‘I have to peddle with patients’, pressure on GP due to postponed operations

The fact that 30,000 patients are still waiting for an operation in the hospital that has been postponed by corona creates a lot of extra work for general practitioners. That is what one of them, the Breda doctor Berend Nikkels, tells us. He sometimes puts pressure on the kettle when he thinks that someone who really needs help quickly has to wait too long. “Sometimes I go after it myself. Sometimes that helps, but nothing goes smoothly. It’s also strange that I have to peddle with patients like that, I have something else to do.”

Written by

Malini Witlox

Even now that the intensive care unit is no longer full, a scheduled operation has already been postponed several times for some patients. Hospital staff themselves drop out due to corona or flu, or employees are stressed after walking on their toes for two years. The patients of Nikkels are regularly told that a scheduled operation will be postponed even longer, although according to him this is not actually medically responsible.

“The waiting time for hip surgery is now six months. Even longer with knee surgery. Often these are prostheses. These people perish from the pain and because of their age, they often cannot tolerate regular pain relief. So they have to put on morphine patches, but that is also very difficult to get rid of. The risk of addiction is high.”

“It’s not pleasant to walk around with a bad heart for months.”

Patients with cardiac arrhythmias also have to be patient, with the risk of getting worse as a result. “Those people have to be operated on, where the heart tissue that causes the malfunctions is frozen or burned away. The waiting period is now three months. It is not pleasant to walk around with a bad heart for so long.”

In addition, many regular consultations have been converted into video calling by the cardiologist. A bad thing, thinks Nickels. “I don’t think that’s possible. Last week I had it with a patient who had had a bypass. A physical exam is needed, but he gets a video consultation asking how things are going.”

“It’s weird that I have to peddle with patients like that.”

Patients regularly visit his office hours, where they say that despite his referral they are still not being helped. “Formally, they have to be with their health insurer, which has waiting list mediation. But I sometimes go after it myself. Call the hospital again or write a letter: ‘You must hurry now’. Sometimes it helps, but nothing goes smoothly.”

Nikkels does not have a solution immediately available either. “Working in the hospital on weekends and evenings. They do that in Belgium too. I also regularly refer cardiology patients to Antwerp where they do not have these problems. But the Dutch hospital staff is already on their toes, you can’t expect them to work any more overtime. There is simply not enough staff.”

“Things are coming to a standstill”

Another bottleneck, dermatology, where people with skin problems should go. Not immediately life-threatening (except for skin cancer) but painful. The regular waiting time is six weeks. That has now increased to months. If your skin is on fire because of an inflammation, that is a really long time.”

In the meantime, some patients, in consultation with their doctor, opt for treatment at a private clinic. “But that is not possible in oncology and cardiology, for example. Things just come to a complete standstill because care has been shut down for two years.”

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