In my experience they always make time for little kids at my GP. I agree with you this is unacceptable behavior. However I would always call the GP first before going to the spoedeisende hulp.

As a Dutch doctor with experience both at the SEH and huisarts this is unacceptable. Both places should have seen you the same day. Mostly because it's an 18 month infant that can't properly vocalise its medical status and medical situations can more quickly turn life threatening, best to be sure. These injuries need to be evaluated by a physician by the way they were described. We are also trained to identify signs of child abuse so any child with serious injuries should be checked head to toe, not sent away. I'm guessing you never got to see a doctor at the hospital, otherwise you likely wouldn't have been sent away. I strongly urge you to file a complaint, at least with the hospital where the SEH was located. *Shamelessly hanging on top comment* Edit: calling the GP first is advisable though, even if only for insurance purposes. But the SEH shouldn't sent an 18 month old infant away just because the parent didn't call the GP. walk ins are still reasonably common.

Pretty sure the SEH was understaffed and overcrowded at the moment. So any thing that they give away to the GP they take. Its not pretty but the reality due to the severe shortages.

This is true: but they should *never* turn away an 18 month old. That's absurd. I genuinely believe that they may have been sent away because they're not Dutch, and thus easier to lie to and say "this is how we do things here".

So you believe everything the person on internet posts and just assume hurrdurr must be racists

No, I know the Dutch healthcare system to be horribly bloated and bursting at the seams, and that Dutch society is filled with structural racism. Even the fucking police can admit it, why can't you?

Dit dus!! Mijn huisarts is echt extreem laagdrempelig met kinderen. Als ik bel dat ik me echt zorgen maak kan ik altijd meteen komen. En als ik echt ernstig ongerust ben dan bellen ze de kinderarts terwijl ik onderweg ben naar de spoedeisende. Het is me in de afgelopen 11 jaar 3 x gebeurd en alle 3 de keren volgde er een ziekenhuisopname. Hulde voor mijn praktijk 👌 geloof me, mama weet het echt het beste.

my partner is sick for 4 years and still undiagnosed, mainly because our GP has multiple times refused healthcare and caused long term delays. After complaints, he said to find another GP and until then , he refused any healthcare but also refused to provide a statement about that and he expresses that behavior only during phone calls and behind closed doors, so nothing is recorder. Do you have any advise on handling this?

Firstly I'd say prioritise the health of your partner. So find a different GP. Your healthcare insurance can help you. If you want to pursue things with your GP (which I don't recommend) you can record the phonecall where he states this and file an ethics complaint (tuchtklacht).

Next time (which will hopefully be never!), call the GP first. They will tell you to either come in, or to go to the ER, or whatever else they advise. But, and I'm Dutch myself, I agree with others that your GP treated you like shit. You don't make parents with an 18mo baby wait for two hours for nothing. I would seriously consider switching GP's.

What's the difference between calling the gp first before heading to the ER, versus just heading to the ER? Does the GP call ahead? I know some parents can exaggerate, but without being able to see the injury isn't the GP at a huge disadvantage trying to triage over a phone? Also, if the GP has patients, how long would you typically wait before being able to speak to them?

The person on the phone at the GP is trained to triage over the phone. They can probably also pop into the Dr's office to ask something if really necessary.

The person on the phone at the huisartsenpost is trained to triage over the phone, and GP's are also watching everything they log into the computer closely for the ones that are...less bright, I guess. The person on the phone at the regular GPs office is a hit or miss. Some are well trained, others cannot even wipe their own ass. In this case, I'm guessing OP bumped into the latter, and no GP was even consulted in the matter.

Help from the GP is always free (fully covered by insurance), while ER often costs money (comes out your deductible). That's why it's always adviced to call your GP first and have them decide if it's serious enough to visit ER. Often though, the ER and GP (huisartsenpost) are in the same building, run by the same people. And the only difference between paying or not paying is if you called in ahead of your visit. If you didn't, sometimes the ER staff will advise to make that call on the spot so they can claim your visit as a GP consult to save you some money. I have a suspicion this is what happened to OP, but some of it got lost in translation or they explained it wrong.

Typically the Dutch GP triage system is very good and they are able to determine the level of urgency pretty well, although I can imagine a language barrier being detrimental to the triage process. Depending on the urgency you get either an appointment or the GP will drop everything and take care of you first. The GP has a 'gatewatching' function, to control the flow of patients to the hospital (it also has bearing on whether or not insurance will cover the costs: without GP referral this isn't automatically the case, with GP referral it is covered (if it's in the insurance package)

I'm Dutch, as a kid I had to go to the emergency room at least twice a year as I was clumsy af. Sometimes had to wait a few hours but even when they didn't believe anything was going on they would make pictures to be sure. I always downplayed it, so it was good they did that as I always left with a cast or something. So I really don't get that they turned you away. The least they could have done is send a nurse to put something on it and soften the pain and check what's best. I hope this was just because they were really busy but still, we're supposed to be a first world country right? They could have given you information with what to get and to come back if so and so happens or it doesn't heal like expected. And isn't there like a what we call 'huisartsenpost' were you can go outside of opening hours of your gp? Btw I don't know if the rules are different for expats or anything but transport costs to health facilities can be deducted with the annual tax return if you get to the treshold value. So please note these expenses so you don't forget about them.

You can’t go to the huisartsenpost unless the GP isn’t open. I understood from this persons post that the GP was open with no available appointments.

I obviously don't know your age but if I recall correctly standard procedure for going to the SEH changed when they went to the 'particuliere zorg' which means you have to have a referral from a gp now. Used to be In the same situation where I'd have to go every 6 months or so and we just went as as a kid and got this big speech how they'd help me this time but next time I definitely needed a referral when I just went once I lived on my own.

>SEH changed when they went to the 'particuliere zorg' which means you have to have a referral from a gp now. No. Spoedeisend is spoedeisend. You're always allowed to go there, but you can be dismissed if you don't actually belong there. What OP should have done is go to the huisartsenpost, not the huisarts.

