Two weeks ago she “stumbled” out of her wheelchair. Since then she has suffered from dizziness and tingling in her arms and shoulders. Normally, Grietje Hof (68) from Enschede would go to the doctor, “but now the threshold is a bit higher,” she says. Hof is one of the tens of thousands of patients who were left without a GP after the bankruptcy of the Co-Med GP chain last summer. They had to rely on online care or hastily organized emergency care. At the time spoke NRC Hof and three other patients. Three and a half months later, their situation appears unchanged.
Since the bankruptcy, Grietje and her husband John Hof can only go to a general practice in the Medisch Spectrum Twente for emergencies. “Was my fall urgent? I’m more likely to think of a cerebral or heart attack,” says Grietje. The couple has developed “a kind of mechanism” to avoid a visit to the doctor as much as possible. The neighbor is a physiotherapist, so Hof goes there. “It’s nice that that is possible, but a GP might also have taken a photo.” To assess whether a patient needs to go to the emergency care GP, the practice has a online questionnaire‘Should I go to the doctor?’ . Hof’s complaints were not on the list.
On holiday in Andorra she bought ‘a whole bunch’ of inhalers, just to be on the safe side
Perone Cobben (60) from Breda recognizes this ‘mechanism’ to avoid the GP. She has been short of breath for weeks. And the coughing just won’t stop. Normally she would have gone to her doctor long ago, but now that she no longer has her own doctor, she is reluctant. “You don’t easily go to an unknown doctor.”
Cobben has asthma and the lung disease COPD. This week, after six weeks of dealing with her complaints, she called Thuisdok, a digital general practice where she can now go. She could go to a doctor in another village, but that was too far for her. Ultimately she can go to a doctor in Breda, the appointment is for later this week. “It is this kind of hassle that makes you prefer to postpone a doctor’s visit.”
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‘Problem spots’
Health insurer CZ has worked hard on solutions in recent months with other insurers and general practitioners from different regions, says spokesperson Arjen Zwaan. And in many places that has yielded results. In The Hague, general practitioners all registered a few extra patients to share the burden of care; in Tilburg, a former practice manager took over a Co-Med practice.
However, it took longer than expected to transfer patients to new general practitioners, because trustees were confronted with “the mess” that Co-Med had left behind administratively, says Zwaan. This made the transfer of patient files difficult. The hope is that the first insured people who are still without a GP will receive a letter about their new GP from next week. It is not yet clear exactly how many people this will affect: some of the patients have already registered with one of the new practices. The digital alternative has now been “almost completely” withdrawn, because structural solutions were found, says Zwaan.
Co-Med had left behind administrative ‘mess’, which made transfer of patient files difficult
The old practice was also adopted in Breda. But Cobben does not live in the correct zip code area. “I once did and when I moved, I stayed with my old GP, because all GPs in my new neighborhood no longer accept patients. Now I have nowhere to go.”
In addition, there are also “problem areas”, says Zwaan, for which no solution has yet been found. These are Bergen op Zoom and Enschede, where John and Grietje Hof live. “There, Co-Med has exacerbated the existing GP shortage and a solution may take longer. Until then, you have alternatives such as a passerby consultation hour or digital care – although that is of course not what we ultimately have in mind.” According to Co-Med, 4,800 patients were registered with the commercial practice in Bergen op Zoom, and 8,600 in Enschede. According to CZ, the actual numbers are lower, “but that is still a puzzle.”
‘puffs’
63-year-old Johan Franken, who lives in Bergen op Zoom, does not like digital care. “Then you have to ask for help in many detours and I’m not the type to do that easily.” If something were going on, he told himself, he would “just call 112.” When he spontaneously gets a nosebleed, for example, where he loses a lot of blood because of the blood thinners he is taking.
He also cannot go to a general practitioner in the area, even when a new practice was recently opened there. He read it in the newspaper and called immediately, but he was already too late: the practice had already received too many requests. Franken is confident that he will see a GP again, “but it is taking a bit too long for me now.”
