In the fourth quarter of 2025, sickness absence in the Netherlands reached 5.6 per cent. That meant 56 of every 1,000 working days were lost to illness. For employers that is a serious concern, given that an employee who is ill costs an average of more than €400 a day.
Engaging an occupational physician is an important step in bringing those costs down and guiding absence. Not only because every employer is legally required to work with an occupational physician or occupational health service, but above all because acting in time offers big advantages for absence guidance, reintegration and prevention. You can read more about the physician's role in what an occupational physician actually does.
It matters to act before threatening long-term absence gets out of hand. Occupational physicians are not only a safety net during illness but a preventive force. They advise on workload and psychological complaints, among other things. If reintegration effort is not carried out in time and in full, the financial consequences can be considerable. To prevent UWV imposing a wage sanction, it matters to have a problem analysis drawn up as early as week 6 of the absence. You can read more about drawing up an action plan in our step-by-step guide to reintegration after long-term absence.
When are you required to engage one?
For many employers, the question of what engaging an occupational physician costs starts not with the rate but with the legal obligation. Under the Working Conditions Act, every employer has to arrange access to an occupational physician, through an occupational health service or directly with a physician, in a basic contract. That basic contract is not a choice but a compulsory part of good working-conditions policy. The Dutch government explains that this contract contains minimum requirements for healthy and safe work and for support with absence and prevention.
It matters to distinguish between a certified occupational physician and other doctors who may work within an occupational health service. Only the occupational physician may judge fitness for work. That is relevant for employers looking mainly at price: a lower rate is not automatically suitable if the statutory tasks are not properly assigned.
For employees it means they have a right of access to the occupational physician, preventively as well. They may also visit the physician without the employer's permission. For the physician it means being able to advise independently, while protecting the employee's medical privacy.
Anyone who wants to understand the legal basis and the practical division of roles better can also look at what an occupational physician actually does and at your obligations as an employer on working conditions and absence.
How it works in practice during absence
When an employee reports sick, not only an absence process starts but a legal and practical one. According to Arboportaal, the employer has to pass the sickness report on to the occupational physician or service in good time. The timeline of the Gatekeeper Improvement Act names seven days as the guideline.
When long-term absence threatens, the physician draws up a problem analysis by around week 6. Employer and employee then make an action plan together. After that come review moments, including the first-year evaluation and later the final evaluation towards a possible WIA application.
What that means for the employer
For you as an employer, speed matters. Not because you have to gather medical information, but because you have to organise the process well. The physician assesses capacity and the possibilities for resuming work; you organise the working arrangements, the adjustments and the follow-up. If you act too late or skip steps, UWV can judge the reintegration effort insufficient, which can lead to a wage sanction requiring you to keep paying wages for up to a year longer.
What that means for the employee
For the employee, what matters most is that the occupational physician does not do the same thing as a manager, an HR professional or a treating doctor. The physician looks at the relationship between health and work. The employee does not have to share medical details with the employer. The physician may not share that information either, but may advise on employability, expected duration of absence and possible adjustments to the work.
What that means for the occupational physician
For the physician the task lies in independent assessment, advice and guidance. That applies to physical and psychological complaints alike. With mental overload or stress complaints in particular, timely involvement matters. The NVAB guidelines and practical guidance on psychological complaints emphasise that quick assessment can help limit worsening and long-term drop-out.
Which costs can you expect?
The question of what engaging an occupational physician costs often turns on one thing: do you pay per employee per year, or per service? In practice both models occur.
A commonly named range for occupational health services lies around €120 to €200 per employee per year, depending on the form of contract, the level of absence and the services provided. Alongside that, some providers work per service. Recent price lists show, for instance, that a consultation with an occupational physician often costs between around €226 and €295. For a follow-up consultation, amounts around €255 are usual, while an urgent consultation can run to around €395 to €410. Separate items such as a problem analysis, an FML capacity list or a current assessment are sometimes charged separately as well.
Examples of rates
- Consultation with an occupational physician: around €226 to €295
- Follow-up consultation: around €255
- Urgent consultation: around €395 to €410
- Problem analysis: from around €97.50 to €350
- FML capacity list: from around €97.50 to €350
- Second opinion: guide price around €1,975
Those differences show that comparing prices is only useful if you also look at what is included. A low annual rate can still work out expensive when almost every service is invoiced separately. Conversely, a higher subscription rate can be more predictable when you need several consultations or preventive services.
Why looking only at price usually falls short
The direct cost of an occupational physician stands out, but the indirect cost of absence is usually much higher. According to Statistics Netherlands, sickness absence stood at 5.6 per cent in the fourth quarter of 2025. That means 56 of every 1,000 working days were lost to illness. Other figures show employees were absent an average of 17.1 working days in 2024 when they were absent at all. On top of that, the cost of an absent employee is often estimated at hundreds of euros a day, through continued wage payment, cover, lost production and the time of HR and managers.
