Where can you expect to receive the best health care?

Large treatment centres versus small treatment centres

For half a decade now, I’ve been working (with great pleasure) at Bergman Clinics in Naarden, a new and relatively small treatment centre. Before accepting my current position, I worked (with equal satisfaction) at several large general hospitals, notably Slotervaart Hospital in Amsterdam. It’s important that patients know where they will receive the highest-quality health care – at a large health-care institution or at a small one.

The Ministry of Public Health wishes both types of health-care institutions to co-exist in the Netherlands, each with their own strengths. The fact that I chose to work at a smaller institution does not mean that I am opposed to general hospitals. Quite the opposite. I often collaborate with neurologists and neurosurgeons affiliated with hospitals all over the country.

Acute and complex care

So how do patients figure out where to turn with their specific back issues? It’s not that hard, really. Some backaches require highly complex care, such as scoliosis of the spine or backache due to a tumour or to a spinal fracture caused by an accident. If you are suffering any of these conditions, by all means go to a general hospital, as you will most likely require treatment provided by specialists from various medical disciplines. Such treatments cost society a lot of money, but not every patient suffering from backache needs that type of care.

Non-acute and elective care which can be scheduled

Unfortunately, some people claim that private clinics, also known as independent treatment centres, are very keen to operate on people who don’t really require surgery, just to cash in on them. Quite frankly, I hate these allegations, which have been conclusively controverted by the facts, as outlined in this article by Medisch Contact.

I do agree with Minister Schippers that a higher volume (i.e., doctors who perform certain procedures on a regular basis) results in a better outcome, i.e., better results. For that reason, it is vital that you choose a health-care institution and surgeon who clearly perform the type of surgery you are required to undergo on a regular basis. In addition, it’s a good thing if you ‘click’ with the doctor treating you. As far as this is concerned, refer to my previous blog, in which I discuss the importance of proper communication between doctors and patients.

9.0 patient satisfaction rate

As for the quality of the operations we perform, well, in 2012 an independent research group surveyed 6,000 post-operative spinal hernia patients from all over the Netherlands. This survey was carried out on behalf of health insurers. It turned out that the surveyees included 60 Bergman Clinics patients. Their patient satisfaction rate was 9.0 out of 10, as opposed to the national average of 7.3. Needless to say, our team was thrilled with this score. I daresay that we received our very high score because of the patience and respect with which we treat our patients. I talk to patients and listen to what they have to say literally until the very last moment before their operation commences.

Practical example

For instance, two years ago I was dealing with a patient who had been suffering severe pain in his leg for 4 months. The pain was being caused by a spinal hernia. Just after his intake interview with us, I had proposed that he undergo surgery, since he had told me that he could no longer bear the pain. He was relieved to be invited into the operating theatre. Just before he was to be administered general anaesthesia, I asked him if the pain in his leg was still as intense as it had been before, in my surgery. He replied that, for the first time in months, the radiating pain in his leg had actually subsided a bit in the last 3 days. In consultation with him, and to the great surprise of my team, I called off the operation, leaving the patient to go home quite cheerfully.

Two months later he sent me a crate of wine. The accompanying card said, ‘Thank you very much for your highly professional treatment. The pain in my leg has completely disappeared!’ Sometimes nature solves problems of its own accord. And I’ll be the last person to perform an operation that isn’t necessary, just to be able to send a nice, big invoice. I’m a doctor with a conscience, who swore an oath once and continues to live by its ethical principles. However, I’m also a Brabander, and therefore not more catholic than the Pope, and so I greatly enjoyed the wine my patient sent me!

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