Cobben from Breda no longer has that confidence. She uses inhalers for her asthma and COPD. She already told us earlier NRC to use her “puffs” sparingly, because she fears she will not be able to get a repeat prescription without a doctor. Although she has not yet experienced any problems with this, her confidence in healthcare has been damaged to such an extent that her fear remains. On holiday in Andorra, she recently bought “a whole bunch of puffs”, just to be on the safe side. “You don’t need a prescription there.” Oh well, she says, “we’ll take care of ourselves.”
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A Right Royal Health (Care) Mess!
Well, who would have thought that in a world where we can order a pizza from the comfort of our sofas, we’d be struggling to find a family doctor? It’s almost as if the universe decided that healthcare needed a touch of “surprise!” to spice things up. Enter stage left: Grietje Hof, the 68-year-old from Enschede who has given the phrase “falling out of your chair” a whole new meaning, and being wheelchair-bound to boot! It’s like a tragic comedy where the punchline is the healthcare system itself.
Dizziness, Tingling, and the Great GP Expiry Date
Since Grietje “stumbled” out of her wheelchair—an Olympic-level effort of maintaining both balance and dignity, might I add—she’s been experiencing some delightful issues like dizziness and tingling. But instead of a swift visit to the doctor, Grietje finds herself navigating the quagmire of healthcare post Co-Med collapse. You know it’s bad when even a trip to see a doctor feels like a visit to the dentist on a Monday morning—just no one wants to do it!
Now, Grietje’s been avoiding medical attention to the extent where she might as well be auditioning for “Survivor: Home Edition.” I mean, there’s always that neighbor who moonlights as a physiotherapist, so why not? Nothing says “I’m not feeling great” like a neighborly poke and prod instead of a professional’s advice!
From Home Remedies to Home Ruins
Enter Perone Cobben, doing her best impression of a respiratory suspense thriller. Short of breath, coughing like she’s auditioning for the part of a chain-smoker in a bad sitcom, she also finds herself giving the ol’ “GP roulette” a spin. She’s used to her old doctor, but now? She’s stuck with a digital platform for consultations which might as well be written in Klingon for all the good it does her. "Should I just call for help?" It’s like saying, “I’ll take a taxi to the hospital rather than calling an ambulance.” Talk about making life challenging!
And while insurers like CZ scramble to remediate this mess—bless their hearts!—they’re playing a game of “musical chairs” with doctors, but instead of chairs, it’s patient records left behind in Co-Med’s administrative dumpster fire. Who decided that running a healthcare company was akin to running a circus? Because right now, the clowns are winning!
The “Problem Spots” Where GPs Go to Die
Let’s not forget about the “problem areas” Zwaan mentions—areas where having a GP feels like trying to find a parking spot in Amsterdam on a Saturday. Good luck with that! Grietje and John Hof are stuck in Enschede, where every healthcare option seems to have booked a one-way ticket to Neverland. All the while, the rest of us have the audacity to wonder why there’s a healthcare crisis. Hey, maybe it’s because people are hoarding inhalers like they’re canned beans in a pandemic! You’d think Grietje was expecting a “puff” trade on the black market with her stash from Andorra.
Confidence? What Confidence?
Johan Franken from Bergen op Zoom is merrily waiting for his GP visit, which is more elusive than a Bully Billy at a toy fair. He’s got nosebleeds that could rival a horror movie scene, and yet he’s convinced he’ll find a doctor eventually. But let’s face it, he’s in the waiting room of life with no idea when his number will be called. Meanwhile, poor Perone’s confidence in healthcare is now teetering on the brink of collapse. Hoarding inhalers? That’s a solid “just in case” strategy—perhaps we should all join her club of pragmatic panic!
Ultimately, it’s great to see that our healthcare system is providing entertainment value in the form of a “Where Are All the Doctors?” game show! What’s next? DIY surgery kits from your local supermarket? If I were you, I’d keep a stash of Googled medical advice at the ready just in case.
So here’s to hoping that someone figures out a solution—because right now, watching patients navigate this healthcare nightmare is more distressing than the actual ailments they’re trying to avoid. Until then, it seems our newfound strategy is to “just cross our fingers and avoid the GP like a bad date.” Ah well, good luck with that folks!
