You have a choice even if you are sick

In fact, it is so self-evident: consider carefully before starting medical treatment. Yet comparing hospitals and specialists is not nearly as common as comparing telephone or energy companies. Why not? Research by the Dutch Patients Consumer Federation (NPCF) shows that information deficiency in particular hinders patients from taking action themselves.

The same study also found that two in three patients feel their quality of life improves through active involvement in treatment. Three quarters believe that it leads to better treatment results. So put all trepidation aside and take matters into your own hands…

Does the GP not refer?

In case of complaints, the general practitioner is the first counselor. The general practitioner is the one who decides whether a referral to a specialist is necessary. If he does not refer you, while you would still like to submit your complaints to a specialist, you can approach your health insurer. They employ care mediators who can think along with you and advise you. Such a healthcare mediator can make use of the expertise of the advisory physician. Keep in mind that the health insurer is careful not to sit in the GP’s chair. In the end, the doctor has the last word.

What can also help is to collect information about your complaints via the internet in advance, so that you know what you are talking about during the conversation with the GP.

Which hospital am I going to?

Even if the GP immediately writes a referral letter, there is an active role for the patient. Ask why he refers to this particular hospital or specialist. Does this specialist have a lot of experience, is this the best hospital in the region, or do you need a diagnosis quickly? The travel distance is often an important factor in your choice. Logical, but when a major treatment is required, the quality of the hospital also plays a crucial role. It is therefore important to discuss this with your doctor.

Often the choice for a hospital is not so rational. A small and well-known hospital often enjoys the patient’s sympathy. Are you unsure about choosing a hospital? Please contact the health insurer. Most health insurers have care mediators in-house who have a good overview of the various care providers, who can give you a lot of information and can offer support.

In this way, a care mediator knows where to turn for, for example, a mammography, an MRI or CT-scan, so that you do not have to wait unnecessarily long for a diagnosis. He can also indicate which hospitals specialize in a large number of common treatments (such as knee and hip operations and the treatment of prostate, breast and esophagus cancer). That can be a large hospital, but sometimes small hospitals excel in certain procedures.

The healthcare mediator can also immediately tell you which hospitals and clinics have been contracted. For some procedures, health insurers have contracts with Independent Treatment Centers (ZBC, formerly private clinics), which can perform minor interventions at lightning speed, such as placing a new meniscus, repairing an inguinal hernia or cataract surgery. The condition here is that your general health is good, because an independent treatment center has less medical equipment than a general hospital and also does not have an inpatient ward.

Can I go abroad?

For some treatments you can go to a foreign hospital more quickly. There are certain treatments that are still classified as experimental in the Netherlands or are not offered, but are offered in a foreign hospital. This always requires prior permission be requested from the health insurer. This is pre-eminently a matter to be discussed with the healthcare mediator and to be assessed by the medical adviser. Not only to check whether the treatment is reimbursed – that is by no means always the case – but above all to weigh up all the pros and cons.

For frequently occurring treatments, which are covered by the basic insurance in the Netherlands, insured persons can go to Belgium, provided that the hospital in question has a contract with the health insurer.

Who will give me a second opinion?

A second opinion is an established concept: if in doubt about the opinion of specialist number 1, ask for a second opinion from specialist number 2. A second opinion is usually intended to obtain certainty about the diagnosis and the choice of a specific treatment.

Everyone is entitled to it and most supplementary insurance policies reimburse it. A referral letter is required, which you can ask the first specialist or the general practitioner. The first doctor will often be able to name the doctors from whom you can ask for a second opinion, but the patient association and the health insurer’s care mediator can also give you the names of specialists. In the case of ankle or wrist complaints, the healthcare mediator can, for example, point to a specialized center, which may have a different view of the complaints than an orthopedic surgeon at a normal hospital. But the insurer also keeps lists of other specialists who can be approached for a second opinion.

Am I choosing the right treatment?

Sometimes the specialist proposes various treatments, without indicating a preference. Each treatment has its own pros and cons and you have to choose for yourself. Fortunately, the necessary information is available about many treatments: in the hospital’s patient brochures or on the hospital’s website.

Often there is also a patient association that can help you further. Such an association often has a wealth of knowledge in-house about treatments. Through this association you can also come into contact with fellow sufferers, who may have already gained the necessary experience with a certain treatment. Patient forums on the internet are also a source of information, but be careful with this. The experience of another cannot always be literally translated to one’s own situation. Therefore, consider the stories of other patients as additional information and, if necessary, check them with the attending physician. If the choice stress is too high, you can also request a second opinion in this case: does the second specialist perhaps recommend a specific treatment?

After the first treatment, it remains to be seen what the result is. If that doesn’t work, then the question is: what next? Even though the collaboration with the specialist has run smoothly until now, opinions may differ due to a disappointing result. Perhaps the doctor now wants to continue, while the patient would rather stop taking the drugs or treatments that are burdensome for him or her. Or the doctor sees no point in a follow-up treatment, while the patient wants to see results at all costs. Even then, a second opinion can offer a solution.

Who will help me arrange aftercare?

After a major treatment in the hospital, it is not always easy to pick up life again. Sometimes home care is required, sometimes a stay in a care hotel or rehabilitation in a care institution. The basic principle is that you are entitled to care that is medically necessary, including psychological help or medical assistance physiotherapy. If the attending physician does not refer you to this care, you can ask your general practitioner.

In the event of discharge from hospital, the health insurer also comes to the rescue, for example by helping with the application for medical aids and home care.