Persistent somatic symptoms in the Dutch healthcare system

Persistent somatic symptoms (PSS) are common in primary care and often associated with functional impairment, dissatisfaction with medical care, and high societal costs. In the Netherlands, a strong primary care system has provided fertile ground for the development of a comprehensive approach to PSS, including evidence-based guidelines, stepped care pathways, and national patient information resources. This Editorial describes how PSS care is organized in the Dutch health system, the evolution of terminology and clinical concepts, the role of coordinators of PSS care in primary, secondary, and tertiary care, and the integration of psychosomatic interventions within this care. We highlight system innovations such as Thuisarts.nl (i.e. GPinfo.nl), a national, evidence-based patient information platform aligned with Dutch general practice guidelines, national care standards and regional collaborative care networks, reflect on implementation challenges, and describe the Dutch approach. The Dutch experience illustrates that PSS care can be coherently organized when anchored in general practice and supported by national guidance, patient information, psychosomatic and allied interventions, and collaborative networks. Remaining challenges include embedding consultation skills in training, ensuring equitable access, measuring patient-valued outcomes, and aligning system incentives to sustain implementation.