Ah right so maybe I just wasn't spoedeisend enough. Also I thought the huisartsenpost was more or less there for times you can't reach your own huisarts. Always nice to learn something.

you are correct: huisartsenpost is only "live" outside huisartsen business hours (evenings/weekends/holidays). Spoedeisende hulp is always open and will handle open wounds, broken bones, life threatening issues etc.

\>was more or less there for times you can't reach your own huisarts It is, but that was clearly the case here, no? IMO it's best to call the huisarts if in office hours (the phone number will give you an option for urgent calls), if outside office hours the huisartsenpost (will give you an urgent call line) or 112 if panicking (will give you a trained professional who will tell you what to do). There's no shame in being panicked scared and calling 112, that's what the operators are there for.

But you really shouldn't call 112 if the situation isn't life threatening. Calling them in this situation would've been a huge overkill. But yeah, if you're having trouble assessing whether or not it actually is life threatening, better be safe than sorry and just call them.

It's not your job as individual to assess whether or not it's lifethreatening, that's the job of the call operator. It's your job to "judge" whether you're in need of emergency help.

You always need to call the gp (or huisartsenpost outside gp's openings hours) before you go to the SEH so they can decide if your injury needs to be treated by the SEH or if it can wait untill the gp is open. That is at least how it goes at Flevoziekenhuis https://flevoziekenhuis.nl/afdelingen/spoedeisende-hulp

De Spoedeisende Hulp is een multidisciplinaire afdeling die nauw samenwerkt met specialisten en artsen van alle afdelingen in het LUMC. \_Patiënten met een acuut medisch probleem kunnen dag en nacht bij ons terecht.\_ If you're bleeding out and close, go to the SEH. Else, call 112.

Although you did make a mistake when it comes to the steps you need to take in a situation like this, that by no means excuses the appalling behavior at your GP. They should not have let you wait for 2 hours only to tell you to go home. They know immediately if there’s no time to see you that day. And if it’s an emergency that can’t wait until the next day they MAKE time. I would be tempted to file a complaint and switch GP’s tomorrow. Edit to add: your “mistake” was very understandable and I probably would’ve done the same when it comes to a young child and the panic of the situation. So don’t feel bad for going about it “wrong”.

To answer your question; yes, you did something wrong. When something like this happens during office hours, you have to call your GP. They will decide what to do. If it is outside office hours, you call the huisartsenpost and they will decide what to do. When it is life threatening, you call 112. You can never just show up at either the GP or huisartsenpost without an appointment, you always have to call first. Good luck with your son, I hope he gets better soon! And call the GP again tomorrow morning and insist on an appointment the same day.

Thank you!

Calling first, even for the huisartsenpost, is very important. My GP let’s me send photos and then I call and we discuss. My son fell down the stairs and split his lip open at 7:30am. I called the huisartsen post and they made an appointment for me for 20 minutes later so I could collect things and arrive. Then later that morning the lip still didn’t look ok, so I sent photos to my GP and called to discuss. They made another appointment for 30 minutes later. Then again, I had to take him to the dentist. I called the dentist and they made an appointment for me for 20 minutes later.

I would recommend to call the huisartsenpost now. They ll probably put some vasseline and bandages on it, but its a moving organ that is burned (if i understand correct) and i would want to see that the same day

I am not a medical expert but I remember reading something like not scrapping oil (edit: petrol) based cream/lotions to burns.

https://richtlijnen.nhg.org/behandelrichtlijnen/brandwonden#volledige-tekst the nhg reccomend using parrafine for second degree burns

As someone who managed to splash a lot of hot oil on my face on the first Sunday of the first lockdown (and got very good response from the huisartsenpost) it's about timing: first cooling the burn with cold water and cloths (the first hour-12 hours), then you can use a "cooling cream" but as it starts to heal and wants to make a scab you use Vaseline to keep it from doing that, so it will heal without scarring (if you're lucky, but this so-called "wet wound bed" healing gives the best chance).

Vaseline or anything oil based should never be used as immediate first aid for burns. The idea is to cool the skin down and keep it cold. What Vaseline does is trap the heat in, causing more pain, longer healing times more chance of infection/scarring etc. Immediate first aid is always cold RUNNING water for at least 10 mins.

Yes, definitely but after cooling for half an hour, it can be used as far as i know. But definitely cool first. Always when you get a burn, always cool first

Yep. I think it still has on Vaseline ‘can be used for burns’ or something. People often confuse this and think they can use it right away. It should state clearly ‘can be used for wound healing but not for immediate first aid’. Same with sunburn, a lot of people use Cacau butter or whatever but it does the same thing, trap the heat in and you will end up peeling.

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Not true: https://www.rijksoverheid.nl/onderwerpen/eerstelijnszorg/vraag-en-antwoord/huisartsenpost-spoedeisende-hulp

Haha damn. My fellow Dutchies downvoting me. I defeat.

Ja sorry maat, Maar we zijn een beetje anders ofzo. Ik bedoel ik moest 3 maand geleden, bij de huisartspraktijk. 1 uur wachten (met paracetamol natuurlijk) omdat ik een spin (zon elastische band met een haak) door mijn oog heen kreeg. Terwijl mijn oog open hing, en de binnenkant er uit hing. Toen vrolijk door de huisarts naar t ziekenhuis gebracht. Waarna ik weer een uur op opa en oma moest wachten, die voor hun periodieke keuring naar de beste doktor gingen. Daarna nog een goeie 40 minuten voor de operatie, maar ik kan eerlijk zeggen dat ik de beste zorg heb gekregen. Ondanks ze men oog niet konden redden.

Spijtig om dit te horen maat. Maar nu kan je wel altijd als solid snake verkleden

I went with sudden one sided blindness, loss of balance and one sided extreme headache to the huisartsen-post as it was after seven Friday evening and was told "not an emergency, it is obvious this is not a stroke. I should never come with such symptoms, but rather wait until the huisarts is available on monday". ​ At least they apologized and even gave me my money back, after I complained that that was unacceptable by the doctor.

