Nevertheless, you should choose your doctor as carefully you would in your home country. In Belgium you aren’t obliged to register with a GP, but if you incur treatment charges without obtaining a referral from your GP, these may not be reimbursed under some insurance plans, or will be reimbursed at much lower rates. Even in systems where you’re permitted to book appointments or treatments directly with specialists, you’ll find that a good GP is invaluable in terms of guiding you through the system and helping you to find the right specialists or treatment facilities.
Doctors are listed in the Yellow Pages, but you’re more likely to find someone who suits you and your family if you ask friends, neighbours and work colleagues for recommendations. Many Belgian doctors speak English or at least understand it reasonably well, as medical training in the region often involves the use of English-language text books or periods of study in the UK or USA. You may be able to obtain a list of English-speaking doctors from your local British or American consulate or embassy or by contacting expatriate clubs and associations.
Belgian doctors aren’t always particularly open to questions or discussion about your treatment or concerns, so if this is important to you it may take some searching to find a GP with whom you’re comfortable. It’s common practice to make an initial ‘familiarisation’ appointment with a doctor to determine whether you like his ‘style’. The cost of such appointments is usually reimbursed by private health insurers, provided you don’t meet every doctor in the area before making your decision! There may also be some restrictions on your choice of GP, depending on the health insurance system in which you’re enrolled.
Once you’ve chosen a GP, you should ask about office hours and whether he makes appointments ( rendezvous/afspraak) or holds ‘walk-in’ consultations or a combination of the two (which is most often the case). Being able to go to the doctor whenever you aren’t feeling well can be convenient, although there may be a long queue. Some doctors operate a supermarket-style queuing system in their waiting rooms, so that everyone is seen in turn. If you prefer to make an appointment with your GP, it’s normally possible to be seen the same day. On the other hand, it can take several days or weeks to see a specialist, most of whom work by appointment only.
Doctors usually make house calls, and some prefer to attend to you at home by appointment rather than letting you share your ‘germs’ with everyone in the waiting room. Sometimes you need to call before a certain time, e.g. 9am, to secure a place on the house call schedule for that day, and house calls (other than for emergencies) may be limited to certain hours. Make sure you ask your new doctor what his system and preferences are for appointments and house calls.
Most Belgian doctors operate alone, without any administrative or nursing staff to handle phone calls or make appointments, which means that they often take phone calls in the middle of a consultation, which can be rather annoying at first. If you need to see a doctor outside normal surgery hours, at weekends or during holiday periods, your GP will have an answering service or recorded message giving you the name and phone number of the duty doctor ( médecin de garde or de nuit/wachtdienst).
The names and phone numbers of duty doctors are sometimes listed in local newspapers and neighbourhood publications, but it’s generally best to call your GP first. In many cases the duty doctor will have access to your doctor’s files or understand his preferences for treatment.
Doctors’ surgeries are generally set up for consultations and general examinations. If you need to undress for an examination, it’s unlikely that you’ll be given a gown or even a sheet to cover yourself, so dress accordingly. (For some reason, doctors’ surgeries tend to be cold, so it’s sensible to wear a loose shirt or top you can keep over your shoulders.)
If the doctor determines that you need medication or a specialised examination or treatment such as x-rays, he will write a prescription for you to take to the appropriate facility. The doctor will normally recommend the closest or most convenient chemist or clinic, although in most cases you’re free to choose where you go.
Examination or treatment results are sent directly to your doctor, although you can ask to have a copy sent to you (either by the clinic or by your doctor). X-rays, scans and mammograms are generally given to the patient, along with a brief written description of any findings. You should take these with you on subsequent visits to the doctor, and keep them with your medical records in case they’re required in future. If your doctor gives you an injection from his own store of vaccines, you’ll be given a prescription to purchase a replacement for the doctor’s stock from a local chemist.
It’s normal practice in Belgium to pay your doctor directly for both regular consultations and any services you receive. Doctors normally only accept payment in cash or by cheque. Clinics and chemists may take credit cards, but not all do. You’ll be given a receipt, which is also the form you need to complete to claim reimbursement. If you’re covered by private insurance, particularly expatriate coverage, make sure you know what forms and information you require to claim any reimbursements due. In many cases, insurers insist on itemised receipts showing services rendered or indicating a specific diagnosis, which may not appear on a standard national health service form.
Doctors in Belgium have trained for a minimum of seven years, in the case of a GP, and up to 12 years to become a specialist, and they’re required to undergo additional training annually. Many Belgian doctors have undertaken at least part of their studies in English, so finding an English-speaking doctor shouldn’t be difficult. Belgian doctors also have a reputation for taking time with their patients to answer questions and discuss treatment, which isn’t always the case in other countries.
Under the Belgian national health care system, you can make an appointment directly with a specialist without requiring a referral from your family doctor, but your GP is often the best person to advise you on choosing a specialist.
This article is an extract from Living and Working in in Holland, Belgium & Luxembourg from Survival Books.