Sickness absence in the Netherlands reached 5.8 per cent in the first quarter of 2025, averaging 5.5 per cent at larger organisations with 100 employees or more. With the cost of absence running from €360 to €400 a day per employee, it is worth considering whether an in-company occupational physician would be a valuable addition to your organisation. A regular physician on site can respond faster to absence, workload and prevention, especially now that 22 per cent of absence is work-related and stress accounts for a quarter of absence days.
In a period when one in five employees has burnout complaints, a structural partnership with an occupational physician has clear advantages. It is not only a legal requirement; it can also bring calm and continuity for your employees and your HR team. Because of the growing national shortage of occupational physicians, it is worth knowing when and how such a partnership adds value. In this article you will read about the benefits and the practical and legal sides of it.
When an in-company physician adds value
An in-company occupational physician is not needed in the same form by every organisation, but can be particularly valuable as soon as absence, workload or prevention call for structural attention. Under the Working Conditions Act, every employer must have a basic contract with an occupational health service or physician. Through the standard and tailored arrangements (in Dutch) there is room to shape that support to fit. An in-company physician fits well there: a physician who is regularly on site and gets to know your organisation.
For employers this is especially worthwhile when absence is no longer only a matter of individual cases but shows a pattern. According to figures from Statistics Netherlands, absence in the first quarter of 2025 stood at 5.8 per cent. At larger organisations absence is on average higher than at small companies. Organisations with 100 employees or more therefore benefit more often from a fixed structure, a recognisable point of contact and periodic discussion of absence and prevention.
The nature of the absence matters too. Figures from Statistics Netherlands and TNO show that workload, infection at work and physically heavy work are important causes of work-related absence. On top of that, one in five employees had burnout complaints in 2024. When psychological absence rises or teams are under prolonged strain, an in-company physician often has more effect than reactive absence guidance at a distance.
What an in-company physician means for employer and employee
A settled presence on the floor
The practical difference lies above all in proximity and context. A physician who visits your organisation regularly sees not only files but also work processes, managers, workplaces and recurring sticking points. That makes the advice more concrete. With back complaints it might be about physical strain in one department. With stress complaints it is more likely to be about workload, rosters, autonomy or how people work together.
For employees this often lowers the threshold to ask questions. The NVAB stresses that employees must have free access to the occupational physician, without the employer's permission and also when there is no absence. So a walk-in clinic is not only meant for employees who have reported sick, but precisely also for preventive questions about health and work. That fits how we prefer to organise prevention: spotting things early, before anyone drops out.
For employers this means an in-company physician can do more than handle absence files. Think of:
- periodic clinics on site;
- discussions with HR, managers and the prevention officer;
- spotting recurring causes of people dropping out;
- advice on preventive medical examinations, workplace strain and sustainable employability;
- support with complex cases and reintegration.
Anyone who wants to know more about the physician's role and tasks in practice can also read what an occupational physician actually does.
A lower threshold, faster action
A well-known advantage is speed. When you agree fixed clinic times, employees and managers know when the physician is available. That helps you get in early. Rather than only acting once absence is rising, you can move earlier on recurring complaints, on someone at risk of dropping out or on questions about what an employee can bear.
That is not only better for the employee but often financially sensible. The cost of absence rises quickly: on average it comes to hundreds of euros per absence day per employee. Certainly with long-term absence through stress or psychological complaints, an early assessment by an occupational physician can help take fitting steps sooner.
The in-company physician and statutory obligations
An in-company physician is not an optional extra alongside the law, but has to fit within the legal framework. Every employer must have a basic contract (in Dutch) with a physician or occupational health service. That contract covers, among other things, absence guidance, access to the physician, the walk-in clinic and the physician's ability to visit the workplace.
For organisations that want more of the lead themselves, the tailored arrangement offers room. You then do not automatically take one standard package through a service, but organise parts of it more deliberately. An in-company physician can fit well within that, provided the statutory tasks are properly assigned.
Employers should be aware that the Netherlands Labour Authority enforces on the basic contract. The Gatekeeper Improvement Act also continues to apply. That means, among other things:
- a problem analysis by the physician or service by week 6 at the latest;
- an action plan by week 8 at the latest;
- timely reviews and adjustment of reintegration steps;
- a complete reintegration report for UWV.
A physician who knows your organisation well can often place those steps better within the reality of the work. In practice that helps with workable reintegration advice, for instance about building up hours, adjusted work or capacity in a particular role. You can find more background on this in your obligations as an employer.
