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Diagnosing Tietze of Costochondritis is just the beginning.

The care system in the Netherlands is quite advanced. However when you have been diagnosed with Tietze of Costochondritis, it appears that there is little knowledge about this disease. Sometimes the knowledge that’s available is hard to find or scattered. GP’s in the front line do not always lay a connection to Rheumatism and therefore won’t send you to a Rheumatologist. Sometimes you get the advice : Learn to live with it” or ” take a pill  against the pain”. The patient can get the feeling not being taken serious and feels left to his/her own. To make the diagnose of Tietze can help the patient, but that’s not where the role for the GP ends. The patient may know what ails him/her, but the GP is not a specialist and knows in general little about het course the disease and the treatment. Normally the GP’ have a guiding and often also a coordinating role in chronic and rare diseases like Tietze and Costochondritis. This goes further than making a diagnosis. Listening , taking signals serious and sending the patient when necessary to a specialist is a good begin.  

Listening to a  outspoken and experienced patient.

GP’s and specialist who work in the Netherlands are well educated, experienced and thrust wordy. Better doctors are those who understand that listening is sometimes as much or even more important than prescribing a medicine or referring to a specialist. They know that empathy for the patient will help in curing the patient. They are more effective and are more professionally satisfied and will have lesser chance on a burn out. Not every doctor has a natural ability for that, but it can be taught.

De client is important. If we buy something in a shop or we go out dining, we expect quality for our money. Do we not get what we expect, we make a complain, and extreme situations we won’t come back as client. The relation between doctor and patient is  just like that. Doctor’s “sell” a service for which we, as client pay. Therefore we may have some expectations from service that the doctor delivers. We also have our own opinion on the condition of our own body, its ailments and the treatments. If we feel the need, we can ask for a second opinion. A positive development, however sometimes a bit confusing for the consulting GP or specialist. To question is : how far does own responsibility go and where does it end.

In medical schools more than ever before students are taught how to cope with a outspoken and knowledgeable patients. Some  patients like to leave the responsibility of the course of treatment to the GP or specialist. Nothing wrong with that. In most cases they can come to the right conclusion and treatment. However in more complex cases, like with Tietze, where private and work circumstances are to be taken in account, some input from patients can help in finding the right treatment.

Since 1995, the law in the Netherlands on medical treatment agreements dictates the GP must give complete information, the pro’s and contra’s of different treatments and explain why he or she has come to the conclusion to prescribe a certain treatment. In most cases this is not a problem.

Tips for a good relationship with your GP (doctor)

  • Ask during a consultation, what the GP’s opinion is on Alternative treatments or prescription of medicines.
  • Write down before a visit all the questions you have. This will help you  as a reminder during the consultation and as a checklist at the end of the session.
  • Be open and say what you want to say, how you feel and what you want. Speak out when something is not clear to you and you require more explanation.
  • Speak out when you have the feeling not being taken serious or if you not satisfied about the treatment.
  • If you have fears or are doubtful, talk about it. Once home, it is too late.
  • At the end of the consultation, summarise  the given information to see if you have understood everything well.
  • Ask if there is a flyer or reading material.
  • Do not hesitate to ask for a second opinion in a complicated or important matter. After all it is your body and your health we are talking about.

Golden Rules

A patient may trust that his/ her GP or specialist:

  • Will always see and provide care to the patient in cases of acute chest pain.
  • Will take the signals from the patient serious even when the causes are unknown to him at the moment.
  • Will trust and  act upon good common and clinical sense.
  • Understands that the pain is as worse as the patient expresses.
  • Won’t send the patient home telling him to learn to cope with the condition.
  • In certain situations will send the patient to a specialist centre for treatment of chronic pain near the patients residence.
  • That in case of medical treatment understands that sometimes people suffering from chronic pain might require more or other medicines.
  • That a patient might look well and act cheerful, even when the patient is serious ill.
  • Himself acts as a link between the therapist and the patient and will look with the patient to the best solutions and treatments.
  • Always show and discuss without asking test results.
  • Always invite to contact him again if the condition does not improve.
  • If there is some diagnostic doubt, at least prescribe a pain killer (except in cases of allergy)
  • Treats a patient the same way as he would like to be treated.

Making a complain about Medical professionals

In a perfect world every time we seek help from a health professional we’d be 100 per cent satisfied with how we are treated. But the world isn’t perfect, and like any provider of a service, doctors make mistakes. These mistakes can range from unprofessional behaviour to incompetence or simply a momentary lapse in judgement where the doctor makes a poor decision. It’s important not to accept poor treatment, but to make a complaint about it. This doesn’t just benefit you the consumer, it’s also in the community’s interests because it means there’s less likelihood of someone else will experience the same problem in the future. In many countries there are consumer organizations or authorities, that can help you finding the right way to lodge a complaint. You can find these by searching the internet. In the Netherlands you can contact the consumentenbond (consumer protection). (tel: 070-4454545) They can be reached from Monday till Friday from 08.30 till 18.00 hrs. They can advise you on questions about complain procedures and about your right to request  for an other medical practitioner or a second opinion. For members of the consumentenbond this advise is free.

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