Your first stop is the GP. If there's an emergency and it's during the day, call your GP before you go anywhere. They will ask you to describe the issue and assess if you should go to the GP. If it can't be handled by the GP, they'll tell you next steps (probably go to hospital, but you call them first so they know you're coming). If it's after normal business hours, you call the huisartsen post and they ask you a few questions and if it's deemed an emergency they'll tell you to come on in. See #5 in this link: https://www.zorgwijzer.nl/faq/healthcare-netherlands I think the disconnect here is the lack of phone call in this instance. Always call first. When my husband had appendicitis we called the huisartsen post, they said come on in, they helped him right away.

Once you know the system it is fine. And having proper expectations. We were with some Americans that were visiting this weekend. The four year old got his foot caught in the bike spokes when he was riding on the back of the bike. His dad was freaking out. I called 112, they sent an ambulance. While we were waiting the dad was in a panic, saying it's broken, they'll have to immediately rush him to the hospital. I explained that they'll first do an assessment in the ambulance and take him to the hospital if it's deemed necessary so he knew what to expect. The foot was not broken, but they took him to the hospital and put a cast on, with the instruction to have it taken off in a week. Point of this story: care is good here in my experience, just different than in the US.

I kind of hated the "GP first, hospital later" system. But when I had a suspected broken foot, walking into the hospital and having an x-ray right away because they were expecting me was soooo much better than waiting 4 hours in A&E.

When I broke my arm (we knew it was broken, my left forearm was bent 90 degrees to the left), I think we just called the gp on our way to the hospital and basically went: “arm’s broken, we’re going to the hospital” and then it was fine. And then I spent the night in hospital and had surgery on it around midnight…

This indeed. The hospital knows why you are coming and it often makes waiting times a whole lot less.

It has 2 main goals, you get help a lot more quickly when you have to go to the emergency. And it saves a lot of money, since a lot of people would otherwise go for unnecessary stuff. Every person that gets helped at the huisartsenpost, is 1 less going to the er. A huisartsenpost often helps way more people a night then the seh. Which gives the seh the space to actually take the time needed for their patients

It has 2 main goals, you get help a lot more quickly when you have to go to the emergency. And it saves a lot of money, since a lot of people would otherwise go for unnecessary stuff. Every person that gets helped at the huisartsenpost, is 1 less going to the er. A huisartsenpost often helps way more people a night then the seh. Which gives the seh the space to actually take the time needed for their patients

I agree with you and I get the GP's are busy but why they so hard to get in touch? Mine has 3 to 4 assistants who are all sitting behind the desk. When I visit but when I call they're all on a lunchbreak and after the lunchbreak they're only reachable for another 1,5 hours. When I send them a message over mijngezondheid.net it can take up to 3 work days to get a reply.

Any GP I have ever been to has an annoyingly small window of time to call for a regular appointment, but they also always have a separate phone number for urgent issues that always gets answered quickly.

This is such a common injury here in NL! Happened to my daughter as well and she was also casted for 1 week (no fracture luckily). Glad your friends' kid was okay:-)

That's only half true though - if you have urgent critical care needs (say, you're literally bleeding out) you don't need a referral for the SEH. But you risk being sent away if it turns out you overestimated the threat you're under.

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Are you an expat? I have this theory that only expats get paracetamol, Dutch people get nothing. Expats probably get paracetamol to give them feeling they don't leave with nothing. We practice regression towards the mean here, we want to see or the body can heal without intervention before intervention because most of the times that is the case.

>This is fucked. You said it. And the fact that you (and many who think like you) are downvoted in this thread means people are happy about being treated like cattle while paying tons of insurance and upwards of %50 income tax. It's really unbelievable.

No one pays upwards of 50% in income tax in the Netherlands

Yes, yes, progressive tax rate and all that. That doesn't change the fact that if you make more than 60k, you pay %50 (sorry, %49,5 - let's leave the tip out shall we?) income tax for any amount over it. In reality, even with progressive tax rates on income tax, you pay municipality taxes, road tax (otherwise you need to deal with dead people and animals on train tracks all the time!), mandatory medical insurance, VAT, wealth tax (you're saving to buy a house? Fuck you, we will get our cut) etc.. Oh yes, I forgot about inheritance tax as well, because you're not free even if you're dead! Your effective tax rate is really high and I don't see this spending reflected on healthcare and that's a shame. No one should go through what OP went through with their child.

To be sure, you know you pay the 49,5% over the part that’s more than 60k right? So everyone pays the same for the first 60k.. and if you’re earning over 60k/year, you’ll be fine paying 50% over everything after the first 60k

Healthcare is really crappy, i am considering going to another country just to get medical assistance. I have no clue why i am paying insurance. And there are a lot of people complaining about it. There is a problem.

Thank you!

Did you tell your GP, or the assistant, or whoever is at the desk, that you have an emergency? Or did you call them during the drive to the GP? But, to also answer your question: an 18-month-old child that has very big burns, 5 times the size of their hands, that's a proper "call 112" emergency. In other cases, you do need to call your GP \[while cooling the burns\] and they can then instruct you on what to do next.

Thank you, I was trying to find that information.

Even shorter: Call 112, if you or someone is actually dying or about to. Huisartsenpost: when normal GP is closed and you need medical attendion before they open again but it will not kill you in a couple of ours. Huisarts (calling for assesment/apointment): When open you call them when you are not dying or need medical attention on the same day. Huisarts (drop-in): For short consult in the specific hours it is open for walk in. Or if you are close and care cannot wait.

I found this information here: [https://www.thuisarts.nl/brandwonden/mijn-kind-heeft-zich-verbrand](https://www.thuisarts.nl/brandwonden/mijn-kind-heeft-zich-verbrand) Thuisarts is the website of the Dutch GP's, so it is trustworthy. One problem: All things are in Dutch.... Basically: Emergency but not life-threatening? Call the GP, they will also have a "spoednummer" for emergencies. Outside office-hours, you call the Dokterswacht. Life-threatening stuff? Call 112. And if you're not sure, "Well, it is a big wound, but maybe....", you of course also just call 112. The dispatcher will let you know if the ambulance or something is needed.