For which organisations it is often worthwhile
Larger organisations and higher absence
As an organisation grows, the chance increases that absence guidance, prevention and policy need more coherence. At 100 or more employees, several cases often run at once, different managers are involved and the need for fixed discussion moments, such as a social-medical review, arises sooner.
In such a setting an in-company physician helps bring structure. Not only in individual cases, but at department level as well. If certain teams drop out more often, the physician can think along about underlying causes and suitable support.
Sectors with physical or mental strain
In sectors where work is physically heavy or where emotional strain is high, an in-company physician can mean a great deal. Think of healthcare, logistics, industry, education or business services with high workload. When the same type of complaint keeps coming back, individual guidance alone is often not enough. Then the organisational level matters at least as much.
TNO and Statistics Netherlands show that high task demands and little autonomy are important predictors of work stress. When a physician is regularly on site, they can pick those signals up earlier and raise them with management, HR and the prevention officer.
Organisations going through change
During reorganisations, rapid growth, mergers or changing rosters, an in-company physician is often extra valuable for a period. Change brings unrest, and you regularly see that come back in absence, stress complaints or questions about employability. Extra presence of a regular physician makes it easier to move quickly and to offer employees a familiar point of contact.
Practical conditions for making it work
An in-company physician only works well when the conditions are right. Privacy comes first. There has to be a quiet room that can be closed, where employees can speak to the physician in confidence. That is not only practical but important for trust. Employees have to be sure that medical information stays protected and does not travel through the employer.
Clear communication is needed as well. Employees have to know:
- when the clinic takes place;
- that they may get in touch without their manager's permission;
- which information is and is not shared with the employer;
- that the physician advises independently on medical matters.
For HR and managers it is wise to agree in advance what the cooperation looks like. For instance:
- how often the physician is on site;
- which cases come to the clinic or to the review;
- when a social-medical review takes place;
- how signals about prevention are fed back;
- how roles are divided between physician, HR, manager and prevention officer.
Anyone still comparing this with regular services may also benefit from how engaging an occupational physician works and what it costs.
An in-company physician in a tight market
One more point to watch is the availability of occupational physicians. According to figures from the NVAB and the Dutch capacity body, the shortage will remain large for years to come. Too few new physicians are starting, while a considerable part of the current profession will leave within ten years. For employers that means quick, occasional availability is becoming less of a given.
That is precisely why a settled partnership can be wise. An in-company physician who already knows your organisation has to spend less time building context and can come to fitting advice faster. That matters for continuity, in absence as well as in prevention. In that light, the shortage of occupational physicians in the Netherlands is also relevant to strategic choices in your health, safety and absence policy.
What to weigh in the decision
Not every company needs a full-time or weekly in-company physician. The question is above all: does a settled presence deliver more than separate consultations? You can look at a number of signals:
- your absence is rising or stubbornly high;
- psychological complaints are increasing;
- managers need easily accessible advice;
- prevention still gets too little attention;
- the organisation is growing fast or changing considerably;
- you want more grip on recurring causes of people dropping out.
For employees the right choice means above all better access and faster advice about health in relation to work. For employers it often means more overview, earlier support and better-founded policy. For the physician, a settled presence makes it possible to work not only curatively but preventively. And that is where the biggest gain lies in many organisations.
With a regular physician on site you prevent absence earlier and create calm, clarity and grip.
An in-company occupational physician can be of great value if you want to get serious about healthy work, lower absence and sustainable employability. Being structurally present in your organisation produces a sharp picture of what employees need and of what you as an employer can improve.
Key takeaways
- An in-company physician is most valuable when absence, workload or prevention have needed a lot of attention within your organisation for some time.
- Regular presence on site gives a better view of work processes, sticking points and the patterns behind recurring absence.
- Employees get in touch with the physician sooner when the clinic is organised in an accessible, visible and familiar way.
- For HR and managers a regular physician is an important sounding board on absence, reintegration and preventive questions.
- Clear arrangements about roles, availability, privacy and reporting are needed to work together well within the legal framework.
- Investing early in prevention and healthy work strengthens both the sustainable employability of employees and the resilience of the organisation.
Would you like to look into whether an in-company occupational physician suits your organisation? We will gladly go through your current absence figures, workload and prevention policy with you. That way you take targeted steps towards a healthier organisation, where people keep working with pleasure and stay employable longer.