Expatriation is an exciting adventure, synonymous with the discovery of a new country, a new language… and, often, a whole new relationship with health.
For expatriates, a simple visit to the doctor can become a veritable cultural voyage. Express consultations, the absence of a physical examination, different privacy standards, or the omnipresence of certain medications: these differences, known as “medical micro-cultural shocks”, can be destabilizing.
United States: from questionnaire to technology – The secure approach
For expatriates from countries with a local medical system (such as France), the American system is often shock number 1. Doctors prefer legal certainty and technology in their approach.
- Less systematic physical examination: Unlike in France, the American consultation often relies more oninterviews, detailed medical histories and questionnaires than on routine physical examination (auscultation, palpation, etc.).
- Complementary examinations are preferred: The American doctor will tend to quickly prescribe blood tests, MRIs or other tests to secure the diagnosis and avoid any errors.
- Hyperspecialization: The system is highly compartmentalized. Each specialist remains strictly within his or her own perimeter. It’s rare for a generalist to deal with problems that, in France, would be considered semi-specialized.
- The role of technology: Electronic medical records and the integration of test results are central to the care process.
Expat tip: Prepare a summary medical file (history, allergies, treatments) in English before your first appointment.
Dubai and the Gulf: the “antibiotic” reflex and patient expectations
In many Gulf countries, such as Dubai and parts of Saudi Arabia, doctors are quick and easy to prescribe antibiotics. Expatriates are often surprised that antibiotics are prescribed even for infections considered benign in Europe.
- Local medical habits: These practices are linked to local habits and protocols.
- Patient pressure: There is sometimes pressure from certain patients (local or expatriate) who want “fast, effective treatment” and to leave with a prescription supplied.
- The Pharmacist: In some cases, it’s possible to access drugs more easily, which changes the dynamic of the consultation.
Expat tip: When in doubt, always ask why an antibiotic is necessary, or whether a “wait-and-see” solution is possible. Your role is to understand the treatment.
The Netherlands: “Low-Intervention” pregnancy
If there’s one area where the shock is greatest, it’s maternity. The Netherlands has adopted a philosophy of pregnancy and childbirth that stands in stark contrast to France’s often more medicalized approach.
- The midwife, the linchpin of follow-up: The verloskundige (midwife) is the professional of reference for a physiological (uncomplicated) pregnancy. Obstetricians only intervene if risks arise.
- Home birth: Although numbers are declining, home births and kraamhotel birth centers are still frequent and well supervised.
- Fewer tests and ultrasounds: Pregnancy is seen as a natural process. Expect fewer ultrasounds and blood tests than you’re used to.
- Kraamzorg (Post-natal assistance): This unique system provides professional help at home during the first days after childbirth.
Expat tip: Embrace the “low-intervention” philosophy. If you want a high level of medical care, it’s essential to choose a hospital maternity unit from the outset.
Japan: rigor, protocols and innovative equipment
The Japanese healthcare system impresses with its rigor and attention to detail. It creates a unique balance between tradition and hyper-modernity.
- Extreme Hygiene: The level of cleanliness and hygiene is impeccable.
- Very comprehensive examinations: The annual health check-up (or Ningen Dock) is extremely comprehensive and detailed, sometimes considered “too” extensive by the French, but aimed at early detection.
- Verbal Communication: Consultation can be highly technical and formal, with less verbal exchange or detailed explanation than in Latin countries. Precision takes precedence over discussion.
- Specific equipment: Medical equipment, particularly for ENT and dental consultations, can be surprising and reflects a particular attention to local innovations.
Expat tip: Use translation apps or, if possible, have a bilingual speaker accompany you so you don’t miss any instructions.
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Southeast Asia (Thailand, Singapore): ultra-fast consultation
In Bangkok, Singapore, Kuala Lumpur or Hanoi, new arrivals quickly notice a surprising phenomenon: the speed of consultations. This phenomenon is particularly noticeable in private clinics, where doctors keep very short appointments.
- Efficiency First: It’s not unusual to see a doctor in less than 5 minutes, receive a diagnosis and leave immediately with several medications.
- A High Demand Model: This model aims for maximum efficiency in contexts (especially in the private sector) where patient volumes are very high.
- Rapid diagnosis: The practitioner’s experience is often put to the test to establish an immediate diagnosis.
Expat tip: Don’t be afraid to insist on asking questions or requesting a few extra minutes of discussion if the diagnosis doesn’t seem clear to you.
Canada: the obstacle course for family doctors
In Canada’s public healthcare system, patients face a difficult reality: access to primary care.
- Shortage of family doctors: In many provinces (especially Quebec), finding a family doctor can be a real obstacle course, leading to long waiting lists (le Guichet d’accès à un médecin de famille or GAMF).
- Walk-in clinics: Meanwhile, expatriates often rely on walk-in clinics, where the wait is long and the follow-up less personalized.
- The role of the Specialized Nurse Practitioner (SNP): To compensate for the shortage of doctors, nurse practitioners are playing an increasingly important role in basic care.
Expat tip: Register for a family doctor as soon as you arrive, and familiarize yourself with online appointment booking services (e.g. Rendez-vous Santé Québec).
Australia: preventive medicine and the role of the GP
Australia is based on a system in which the General Practitioner (GP) is the guardian of the system.
- The Gatekeeper (GP): To see a specialist, you must go through your GP, who will provide you with a letter of referral. Without this document, the specialist will not accept you.
- Preventive medicine: Health professionals emphasize prevention and encourage a healthy lifestyle (sun, diet, exercise).
- The Mixed System: You can opt for the public system(Medicare), or the private one, but the GP is central in both cases.
Expat tip: Your GP is your first and most important point of contact. Establish a relationship of trust and ask for all necessary references.
Intimacy and Comfort: When Standards Change
The most striking cultural differences often concern intimacy, comfort and modesty.
| Country / Region | Special feature Often observed | Impact |
| United States, United Kingdom | Systematic presence of a chaperone (a third party, often a nurse) for intimate examinations. | Aiming at the legal protection of the practitioner and the patient. |
| Certain countries in Asia and the Middle East | Less concern for confidentiality in the consultation cubicles. | Privacy is sometimes less protected than in European standards. |
| Japan, some US states | Tendency to keep clothes on or to be scantily clad during physical examination. | Reflecting standards of modesty and a non-systematic approach to physical examination. |
Expat tip: You always have the right to ask for more confidentiality or to refuse the presence of a third party if this is not a legal obligation. Communicate your comfort zone.
The Essential Pillar: International Health Insurance
Given the diversity of systems and unpredictable costs,international health insurance is not a luxury, but a necessity for expatriates. In countries such as the USA, Canada or Singapore, costs can become exorbitant without adequate coverage. A good insurance policy offers much more than simple reimbursement. It guarantees access to a network of private practitioners, often bilingual. It also enables you to obtain a second opinion with complete peace of mind and, above all, it covers medical evacuation or repatriation. It’s the essential safety net that enables you to navigate foreign healthcare systems with a minimum of financial and logistical stress.
Anticipating for better adaptation
These micro-shocks shape the way expatriates experience their healthcare. Anticipating them means feeling better armed, more serene and, above all, more involved in decisions concerning your own health. The golden rule? Ask questions, stay curious and never give up on good communication with your doctor.