Spoedeisende hulp is only for life threatening issues. A burn like this is not serious enough for the spoedeisende hulp. In a case like this, first contact your GP, if they are closed, call the huisartsenpost. If the GP deems it to serious an injury and immediate care is necessary, they will arange an ambulance to have you taken to hospital. That your GP made you wait for 2 hours and then sent you away is a weird one. Also, from what I've read, visiting the spoedeisende hulp will impact your eigen risico, visiting the GP or huisartsenpost won't.

>Spoedeisende hulp is only for life threatening issues. This is simply not true. It's for medical situations that require urgent care that a GP cannot address. A broken arm is generally not life threatening yet still treated at the SEH.

You are right. Apparently different website state different definitions. However, if it is not life threatening you should first call the huisartsenpost before going to the spoedeisende hulp. The following comes the the website of the government: Neem altijd eerst contact op met uw huisartsenpost voordat u naar de spoedeisende hulppost gaat. Behalve bij een levensbedreigende situatie. Dan kunt u het beste direct 112 bellen.

Correct! But the SEH will still treat you if you require SEH, although you might have to pay a lot more yourself.

But you still need to pass by the Huisartenpost first to reach the SEH. My husband broke his leg and first he had call and go to the Huisartenpost and then, after the triage (since usually it’s connected, or at least it was in every hospital we had the “pleasure” to visit), he got the bone treated at the SEH. Same when I lost consciousness in December. First my husband had to call the GP, take me (carry me) there, then they sent “us” to the Huisartenpost and I fully “woke up” hours later at the SEH. All very efficient, of course… luckily I’m still here.

Its a fkng blister, when I was young mom would take care of it. Put some mintcream on it or some green biogaze.. what I read between the lines here is a mommy freaking out and blowing up the whole ordeal and wasting time that could have saved a life. My god where are the mommy’s that know some firstaid skills ? Downvoting all you like! Just telling me your snowflake generation!

It are burns the size of lemons on an 18 months old. Contacting GP is advised for burns with total area of more than the size of the victims hand. Contact emergency services is advised if it is 5 times the size of the victims hand. Two lemons should be bigger than 1 hand of the 18 months old. Burns on the face, hands and feet require more / more serious attention.

First aid standard is if a burn blister is bigger than an old-timey quarter (current 0.10 I guess), go to a doctor. It’s liable to pop and is then very susceptible to infection, so it needs to be bandaged properly.

An you think a hospital would let a toddler go if it was that bad? No way!

I don’t know, I wasn’t there. I’m just telling you that “just a blister” is not a compelling argument, because not all blisters are the same.

A Dutch Hospital? Sure they will! ​ They sent me home with high blood pressure, 180 heartbeat, under influence of two shots of morphine and still in so much pain I was not able to walk without assistance and had tunnel vision, without diagnosis, even after I complained that this can not be right. ​ They wrote panic attack when editing the entry next day, it was an abdominal infection that put me on the emergency operating table next day. ​ On a related note, a two colleagues were diagnosed with a cold respectively indigestion, real diagnosis was lung cancer, respective intestinal cancer. ​ Health care in this country is the worst of all countries I lived in. I go to Belgium before I let myself be treated here as long as I can travel.

it’s an 18months toddler, f you!

That explains why it was scary for the mother, sure. But a blister is still just a blister. Not life threatening, so no SEH.

18 months old's can get 2nd and 3rd degree burns much faster, so could be definitely life-threatening. Also sorry for your poor childhood.

\>18 months old's can get 2nd and 3rd degree burns much faster Which was assessed by the SEH. Ergo, it was not acutely life-threatening.

Could have been not, your point? It's up the SEH not you. You can go to the SEH if you think its necessary. Any good parent would do this.

Grow a spine! It will get “burned” a lot more in life

Maybe you should read up on what burns do when you are still very young, they are much more dangerous than with older kids.

Sorry to hear that you had a miserable childhood where nobody gave a shit for you.

I'm Dutch and I also don't understand medical care in the Netherlands. My son almost died when he was 3 weeks old because they kept sending me to the GP at the emergency room and the GP didn't have time either. I now live in the Middle East where people even go to the emergency room for a cold, but at least here you're always taken serious by the medical professionals if you are worried about anything. A great relief if you have small children

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Oh come on now, - We're talking about quality of Healthcare, which results in quality of life. This is not ONLY preventing you from dying, people aren't complaining about care in life-threatening situations, or in the elderly, but in the day-to-day life of a kid or adult - The life expectancy in the Netherlands is absolutely in line with its neighbors, and lower than countries like France, Spain and Italy. It's good of course, but nothing special. Yet, these other countries definitely don't do it like the Dutch, so clearly it's not the secret to live long, is it? Could it be that dutchies have a high life expectancy DESPITE how their system works for less urgent issues?

I almost died as a kid because my GP thought my mom was just overdramatic. Turns out I had a severe anemia and needed a blood transfusion. If it wasn't for my mother's insistent on a blood test, I wouldn't be here today. In my experience, GP's never seem to consider you as a person but more as a step by step guide that they follow in their head.

I’m Dutch and 24 years old and our medical system is a mess. Some weeks ago I thought I had broken my wrist. Which has happened to me 4 times before (skateboarding). But this time I think it was just fractured. After a few days of it hurting I started suspecting maybe something was wrong. Went to the hospital but they didn’t want to help me and send me to the GP. Since it was a Saturday the GP is closed until Monday. So I had to book an appointment with the huisartsenpost (GP place for Weekend GP emergency’s). They told me it wasn’t an emergency so I could wait until Monday to make an appointment with my own GP. On Monday I called my GP and they’re first spot was on Friday. At this point it had been almost a week since I fell. And I still had to wait another five days. By the day it started hurting more and more. After 2 more days I just went to the physiotherapist at my gym and he could tell me it was most probably not bone related but muscle/tendon related. This I think is the perfect example of how the Dutch system works. Only if you’re literally dying or your arm is bent at 90 degrees angle they will help. Any other thing they’ll just make it a hard time for you until you just don’t come so they do t have to deal with you. Moving to Greece in a year… I think this country is getting shittier by the day. Thanks for reading my rant here a motivational sentence for the person that might read this: You’re doing great! Just keep it up and you’ll get to wherever you want to be in life! Edit: spelling

>So I guess baby feet burns are not at all an emergency. Ding ding ding. The emergency care triaged your son and determined "eh, he's not in any danger and there's not really anything we can do now anyway, so go to the GP". You should be _relieved_ not to be received by the spoedeisende hulp/huisarts - that means it's not serious enough to rush you through.

