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?