Which is why what engaging an occupational physician costs is not only a purchasing question but a question of managing risk. A timely problem analysis, clear advice on resuming work or preventive involvement when complaints mount can help limit longer absence. That does not make an occupational physician "cheap", but it often makes one financially sensible.
That matters too in a tight labour market, where drop-out weighs more heavily. In that context it makes sense not only to act reactively during illness but to invest preventively in employability. That fits the physician's role as an adviser on health, workload and sustainable employability.
Safety-net arrangement or tailored arrangement?
The cost also depends on how you organise your occupational healthcare. You can choose a safety-net arrangement or a tailored arrangement.
With a safety-net arrangement you join a certified occupational health service that carries out the statutory tasks. That is clear, but often broader and sometimes more expensive. With a tailored arrangement you choose the experts you need yourself, for instance an independent occupational physician combined with other working-conditions experts. According to Arboportaal that can be more cost-efficient, provided the employees or works council agree in writing and the contract meets the legal requirements.
When can a tailored arrangement be financially attractive?
A tailored arrangement can be interesting if you:
- have little absence;
- are a smaller organisation;
- are looking for specific support;
- want more direction over consultations, prevention and additional expertise.
When does a safety-net arrangement fit better?
A safety-net arrangement can fit better if you:
- want one point of contact for all occupational health services;
- have little internal capacity for direction;
- need fixed processes and broad support.
For the occupational physician, the form of contract matters less than the quality of the cooperation: clear arrangements, timely referrals and enough room for independent advice count for more than the purchasing model alone.
Preventive use can limit higher absence costs
Many organisations only engage the occupational physician once an employee has already dropped out. That is understandable, but often not the smartest route. Employees have a right of access to a walk-in clinic and can visit the physician before any sickness absence arises. A physician can also think along about a periodic occupational health examination, capacity, workload and workplace adjustments.
For employers that means what engaging an occupational physician costs also has to be looked at in the light of prevention. An early conversation when stress complaints are just starting, or when physical strain keeps recurring, can help prevent drop-out. With psychological complaints in particular, early involvement matters, because these complaints relatively often lead to longer absence.
In practice we see preventive use working above all when managers recognise signals in time and employees know the physician is there not only for checks but for advice and support. In that light it can also be relevant to consider the shortage of occupational physicians in the Netherlands, because availability can affect waiting times, scheduling and ultimately the speed of absence guidance.
What to watch when choosing a provider
When you compare providers, look not only at consultation rates or an annual price per employee. Watch also for:
- whether there is a legally correct basic contract;
- whether the occupational physician is registered in the BIG register as a specialist in work and health;
- how quickly an employee can be seen;
- whether the problem analysis and follow-up consultations are included;
- how availability is arranged for employer and employee alike;
- whether a preventive clinic is possible;
- how the second opinion and privacy are safeguarded;
- which other core experts can be brought in, for instance for a risk inventory and evaluation or workplace questions.
For employees, what matters most is that access is easy and confidentiality is well arranged. For employers, it matters that the advice is practically applicable on the floor. For the physician, it matters that the context of the work is well known, so that advice is not only medically sound but workable.
That is often exactly where the difference lies between simply buying in care and organising good absence policy: not the lowest price per consultation, but a workable cooperation that helps support health, employability and reintegration well.
Engage an occupational physician in time: that way you prevent longer absence, limit costs and help employees move forward.
With the right occupational physician and clear working-conditions arrangements you keep a grip on absence, on costs and on the support your people get. By making choices now that suit your organisation, you lay a strong basis for healthy and lasting work.
Key takeaways
- Always arrange a legally correct basic contract, so that your organisation demonstrably meets working-conditions law and has access to an occupational physician.
- Assess not only the rate but what is and is not included in the service, so that you avoid surprises and hidden costs.
- Engage the occupational physician in time during absence to organise the process well, watch the deadlines and limit the risk of wage sanctions.
- Use preventive support such as clinics, advice and early spotting to prevent absence rather than only reacting to it.
- Invest in good cooperation with the physician for practical advice, careful handling of privacy and workable reintegration arrangements.
- By steering actively on healthy work and sustainable employability you reduce the chance of complaints growing into long-term drop-out and high costs.
When you invest early in prevention, clear working-conditions arrangements and an involved occupational physician, you build step by step towards an organisation where people can keep working healthily. That way you create not only less absence and lower costs, but above all a working climate in which people can do their work with confidence and energy.