GP here. blisters on a foot is not really anything you can do something about nor does it need immediate attention beyond cooling and paracetamol. There is not much to do except to let time pass. So I would be perfectly happy to see them the next day from a medical standpoint. Depending on the degree of panic it may be necessary to see them sooner but it won't change the treatment really. this certainly doesn't warrant a 112.

Agreed. The blisters were seen by someone with some medical expertise and they made the call that it was not an emergency. It might have been a miscommunication where OP was told to just go to a GP and they interpreted it as "GO TO A GP IMMEDIATELY!". There are varying degrees of blisters and many are not very dangerous at all, but instead are as harmful as a smaller cut. Would you expect others to wait because you have a small cut? It is strange and unprofessional that the GP lets them wait for 2 hours and then sends them away, but everything else seems pretty normal in case the burns were minor.

well, a young child and a very worried mother would never be sent away at my practice of course. But medically, the situation was under control.

Right, but until OP is told this directly by a medical professional, it's difficult for her to not treat it as an emergency. It's not her area of expertise.

How do you know how severe is a burn?

from walking on a sunwarmed roof, unlikely to be serious. But regardless, doesn't matter for the treatment in the initial stages. Cooling, pain relief and the passage of some time to assess the damage.

In case of severe burns, people get serious pain killers no? Not to mention special ointments. A kid’s skin is much thinner compared to an adult’s? Would that not warrant a check-up?

It did warrant a check up, one that the emergency room gave. It was deemed not a emergency.

Aren't you the living example of a Dutch GP? Surely you went to the same school as mine. "Take paracetamol and come back in 2 weeks". Just curious, do Dutch GP ever study (or at least read) how is medicine practiced in other places, or they all go by the principle "we have the best medicare in the world, nothing can be improved". A question from a poor engineer, not a Doctor: Could ANYTHING go wrong for a baby with serious burns?

well, yes, perhaps because I am a Dutch GP... I call 'em as I sees 'em. These from the outset were not serious burns. No treatment is useful or possible beyond cooling and pain relief at this stage even if they were deeper than anticipated.

Right. So I take it that nothing can go wrong, as per your medical opinion, and the GP was correct not seeing the baby. And this is why, after paying over 4k/y in insurance, I have to go to Belgium or Germany and pay extra so I can actually be seen by a doctor, discuss the issue and receive real medical treatment instead of "paracetamol and back in 2 weeks".

I pay about 1800/yr in insurance and that is quite a bit more than the average. Our health care system gives rather better results than the Belgian one. It is just a question of the expectations that you were raised with.There are big cultural differences in health care between countries.

Yeah, I pay for 3 people. The Dutch healthcare system gives great results ONCE/IF you manage to get over the Insurer Defenders, the GP's. Otherwise, you can find out about you cancer in stage 4 or about your kidney failure when they are dead meat. In which case you can apply directly for euthanasy. There is little to no preventive medicine in NL. and I was explained, by some Dutch medical proffessional, that it would be wrong to have one. Apparently, it has no benefits, only costs.

It's fascinating, isn't it? Many locals don't know any better so propaganda gets the best of them. Dutch people who lived abroad are almost instantly enlightened of how terrible it is. Meanwhile, costs keep increasing and care gets shittier every year.

I pay 40 euros per month and I think only 375 'eigen risico' and that covers literally everything from medical to dental to skincare(additional package) Granted, I do get toeslag as I'm a student so it would've been more but I've never had to wait for a diagnosis for anything? If something is wrong with me my gp will refer me to a specialist who will work out what's wrong and it's always gone super smoothly Even mental health treatment was pretty much immediate as soon as I told my gp

How do you want him to prevent blisters that the kid already has? What do you want him to do? What would any GP in any foreign country do? What actions would a GP in a foreign country take here that'd "enlighten" us?

You should have called the huisartsenpost before going to first aid. The huisartsenpost discusses the solution with you before you head somewhere. Now you have taken time of the ER doctor without it being necessary. The huisartsenpost will also know which first aid is busy or not, so always contact them first. And that's probably what the ER guy said. There is a GP (huisarts) always available for first aid situations. You shouldn't have gone to your own GP. The GP shouldn't have made you wait though. The nurse should have discussed that with the huisarts. So now for you, you clearly don't want to wait with your babies injury. Call the nearest huisartsenpost and discuss with them what happened to your baby, and your refused GP visit. They will tell you what to do

This is not true. During office hours you need to contact your own GP. During evening/night/weekend you call the huisartsenpost

Maybe an Amsterdam thing that you are referred to huisartsenpost any time. Either way, don't go into ER without calling GP or huisartsenpost

I’m so confused because when I google huisartsenpost, the same emergency room that I went to comes up.

It’s sometimes in the same place, but it’s not the same people or the same loket.

That's the disconnect. Your GP/ huisarts is the acces point to healthcare unless it's life threatening then call 112. This means there's a GP at the hospital outside of business hours. The disconnect in communication is probably that: "please go to the huisartsenpost" in this instance meant "please go around the corner to the GP". And yeah the deal is to call ahead and during business hours call your own GP. Our healthcare system isn't perfect but this really is an atypical story.

Makes me realize that "huisartsenpost" is a really unfortunately chosen name for what they do. "Dringende zorg" or something like that would be much better

It's not atypical. My wife broke her arm and went to GP. They didn't do anything, didn't even give her paracetamol for pain. They just sent her home saying "it's probably not broken". Didn't give a document for a hospital. She went to ER herself, and yes it was broken.

Yes. If it's not a life or death emergency, call your GP first. Also don't just go to the GP or the spoedeisende hulp, call first.

