Momma Knows Best

We knew it was just a matter of time before we'd be experiencing the Dutch healthcare system firsthand. This last episode even included a bonus trip to the ER. Might as well go big, right? It all started last week with Brie running a high temperature between 103-104F. Knowing the Dutch approach is to wait and see, I bided my time with plenty of Children's Motrin and Tylenol horded from our last trip back to The States. Sure enough, even after three days, I was told "give it a few more days" and call me on Monday.

Before I go further, I have to mention a few pros and cons about healthcare in the Netherlands:

 It's not bad, it's just different: Pediatricians are only seen for routine checkups and vaccinations through the government's children bureau. Kids go to the GP for all immediate issues just like an adult. This can be frustrating as the GP does not see kids often enough to cater to their common illnesses. Case in point, getting a flu shot here for a kid (or adult) is a rarity especially if they are deemed healthy. We went through a bit of red tape to get it but things were made worse by the fact that the nurse administering the vaccines had little experience with children. First, she asked ME where it should go. Then poor Brie was stuck with the needle not once but TWICE since the nurse pulled it out for fear of hurting her.  

Efficiency, Cost, and Control: You can't just go to any doctor. The location (our postcode/zip code) dictates what doctor(s) are available within a certain radius of home.  I can't complain about a 5 minute walk to see the doc. The costs appear to be lower since an out-of-pocket visit is $30 (without insurance) compared to a $75 copay for our doc back in Nashville. However, lower cost comes at a price. The GP is the gatekeeper and it is up to them to refer you to a specialist or the ER. Without their approval you can't pass GO and forget about collecting any medications.  

Finding someone who cares: For the Dutch, customer service is not a priority. From dining out to healthcare, there is little incentive to provide extraordinary service. In trying to get an appointment for the GP, the office receptionist mom-shammed me for debating to bring her in since the only appointment time conflicted with a job interview. To make matters worse, she told me they would reject my ER request (the only urgent care option) since an appointment was available. When asked if I could be placed on a wait-list in case of a cancellation, I was told there would be no cancellations that day. Ugh! Talk about making life difficult.

On Saturday morning, after four days of high fever with a kid not eating, sleeping, and generally miserable, we headed to the ER. Upon pulling up, we were greeted with an empty parking lot and a single person in the waiting room. Further proof that GP gatekeeper/approval system seems to work. 

Our ER doc experience mirrored the GP visit with the same "wait and see" diagnosis. I dug in my heels as I couldn't bear another day without a solution. We suspected it could be a UTI (yes, kids get these) with the help of Google and WebMD. The three hour ER ordeal was worth it when the results came back positive-ish. The doc believed the sample had been contaminated and was only 80% confident. He suggested that we catheterize Brie to get another urine sample and test again. What? It was tough enough getting a toddler to pee in a cup! With my feverish toddler nestled in my arms, I tried not blurt out "Are you crazy? No way in hell is this happening just to be 100% sure she needs amoxicillin." Ben, seeing the look on my face, quickly asked if it was necessary and if we could get the antibiotics without it. This should be no surprise as Dutch doctors are notorious for a selective prescribing habit. The Netherlands has the lowest prescription rate of antibiotics compared to all other EU countries. 

There is something to be said for the Dutch approach as the Netherlands doesn't have an opioid epidemic or antibiotic resistance issue. It's also worth mentioning that the Dutch Healthcare System has consistently outranked the U.S. in terms of healthcare quality. 

While I respect the system that is in place, healthcare is personal. Trusting your intuition is sometimes the best prescription you can give yourself and your family.  Stay well!