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Where can you expect to receive the best health care?

Large treatment centres versus small treatment centres

Since November 2010 I have been working with great pleasure at the Bergman Clinics in Naarden and since January 2020 also at the Park Medical Center in Rotterdam. Before, 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!

Surgery manual

Dr. Schröder is happy to inform you about the surgical treatment of your neck or back condition. He also discusses the possible complications of the procedure with you.

After you've carefully weighed up the pros and cons of the surgery, you can decide for yourself whether you consider your condition serious enough to operate.

View the surgery manual

  • Instructions for after you have left the clinic

    Once you leave the clinic:

    • Make sure that someone comes and picks you up in a car, and refrain from driving yourself
    • Make sure that you recline your car seat
    • Make sure that you are not home alone for the first few days following the operation
    • Allow the wound to heal for the first 2 to 3 weeks
    • You are allowed to shower, as the nurses will give you a waterproof plaster to cover your wound before you leave the clinic
    • You must not drive for 3 weeks, but you will be allowed to sit in the passenger seat while someone else drives you around
    • You are allowed to do whatever you feel up to, as long as you keep listening to your body and stop doing whatever it is you are doing whenever your body tells you to stop

    Your doctor, nurse and/or physiotherapist will provide you with more information on how to look after yourself following the operation.

  • How long will I have to stay at the clinic?

    Depends on the nature of the operation

    The duration of your stay with us will depend on your situation and on the type of surgery you are undergoing. If everything goes according to plan, and if you are undergoing a minor back or neck operation, you will only have to stay with us for one night. If you are undergoing major surgery, such as a spinal instability operation, you will generally have to spend a few nights at our clinics.

  • Swelling after surgery

    Swelling reduced after 2 to 3 months

    After the operation, your wound will swell, which may be painless but may also be a little uncomfortable due to your skin being pulled so taut. Generally speaking, the swelling will subside of its own accord within 2 to 3 months of the operation, and the skin will grow less thick.

  • Medication after surgery

    Following the operation, you will be given painkillers for as long as you need them. You will receive these painkillers in accordance with a set schedule. It is vital that you take your medication at the scheduled times, even when you are not experiencing any pain. In this way, your body will build up a steady level of analgesia.

    Most people will be able to stop taking painkillers a few days after undergoing back or neck surgery. If your painkillers somehow fail to provide you with a sufficient level of relief, we recommend that you notify a nurse as soon as possible. If you were on morphine-like medication prior to your operation, we advise that you gradually cut down on your medication after the operation, if your level of pain allows you to do so, in consultation with your GP. Acute withdrawal may result in adverse events.

  • Post-operative pain

    If you are experiencing an excessive amount of pain, you will receive additional painkillers

    The level of post-operative pain differs from person to person, and from operation to operation. Generally speaking, major lengthy operations will prove more painful than brief minor operations. At our clinics, all patients receive proper painkillers following surgery, as a result of which very few of our patients ever experience a great deal of pain. In consultation with yourself, we will determine your pain score, both at the ward and once you are home (we will call you to discuss this with you). If your pain score is too high, you will be given additional painkillers.

100% insurance covery

Nearly all treatments performed by Dr Schröder are covered by health insurance. This is true for the following conditions: neck hernia, spinal hernia, lumbar spinal stenosis and cervical spinal stenosis.

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Dr Schröder's blog

Dr Schröder regularly publishes new articles on his blog. Read all about spinal hernia, neck hernia, spinal stenosis, neurosurgery and other related subjects.

View all blog posts

  • 13. On coincidence, bad luck and science

  • 12. Dozing off

  • 11. The Big Spinal Quiz for the articulate patient

  • 10. Sherlock Holmes and Dr Watson

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