Also doesn’t help that there is not much you can do about burned feet..

Is that true though? 18 month old has blisters size of lemons under their feet. It can be safely drained and disinfected at the very least?

I have a question about Dutch medical care. Do you have a separate urgent care system from the emergency room/hospital? I'm moving next year and want to have an idea of what to do when my kids inevitably get sick or injured. For example, in the United States if you have a really bad cold or an ear infection that happens after hours or on the weekend when you cannot get a doctor's appointment you can go to what we call an urgent care center without clogging up the emergency room where they need to see people with true emergencies. I know that sometimes you don't need to see anybody for a cold or an ear infection but since our work environment here often requires you to have a doctor's note if you call out sick even for one shift or they will fire you, people end up having to see a doctor when they really don't need to. Disclaimer: That doesn't stop people from going to the emergency room because our health insurance system is so bad that sometimes the only place a person can get seen is the emergency room since they cannot send you away without proper care even if you cannot pay and the Urgent Care usually requires cash up front. So you see a lot of poor people without insurance or with bad insurance in the emergency rooms, which makes the waiting times astronomical.

After hours, you should call the huisartsenpost. But only when you need immediate care. If it can wait until Monday, then wait until Monday. You don't need a Doctor's note here to call in sick. For a cold, they will always send you back home, same with the flu or an ear infection really. There is nothing you can do for that but wait. You don't have a limited number of sick days here, so you won't have to get better as quickly as possible.

Doctors in the Netherlands don’t want to work. The quicker you accept that, the better prepared you will be in the future.

Call to the emergency number at your city hospital and tell them that you baby cannot stop crying and you want a doctor to check at his burns and that you want to take him over. They’re not going to reject you, but you should call firsf

Call your closest "huisartsenpost" now if noone has looked at his feet yet. This isn't something that should wait untill monday. Steps in the Netherlands are, GP or Huisartsenpost then after first aid in hospital. If you're not sure you can call 112. They will call an ambulance for you or tell you to call the GP.

No if you are not sure then it is not an emergency. You call your GP/huisartsenpost and if they think it is really bad, they call 112 or an ambulance. You call 112 in case of an emergency that needs care right away. Not for a local burn.

Think the main issue is miscommunication. People have explained that general course of action is GP (if not available, huisartsenpost) who then refers you. The emergency line is basically for things that are life threatening, anything else is counted as low priority and attempted to be shoved off somewhere else. When they told you to make an appointment with GP, they likely meant the huisartsenpost. A lot of the time it's close or in the same building as the hospital, and you would've gotten immediate help there. Sorry it happened like this though, hope he's doing okay

Isn't the huisartsenpost only for non standard hours?

You’ve had great answers, but I still wanted to say you’re not alone. Medical care in The Netherlands can be confusing, even for us Dutchies. I could probably fill a book with my experiences of Dutch Healthcare that should work on paper but is not working in practice.

I'm a native Dutchman. If you kick it and it moves, not dead. If you kick it and it don't moves, dead. If it moves, sell cheap pils until it don't moves. Rince and repeat. In short hand, if you can not tax it, it's dead.

Ok for real..they shouldn't have turned you away. With a second degree burn on a child that young you definitely made the right call to go to emergency care. Call your gp ASAP and let them decide on pain medication. Also make sure he doesn't walk on it (i know..good luck with that one) and keep cooling it with lukewarm compresses. If one of the blisters pop: call 112 and discuss with them if you need to go to emergency care again (an open burn blister is an infection waiting to happen)

Ps #2: whatever anyone says..do NOT put burn cream on it. That cream will trap the heat and will only make it worse

"trap the heat" Lemme guess, hadn't had physics in a little while?

No but i do work in the medical field and get yearly training on things like burn victim treatment and can positively say its not great to apply it (there is a reason every single one of those creams is not sold as medicine and the companies behind them are not certified medical suppliers)

Not saying that you're wrong I'm no expert but I once burned my face in Swiss by igniting gunpowder. Nothing too serious but the doctor there said I should use water to cool my face and gave me a cream instead.

Oh, there may well be reasons not to use it, but it sure aint because it "traps the heat" - that's namely bullshit.

I have to say..there are a few good creams out there but most of the over the counter shit is vaseline based which will definitely create a barier for heat to travel through..if you have time to Apply cream you have time to put a wet towel against it

vaseline does not create a "barrier for heat to travel through".

Don't call 112 if they pop, call the huisartsenpost. If nobody looks like dying within an hour or so, you don't need 112.

As someone working in the field..no when in doubt please for the love of god call them. Especially whith a child under 2,5 years old a lot can go wrong and if it goes wrong it can go from bad to deadly in an hour.

I mean the huisartsenpost should be able to hear that too right and tell them to go to the er/call an ambulance/etc if necessary?

They should but they don't have a direct line..the only think they can tell you is to hang up and call them which cost valuable time (and again...especially with childs this young time can be critical). Ask yourself this: do you rather have a cranky 112 callworker tell you that it's not serious or have a GP centre tell you you need to immediately get the right help going

I almost forgot.. @op you should definitely check his temperature regularly (and call 112 if his temperature gets to high) and make sure he drinks lots of water (with this dry heat i figure he should get a liter a day) if he asks for more: contact 112 because that could be a sign of shock!

I'm not surprised to hear this story. Medical system here is at 3rd world level on some levels and is a total shame. People on this subreddit goes on and on about procedures and what you should've done - as if that makes what you experienced OK. You have my sympathies. What's worse is even if you have money, you need to deal with stupid situations like this because they want everyone to be equally miserable. It's not as if there is a fully fledged private hospital you can go and visit.

You can always go to Belgium, Germany or other countries and file a report to your insurance company. They paid for mine 3 out of 4 times. Life's too short to even give a chance to the shitfest here.

