Holland Expat – Emergency Room Gatekeepers

15 Dec
Construction near the hospital forces an almost complete loop of the facilities before entering the ER drive way.

Construction near the hospital forces an almost complete loop of the facilities before entering the ER drive way.

On a crisp winter day our family was enjoying the third basketball game of the season and cheering our older sons when it happened. You know the moment in sports contest when one player collides with another making the smack that causes every parent to cringe? Well, this time my son went up for a lay-up (made it), took the hit and it was the floor he whacked with his body.

I confess I’m not above screaming “No injuries!” from the bleachers. It was too late.

Getting to the emergency room in the Netherlands is quite different from the US where we hop in the car and take off expecting long waits for anyone not arriving in an ambulance. In fact, if you’re not arriving in an ambulance here, you need an appointment. (Link to emergency numbers and info in English here.)

My friend, who happens to be nurse, reminded me that I needed to call SMASH (i.e. Mobile Doctors Service The Hague – (070) 346 96 69) and consult with their service about the injury and whether or not an ER visit was warranted. I’ve heard these are chargeable calls, so I’ll not be surprised if a per minute toll hits my phone bill. Apparently since everyone knows this, there was no need for the call-line to tell me.

Conversation went like this–bruising, no relief from pain after resting and pain killers (i.e. tylenol), purposefully shallow breathing, and, most concerning to Mom, refusal to eat dinner. Was he nauseous? Did he hit his head? No and no. The bruising was close to a kidney, maybe a floating rib broken, Dad said. “Bring a urine sample from home to save time,” the nurse said.

SMASH determined emergency diagnosis necessary and made an appointment for us with…a general practitioner (i.e. GP), the gatekeeper to almost all healthcare in Holland. Our appointment in one hour, we packed books, electronics and the requested urine sample. Glad I had that small jar on hand.

Because our insurance is US-based, the next step was to call them and get cleared for the appointment. For us the GOP is not a political designation, rather it is a “guarantee of payment” so that we can receive care without having to pay upfront. On the weekend and off hours, though, the staff who issue the GOP are not working, so I was grateful for the recent funds transfer we made to our NL bank account in case I needed to pay for services on the spot.  What about using a credit card? Not an option, see “My Credit Card Doesn’t Work?” for more on that.

We arrived at 8:40 for our 8:50 appointment. We did not enter the hospital, though. A make shift (i.e. looked temporary) entrance led us into a small waiting room. That’s where the differences could really be seen.

There were three or four groups waiting. Groups, you say? Yes. Where my husband stayed home with the other children, here it appears most everyone comes. Beside my son and me were parents with a coughing babe and their toddler. One family entered with a teen and no less than five adults.

Although attached to the hospital, paramedics arrived with their wheeled stretcher, greeted us all “Hallo” and then took a walk-in patient out strapped to the conveyance a few minutes later. Was he going to another hospital? Being admitted to this one? I can’t say. I do know greeting everyone as you enter the waiting area is common because some other new arrivals did that as well.

And hold on–what’s this? Free coffee, tea and water. Why thank you, thank you very much. I thought the drink station in the grocery store was nice, but the ER beats that hands down. Wonder where else my teens will get free hot beverages this winter?

We were called back by the doctor himself at 9:05, so the only nurse we interacted with all evening was the one that took our call at SMASH. We sat in chairs facing his desk, described what happened, then my son stood and took off his shirt. There was some prodding, checking of ribs in the area, notice of the bruising and we all sat back down. Broken rib confirmed, ribs above and below fine. They’ll hold that one in place. Limit movement for 2 weeks and take extra pain-killer at night. (Paracetomal again, see more here.)

That was it. No temperature taken. No blood pressure measured. No x-ray to confirm what the doctor already knew. We were out of the exam room in 10 minutes even with our couple of questions asked and answered. I inquired at the front desk and found we would get the bill in the mail, and we were on the road and home by 9:45. This is the kind of Dutch pragmatism I can appreciate in terms of time and money saved.

Now if I can just get my son not to over do for a few weeks.


Kristin King is an American author recently relocated to the Netherlands. To peruse her novels and author information visit this link

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Posted by on December 15, 2014 in Living in Holland


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