refilled. I realized I needed to make a doctor's appointment to get a new prescription, and because I'm accustomed to having to wait to get into the doctor's, I decided I should make the appointment early. I had also heard several stories (via expat get togethers and online forums) of people having trouble scheduling appointments in the summer when much of the country is on holiday, so I was concerned it might take a little longer to get into the office if I waited a few weeks.

When I called to make the appointment, the receptionist advised me that I would need to register with the physician's office using their online form. She told me to fill out the form, wait for an email confirmation, and then call back to make the appointment later in the day. I didn't receive the email confirmation, so I waited until the following day and called back to make the appointment. I was surprised that the receptionist didn't ask for the reason for my appointment, since in the U.S. most of the time you can get in relatively soon if you are sick but normally have to wait longer for something like an annual exam. She went ahead and scheduled my appointment for the following day.

I arrived a few minutes early at the doctor's office and flipped through the Dutch magazines and children's books until the doctor called me into her office. The office was set up less like the American physicians' offices with which I'm familiar and more like a business office. Instead of a bench/bed to lay down on for an exam, the office had a large desk. The physician sat behind the desk and directed me to the seat on the other side. She proceeded to ask my reason for the visit.

I told her about my need for a new prescription, and she asked me a few clarifying questions regarding the brand and my satisfaction with the drug. Then, she found a similar drug in the system, printed me a prescription on the spot, and after asking if I had any other concerns or questions she sent me on my way.

I paid 30 euros in cash at the check out desk and received a receipt to file with our insurance. (Notice that the price for the entire appointment before insurance was filed was about the same as a copay in the U.S.) The process was quick, easy, and painless (literally... no needles or pushing and prodding). I would say, though, that while I enjoyed the absence of tests or procedures (considering I have plans to visit my regular doctors when I go home for annual visits), I'm not sure this lack of attention to detail would always be preferable.

I think the general mentality of Dutch medicine is to only treat what is wrong. Emphasis is certainly not on prevention or catching things early, especially in the area of women's health, as the following practices tell us:

"Routine check-ups are not the norm in the Netherlands. Women have pap smears every five years and those over 35 get a mammography every two years. There are no regular screenings for different types of cancer."

"In the case of pregnancy it is not common that a gynecologist checks a Dutch woman after the age of 30, even if she’s pregnant with her first child."

As a temporary expat, living here for a little less than a year, these practices hardly affect us. It would definitely take a little adjusting, however, if we were planning on staying longer. For now, though, I just think it's interesting to consider the differences in practice and mentality.