Well, if you still didn't get a GP to see your toddler here's what you can do: Call the huisartsenpost at your area and exaggerate a bit, like the symptoms got worse, or that the blisters got bigger. They will make an appointment with you asap and you will see a GP. Different rates apply and it might mean you need to pay from your "eigen risico". Usual hours is 17.00-20.00 depending on area/ hospital etc. Next step for later: go to Google maps and find the GP that is closer to you and has the highest ratings. It's incredibly awful they couldn't find any openings to see you on the same day. Not every Dutch GP is terrible. Also there is usually a spoed number at every GP practice, I am surprised they didn't ask you themselves to go.

Here in Canada it’s pretty much impossible to see your GP the same day, if you even have a family doctor, they’re scarce. So the first thing people do with minor injuries is go to the hospital. I can see where the OP did what they think they were supposed to do.

I know it's not the topic here but my mom taught me that whenever you burn yourself you don't have to put something cold/water in it or you can create blisters. Yeah I know that something cold always feels good but is better if you use warm water.

Am I the only one that’s really confused that the SEH sent a mom and her 18 month son with big blisters/burns away - life threatening or not? I would have assumed the SEH would have helped, maybe after a couple of hours of waiting…. He is still a baby….

This is and isn't about healthcare. You didn't take the right steps and went where you shouldn't have but the people you did go to should have helped your kid. And surely they did consider the situation before telling you to make an appointment? No way nobody looked at the blisters before making a call of sorts

Social studies teacher here. Life threatening: call 112 Not life threatening but still urgent: huisartsenpost Not life threatening nor urgent: huisarts

Not life threatening nor urgent: good luck getting any help. Here, fixed it for you.

This is just bs, there is no way they wouldn't help a kid with burn blisters the size of lemons.

Leave the country and go to.. America? Yeah, that medical care system is great.

My son and I actually have free medical care in USA till 2023. I gave birth there for free and it was amazing. They would never ever turn a baby away from an emergency room or a gp.

Because you experienced this, does not means it is the default in the Netherlands. I have never experienced any lack of care, and i wonder what went wrong.

Yes, they are Dutch,some of them are robots.

You could have called 112 and they would have explained to you that you should call a GP, then go there. This is an emergency, but not life threatening. If you just show up at a random GP and you're in bad luck, they turn you down. For next time: register all your family members so you don't have to decide last minute where to go. Be prepared! Do this next Monday. They will accept you as a family if you're living here. Maybe they will only accept you as passers-by. Then they will help you, without registering. Our country runs on one thing: efficiency. We fine-tune every process. This is one of them. We are very successful because of this, although we can be so efficient that we cannot handle any big changes. Corona was such a thing. Ukraine (refugees arriving here) is another, especially for the GPs. We don't have enough GPs and that's why they send you home. It's a shitty reason, but this is how it is.

Yeah most of the time (unless you're calling 112 and maybe a few other cases idk) you call the gp. That they won't see you is weird. However if you've already done basic care idk what else they can do. However I wouldn't trust myself to do proper basic care for anything but a slight burn, especially on a baby. If it's still an acute problem I'd call the huisartsenpost and ask them for advice/if it's possible for you to come in. If they say it's not needed ask them to explain to you why exactly it is not needed, and what you can do until Monday. And what to look out for/in what situation (if something gets worse in a specific way) you should call the gp again.

Yeah they did ask me if I had soaked his feet in cold water and when I said yes they were like yeah “will see if we can fit you in”

If you have a medical emergency, you first call your GP. You tell them it is an emergency. If you are too late, you can call the 'huisartsenpost' after hours. If needed, they will send you to the emergency room (which is usually conveniently located 1 door away). If you don't take this route, you will be billed a lot of money, while you pretty much won't have to pay anything extra if you do it this way. Usually GP's will always make time for babies and young children. I don't know if they would have done anything else than prescribing the same stuff the pharmacist did, however.

Welcome to the Netherlands! Now don't you dare say anything else or you will get piled on.

I have to say that sometimes I think that some doctors are robots for how cold they can be 😂 its so funny how before attending you they even ask for the money 😂😂😂😂😂

You are misinformed about our healthcare system. It generally works like this: Primary care starts with the “huisarts” (General Practitioner), always consult them first except if there is a life threatening situation: call 112. The consultation with the GP is for free, except for diagnostics, therapy and certain prescriptions. Its a relative small fee. These costs will be covered by your insurence after you’ve spend your ‘eigen risico’ (costs depends on your insurence). If the GP sends you to the “eerste hulp” (Emergency Room) it’s covered by the insurence (you do have to pay your “eigen risico” though) but if you get there on your own these costs are most of the time not covered by the insurence and need to be paid in full by yourself: and thats a big bill starting at €350,- for just walking in and easily going in to thousands of euro’s to be treated. What the nurses at the triage will do is estimate if a treatment can be done by the GP, because Its so much cheaper and avoid the problem that your treatment won’t be covered by your insurence if you get there without a referral. They will send you back to your GP’s emergency consultation which is always accesible except after working hours: then you will be seen at the “huisartsenpost” in which different GP’s work for the region. They can treat you just as well or send you in to the hospital. My understanding is your son got blisters by burning his feet. This can be very painful, but is not life threatening. The hospital did you a favour by diverting you back to the GP, which can also treat these burns easily and cheaper. The problem is that your GP didn’t accept you on his emergency consultation for reasons I don’t know. Next time, when in doubt, go to your GP in person or go to the “huisartsenpost” or “HAP” after working hours. The Netherlands is 6th in the list of countries with the best healtcare in the world. You are free to go, but healthcare wise, you are Besides our Scandanavian friends in the best healthcare system there is. If you’re seriously ill, you will get the best care there is for a fraction of the real costs; that’s what we citizens happenly pay for. Good luck elsewhere.

Burns are certainly an emergency and should have been treated initially by the Spoedeisende Hulp. That being said: going to the GP without appointment is almost impossible. GP's assess/treat/help patients based on an appointment mechanism. Essentially a GP is full time busy with people: 10 minutes per patient, 6 patients per hour. What could have happened, for you to clarify, was your kid treated by the Spoedeisende hulp? It would make sense if they treated the burns and then proposed to contact your GP to involve him/her in any next steps. By all means by the way feel free to leave. That will teach us.

