The Dutch have no shame

Volumes have been written about the differences between the Dutch way of healthcare and that of other countries. Well, ok, volumes of moaning and whinging has been written on expat online forums. But still, there are a lot of differences, and when it's about your health and getting it properly taken care of, you want it done right, so if you feel it's not being done right, it's easy to see why people get a bit ruffled. The biggest complaint is that Dutch doctors don't seem particularly proactive in their work and many times seem to think that you should know more about your problem than them since they ask so many times "Well, what would you like to do?" In addition, general preventative measures that are the norm elsewhere are considered above and beyond here, perhaps due to the socialist nature of the society. It is difficult to get a general check-up done, women don't get yearly exams, an early ultrasound isn't done on pregnant women, and everyone has a story of being sent away from their doctor without any medicine or advice beyond "Come back if it's not better within a couple of days." It all makes for a frustrating experience for expats who expect much different things when they take a trip to the doctor.

My own experience with doctors has been fairly mixed. I'm still intimidated to death by my general practitioner, but I don't think I'm used to their more blunt, rushed way of going about things. A good bedside manner is not something I think many of them can honestly put on their CV. I think doctors in Amsterdam and other cities have it even worse since there is a shortage of doctors, so they are more stretched to their limits. But in healthcare's defense, when I had to have a (non-urgent) surgery last year, I must say I felt the treatment I received from the surgeon was very good, and he did tests that put me at ease in knowing that he wanted to be sure things weren't more negative than they looked.

Besides the care itself though, there are strong differences in the way the care is done, especially for me as an American. My first visit to the doctor was particularly odd when I found out that you don't see the doctor in an exam room, but you are called into his actual office. He sits behind a desk and you take a seat in front of him and start describing your complaints. It all feels very much like a job interview. In the corner of the room is the standard exam table, but it is only used if really needed. In most cases the doctor does an on-the-spot exam, which at times can be a bit awkward and uncomfortable for me and what I'm sure the Dutch would call my prudish American sensibilities. Because in the US you always change on your own and then put on a gown for examinations; it's nearly the standard procedure after you are taken to the exam room. But here, I go to the doctor and he needs to look at something on my back, and he says "Ok, remove your shirt" and it's like "What, here? In front of you? Aren't you going to turn around or something?" And it's silly, it's all clinical, but still, it just feels weird.

A couple of days ago, however, it went a step worse. I went to a clinic to have an ECG done (where they monitor your heartbeat). The woman doing the ECG lead me to a changing room and I thought she asked me to just take off my shoes. But when she had me come into the room where she'd do the monitoring, she said "Oh, do you not understand Dutch? Could you please take off your shirt and also your bra because I have to put a monitor under your breast." Uh, right. Sure, I'll just strip, no problem. I should have expected it almost, but I still wanted to say "Don't I get a gown or something?!" though I know that'd be futile. So I removed my shirt and bra (in the changing room, which seemed a bit pointless since I was going to just come out half naked anyway) and she asked if I was done and I came out into the room with my arms automatically crossed over my chest to hide my breasts. I felt silly looking so obviously uncomfortable and nearly shameful, but I didn't feel like just strolling into the room hanging all out. I then laid down on an exam table and I had to put my arms at my sides for the monitoring. I lay there for about 15 mins totally topless while she did the monitoring and took blood. At least it was a woman clinician, and at least the room was warm, and I eventually got over the fact that I was lying there half naked, but geez, it is just not normal. Do Dutch women really not mind this? Is there no room for gowns in the budget? Maybe she was playing a trick on an unsuspecting foreigner. I wonder now, though, and am terrified at the thought of what happens in the rare cases that a woman actually gets pap smear in this country. Do you get to lie there in a wonderfully compromising position and not even get the decency of being covered meanwhile? As if women weren't uneasy enough having them done. Maybe if I ever have to have one done here, I'll come prepared with my own robe or blanket or something. If they laugh, they can just chalk it up to my prudish American sensibilities.