Wednesday, 18 February 2015

Why Dutch Doctors Are Stingy with the Drugs

Dutch doctors have a notorious reputation amongst expats as being a tad stingy with dishing out pills. No matter what ailment you drag yourself to the doctor with the answer to your problem is invariably paracetamol. (There is a fabulous chapter in Dutched Up!: Rocking the Clogs Expat Style on this topic written by the wonderful Lynn Morrison which you need to read!)


Until I moved to the Netherlands I really had no idea about all the different varieties you can get paracetamol in - factors pertaining to strength, format (i.e. where you can stick it) and target group. A whole new paracetamol world opened up to me when I became an expat here in the Netherlands.

I also learnt that if you want a Dutch doctor to take you serious you must have already gone down the paracetamol road. Otherwise don't dare to darken his or her doorstep with your ailments.

Photo Credit: Richard Dunstan
However, when you are in pain, really in pain, the kind of pain that leaves you hobbling in to your doctor's office in tears, your pain will be rewarded. I was recently prescribed diclofenac for the pain caused by what my doctor thought was a possible hernia - and told to take it with paracetamol three times a day. (Paracetamol is never replaced, it just gains a friend to join it along the road of pain.)

I took diclofenac and lo and behold I felt no more pain. I could walk again. However by day five I felt like a bus had side swiped me. My head throbbed, I felt like someone had blown me up like a balloon. My stomach cramped and ached. I constantly felt like I was going to vomit and I felt so damn tired.

So I stopped with the pills. And carried on with paracetamol only. And a little over twenty four hours later I felt more like myself again, and was almost pain free.

Two weeks ago my husband had keyhole surgery on his knee. He can't take the usually prescribed naproxen which is prescribed in these 'pain' situations as the side effects make him very ill, usually feeling much worse than the ailment itself so instead the surgeon prescribed him morphine based pain relief.

Which make him sleepy and irritable and which play havoc with his stomach some days. He also keeps scratching himself like a flea ridden monkey - but his post-surgery pain is considerably reduced.

If you read up about the drugs I have mentioned above you may (or may not) be alarmed to read warnings about usage and an increased risk of a stroke or heart attack, or fatal stomach or intestinal bleeding. The long list of possible common side effects for each pain relief medication leave your eyes bulging and mind boggling.

Photo Credit: Niels Rameckers
Oh! Wait a minute.... is this perhaps, maybe, possibly, why Dutch doctors don't dish out these pills like sweets? Maybe, just maybe, this is why Dutch doctors make you try everything else first......and save the strong stuff as a last resort. Maybe. Just maybe.

What is the trend with doctors where you live - pill happy or stingy with the meds?
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8 comments:

  1. Ace CB18 February 2015 at 11:59

    Oh so true! My success with the Dutch docs has usually come down to telling them how long I've waited before calling them and all the alternatives attempted first. They seem to appreciate your self-reliance more than the American docs would. When I broke 2 (!!!) ribs coughing in 2013 after a prolonged plague after a quick explanation of what I had tried on my own for a few days before calling, I got a prescription for Codine-laced paracetamol right away (which was extra handy when I proceeded to break a 3rd a few days later). I'm not one to try a lot of pills anyway, so I appreciate that the docs here don't just fill you up without much explanation - and I'm glad to be spared all the stomach issues.

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    1. Amanda van Mulligen18 February 2015 at 14:39

      What?? You broke 3 ribs COUGHING??? What??
      I'm not a throw pills down ya neck sort of girl either so the Dutch way works for me!

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    2. Ace CB19 February 2015 at 16:56

      Yeah... it was kind of awful. But in the US I'd probably have been put on something ridiculously, overly strong. I'm little, so my body doesn't always take well to various pills. I appreciate the Dutch doctor's restraint in that respect.

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  2. Anonymous18 February 2015 at 13:56

    Indeed. The same applies to antibiotic use. In some other countries they are prescribed as a placebo. Here you will only get them if you genuinely need them and if you have a bacteria that needs fighting. Other countries are belatedly starting to adopt this strategy as they realise that overuse is encouraging superbugs that have become immune to antibiotics.

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    1. Amanda van Mulligen18 February 2015 at 14:40

      It's takes quite something special to get antibiotics from a Dutch doctor.... and indeed overuse is just not handy!!!

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  3. Ashley18 February 2015 at 14:38

    This is so true - I once had a doctor who for 6 weeks and 4 appointments told me to keep doing what I was doing (which clearly wasn't working), until they finally referred me to a specialist.

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    1. Amanda van Mulligen18 February 2015 at 14:41

      Yes, there has to be a limit if something isn't working!!! Plan B please doctor....

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  4. AlleyPat5 February 2017 at 22:00

    I avoid Tylenol, whatever brand name it is, because it's REALLY bad for the liver and The Netherlands and Belgium are testing it for accumulated brain cell death over the years and fostering dementia. Gimme good old fashioned aspirin and I, too, like that Diclofenac and Flucsomething I forgot the name LOL. I also get lidocaine cream. Good post. I love Holland. :)

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