First Contact with the Dutch Health Care System

On the afternoon of March 2, I paid a visit to our Human Resources representative on the second floor. Luckily, she was in. She only works a few days a week at our site, and I hadn't memorized which days. I showed her my lump and explained that I had no regular physician, seeing as I had not had any serious illnesses in the 2 years since I moved to Amsterdam and never got around to translating all the insurance literature I had been receiving in Dutch.

She was concerned. She called a few doctors for me, but the earliest available appointments were for Friday and it was only Monday. She suggested then that she drive me to the emergency room at the AMC, the academic medical center which happened to be just a few blocks from the office anyway.

The AMC struck me as a bit disorganized (and in fact, I was later to have this impression during many interactions with the Dutch health care system). The uniformed security officer waved me in to another room, where a nurse was supposed to do intakes. The nurse explained that there were 2 others ahead of me, so please take a seat in the waiting room. But she didn't take my name or give me a number, or even ask what my problem was, so I wasn't sure whether she was going to remember me or in what order I arrived. And 'triage' didn't seem to be in effect. The couple that came in after me, with a kid whose hand was bandaged up, received the same handling. They were Dutch, but just as confused as me, because they tried to go back to ask if they shouldn't at least provide a name, but the nurse waved them into the waiting room again.

More and more people trickled in. About 30 minutes later, the security guard came in and pointed at me. "You're next". And then he pointed at two other people in the waiting room in turn. "And then you, and then you." So, they were paying attention after all.

But the 30 minute wait was just to get my intake interview. I explained in Dutch that my Dutch wasn't that great so perhaps it would be easier if I continued in English. "Easier for you maybe, but not easier for me", the woman replied back in Dutch. Oh okay. It wasn't so much that I didn't want to use my Dutch, but over the years in Amsterdam, I had been conditioned to think that most people preferred to speak English with native English speakers whenever they could.

We muddled through and I felt a brief sense of accomplishment afterwards. If nothing else good came out of this, at least I could see that I was making some progress with the language.

An hour later, I was sitting on the hospital gurney showing the first of three medical professionals in succession my lump. It seemed to me, though I can't be sure, that the three all had different types of clothing, indicating perhaps that the first was an intern and the second a resident, and the third a bonafide doctor. They asked questions and prodded around the area of the lump. The second professional told me that he didn't think it was coming from the breast area, and so it probably wasn't breast cancer. None of them would say anything more specific than that about the lump itself. The third professional told me that this did not qualify as an emergency and that I should make an appointment with a regular physician. Oh, I didn't have one? He asked where I lived and luckily, he knew of a good one whose office was just down the street from me.

When I got back to my own office, just one stop away on the Metro, I called and was able to squeeze in an appointment for Wednesday afternoon, which was a lucky break because I was leaving for a business trip to Milan on Thursday.