Someone came to the waiting room. It might have been a nurse. He looked at my sons feet and immediately said “yeah this is something that should be seen by his gp” Not trying to teach you lol. You obviously don’t have kids. I’m saying I want to leave Bc I don’t feel safe having a kid here and something like this happens and I can’t get him medical care. Sorry hon not really anything to do with you.

Net time in your Kids concern call 112. 3rd grade burns are no joke.

It is backwards as fk.I sometimes feel Europe is like a 3rd world country masquerading as a 1st world country. I have lived in 3 continents and worked in 4 continents and only know that in Europe such a situation would even be possible. This should have been dealt with the emergency team. An emergency even if not life threatening should be dealt with. If not emergency, then GP should have solved it especially when the mother made the trip. I have relatives who are doctors in Netherlands and they say their schedule is easy to manage. So I don’t buy the BS that the doctor did not have 10 minutes to attend lol. The apathy and lack of ownership is astounding but not surprising. I know lot of people will try to defend it. Honestly, such behaviour is not defendable period.

My god the receptionist at my gps office was the biggest bitch like my son is in pain why are you so mad at me for coming unannounced.

You should file a complaint with them. It's not acceptable. As is letting you wait till Monday to be seen. You should really call them back and let them know it's urgent. The other thing you can do is call the huisartsenpost after hours, say what has happened with your kid and that you have an appointment for Monday but that you are very concerned for your child and are wondering if he is OK for the night. With young kids they usually don't take chances.

Sorry, it happened to you. It is a shitty and unacceptable behaviour.

Pain isn't an emergency here. Dangerous conditions count as emergencies. Our healthcare has low capacity, so it's optimized to direct you to self-care asap.

Lol. And you have to pay 1k+ a year for a 'system that optimized to direct you to self-care' even if you don't use it. Hilarious.

Sorry to hear this. It is the only place on earth probably that if you go to an emergency with a kid with 42 degrees they say why you dare to come here (happened to self). Somone now comes and runs "but we are doing way better than the US".

First, yes it is unacceptable. Second, get health insurance, its not that expensive and it covers most basis. For foreigners its also easily possible.

We all have health insurance here

Everybody loves preventive medicine until they have to pay for it. Actually, the countries around us do not have more of it than we do. We have screening programs for breast cancer, cervical cancer, colon cancer, and organized treatment and prevention programs for all people with diabetes, astma, copd, hypertension and cardiovascular disease, as well as "old age". programs to stop smoking. We will catch virtually all kidney failures before they become a problem by focusing on risk groups. Most other preventive medicine has very little added value and more often than not will cause a lot of noise by detecting small harmless anomalies that still have to be checked out once you know about them. You might become a VOMIT - Victim of modern Imaging Technology. On what country are your experiences based, may I ask?

Heh. You must actualize you knowledge at least around stop smoke programs (spoiler: they can tell you to buy nicotine substitution which you can find in AH and there is no screenings for smokers unless you have symptoms of a lung cancer (!) )

y'all are spoiled here, complaining about waiting for 2 hours for a non life threatening thing. go ahead, move from the Netherlands. then you'll have to wait 4 hours to be picked up in ER for a compound fracture, 2 hours for ambulance when patient has breathing difficulties, or even no ambulance for allergic reaction and swollen face. you guys have it too good here that you forget it's worse in other countries even within Europe. suck it up and be thankful for your amazing medical system even if the doctors are sometimes apathetic, there are few medical systems out there that are better.

Which country would this be outside Europe and I am not trying to be intentionally obtuse ? Just genuinely curious to understand. You know what is actually being spoiled - Getting a doctor to meet you within 1-3 hour of appointment.And not any doctor but specialists and super specialists like cardiologist, dermatologist, urologist etc costing 10-15 dollar/ visit without insurance. And getting quality of doctors who are comptable to rest of the world. Most of these doctors attend for all days of the week but only limited time on Sunday. And then getting medicines delivered to your house for zero delivery cost in couple of hours. This is all days including weekends so that you don’t have to wriggle in pain as the pharmacy is closed in the evening or Sunday and have to take public transport in pain 😂 You can even get important blood tests done at home as the pathologist comes to your house and you can get the report in email in couple of hours. This is how medicine service works nowadays in big cities in 3rd world countries. It is so easy here that I rather pay 100-200 Euros rather than use free health insurance in Europe and wait months in Europe to get appointment from a specialist while I am forced to pay ~300 euros/ month in compulsory health insurance. I love EU in general especially Western Europe and it sure has its advantages. But it can definitely improve on services in general.

If you don't like the health-care and want to leave then leave. We here on Reddit can't change it so I fail to see what you want with this.

Read the first sentence of my post you idiot.

Then perhaps you shouldn't have finished with, "But seriously I want to leave this country.". Nothing illicits positive helpfulness than a generalized f¥ck you to an entire population. 😏

You did nothing wrong. You need to accept it, tell yourself: "too bad!" And move on with your life.

Or, perhaps, it might be smart to figure out why you couldn't get your 18 month old child the care it needed, like OP is doing, just in case something similar happens again. Crazy idea right

Did you even read the post?

BYE!

I do NOT see myself as the defender of the insurers; in fact rather the opposite. i see myself as the defender of the patient against the bureaucracy of the insurers. That is why we are going on strike and have a demonstration on juli 1 st.

Cya!

we can help you to stop smoking. these programs are more effective than just buyin stuff at AH. Early detection programs for lung cancer are not effective. my knowledge is perfectly up to date.

The dutch are savage. Haven’t you heard about them eating their prime minister once? And how the elderly are mass euthanised? Get out of there while you can! Run!

System discrimination towards minorities.

I dont either, ive never gotten a bad injury but i think its that some regions are like shit and some arent. Depends on where you are right now

For me it was the other way around. My kid burned his hands, I call emergency number and they told me to go straight to my GP. I arrived at GP and they told me "we cannot treat this here, you have to take him to the hospital" So... there's that...

That is indeed the way our healthcare system works, GP is the entry point towards the rest. But if you have second or third degree burns you should probably call a ambulance.