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More from Europe

I can’t talk about my recent trip to Holland and Belgium without mentioning that I met in Brussels with an official from the European Commission e-health office.

While most everyone who cares about IT in healthcare knows about Connecting for Health (formerly the National Programme for IT) in England, there is plenty going on across Europe in the areas of patient-centered care and regional interoperability. I will be reporting on this in the coming weeks.

April 12, 2006 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

Mea culpa

I must confess, I fell into the same trap so many millions of other Americans do when it comes to selecting a doctor. I took the recommendation of my internist for an orthopedic practice without consulting quality ratings or inquiring about prices.

And, because I am an individual with pre-existing conditions, I actually have a health savings account with a high-deductible health plan that excludes pretty much everything I usually get cared for, so I really do need to shop for quality and price.

I went to the orthopedist for a knee I injured playing ice hockey and, after some X-rays (on film, not digital) and an exam, he diagnosed a contusion and a sprain. I was to rest the knee when possible, keep the knee wrapped, ice it several times a day and take a double dose of ibuprofen with meals. Simple enough.

Four weeks and a follow-up exam later, I got the OK to test the knee with activities like cycling and skating. It’s certainly not 100 percent, and you won’t see me doing much running or jumping for a while, but it definitely feels better.

The three X-rays set me back $180. I’m still waiting to receive the doctor bill because the practice did submit an insurance claim. Hopefully it won’t be too much out of my pocket.

The physician did not even bother to order an expensive (and often unnecessary) MRI because he could tell by touch that there is no ligament tear, most likely just some cartilage damage. That means no surgery either.

In between the two orthopedic exams, I spent two weeks in Europe, doing a whole lot of walking on old, uneven cobblestone streets and sidewalks, and climbing numerous steep, creaky staircases. It was a little too chilly to rent a bicycle, so I didn’t have to subject my knee to any more work than necessary. The knee mostly held up.

I did, however, have a first-hand encounter with the Dutch health system, thanks to my own stupidity. I left one of my prescription medications back home and didn’t bring enough of another.

Fortunately, a pharmacy near my hotel in Amsterdam was very accommodating, and no, I am not talking about that kind of Amsterdam pharmaceutical vendor. It was about 2:30 p.m. in Amsterdam, which was 7:30 a.m. back in Chicago. My pharmacy at home was not yet open to look up refill information and my doctor was not in his office. No matter, since the local pharmacy would not fill a prescription anyway unless it came from a Dutch physician.

I figured I would have to wait in line at some walk-in clinic and hope for the best. Instead, the pharmacist called a nearby doctor’s office, gave the receptionist my name and told me to head right over there. Less than 30 minutes later, I had my script, and the pharmacy filled it right away. The total doctor’s fee was €13.25 (about $16).

The meds—both generics—actually cost a bit more than I would have paid at home. The lower European prices we hear so much about really only apply to brand-name drugs, but no matter, my vacation was saved.

This system turned out to be amazingly efficient and affordable, and yet I couldn’t get out of my mind the potential for error because the physician’s office did not even ask me for a medical history. All I gave them were my passport for identification, the bottle of the medication I didn’t have enough of and a piece of paper with the name and dosage of my other medication, plus, of course, my small cash payment. They had no proof I even was on the other medication. Neither drug was a narcotic or any sort of controlled substance (at least in the States), but I felt like there was a huge potential to cheat the system if I really wanted to.

I walked out the door with a handwritten script and walked it back over to the pharmacy, the old-fashioned way. The pharmacist did fill the prescription correctly, but she had to explain everything to me because the label, instructions and receipt were printed in Dutch. Fortunately, I was familiar with how to take the medications and potential side effects. If it had been a new prescription, I might have had a problem.

Yeah, I’m aware that the majority of Americans abroad don’t often bother to learn local languages (I studied French, not Dutch), but I could go to just about any pharmacy in the United States—certainly any of the major chains—and get detailed instructions in Spanish, Hindi, Russian or Korean. With the European Union and its open borders now stretching across 25 countries, you would think a Dutch pharmacy would have similar language capabilities. The drug suppliers ought to make sure of it.

Perhaps I’m making a big deal out of nothing, since the system worked and I got what I needed quickly and for not a lot of money, but it’s just another argument in favor of electronic prescribing. Besides, it’s my blog, I can say whatever I like.

I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.