“We want to unburden our participants”

Published on: 3 April 2023

She is a dermatologist as well as a pension administrator. Those two roles have a lot in common, says Amber Goedkoop, the new CEO of SPMS, the pension fund for independent medical specialists. “The medical and pension worlds touch each other, which is fascinating to me.”


When Amber Goedkoop gives an interview, it is usually about the dangers of skin cancer, due to too much and too frequent exposure to the sun. In recent years, for example, she has told women’s weekly magazine Margriet and the Jeugdjournaal how best to protect our skin from the sun. (We repeat it here once again: apply, apply and re-apply sunscreen - even to the tip of the nose, ears and lips). “Skin cancer is becoming more and more common and that worries me,” she says from the St. Antonius Hospital in Utrecht, where she is a dermatologist.


Talking about her medical profession is a lot easier for Dr. Goedkoop than talking about her role as the brand-new CEO (as of March 1, 2023) of SPMS, the pension fund for the 18,000 independent medical specialists, she laughs. But she is willing, because the financial health of her fellow professionals - now and in the future - is also close to her heart. “As a young specialist, retirement seemed very far in the distance; it was something I had never dealt with it. Only once I started looking into it did I see its importance: not only for myself and my colleagues, but also in a social sense. Incidentally, I also see a lot of common ground with the healthcare sector.”


What parallels do you experience between your roles as a physician and pension administrator?

“As a doctor, you talk a lot with patients: what is the problem, what treatment can we choose for it, and what are its advantages and disadvantages? You’re always weighing the options, always keeping the patient’s best interests in mind. And as a pension administrator, you’re basically doing the same thing. In that role, you also listen to participants and weigh all the interests against each other, ultimately arriving at financially sound choices in pension policy that you then communicate clearly. So, the medical and pension worlds touch each other, which is fascinating to me.”


SPMS is a mandatory pension fund. As independents, are medical specialists not capable of providing for their own pensions?

“Sure they are, but there are many advantages to mandatory membership in a professional pension fund. First of all, it is more favorable fiscally. Also, as a fund, we can get better investment returns because we have more scale and can invest in different categories than private investors. Plus, the costs and risks of asset management are shared. The majority of our participants see the added value of this; there is a lot of support for mandatory membership. For example, eighty percent of independent medical specialists are members of our professional association, even though only sixty percent is required for a mandatory pension scheme.”


Don’t younger specialists prefer to manage their pensions themselves?

“It’s true that they are sometimes more skeptical than older participants about mandatory pension schemes. When you finish your training as a specialist, you’re usually around 35. At that age, a number of life events come together: you start a family, you buy a house near the hospital where you settle, and you buy into a partnership. So, a number of things come together financially as well. If, in addition to your mortgage and all the other expenses, you also have to pay your pension contributions every month, that can be quite challenging. Young specialists also sometimes say: why can’t I just invest for the future myself? We therefore want to enter into more discussions with them in the near future: explain what we have to offer them as a fund and find out what they expect from us. But often the subject of pensions doesn’t appeal to young specialists. However, the returns are greatest if you start building up a pension early and consider in good time whether you need to take additional measures for a healthy financial future.”


How do you try to get participants - young and old - more interested in their pensions?

“In our communications, too, it is especially challenging to reach younger specialists. We are looking for all kinds of new ways to better convey the message to our participants. For example, we have now switched to paperless communication; everything is going digital. We also recently started putting the fund’s financial performance and, for example, the sustainability report, on LinkedIn to appeal to people’s wider interests.”


Medical specialists are highly educated; do they understand their UPO right away?

“Being highly educated does not mean that you immediately understand complex pension issues. So even for this group, you have to write it down comprehensibly and explain it well. As a fund, we also employ financial planners who can advise people about their financial situation and their pension choices, free of charge. We feel that this is part of our duty of care. This will certainly be important later, when we switch to the new pension system. But we would actually prefer to talk to every new entrant into the fund right away: how do you make sure that your finances are in order for now and for the future? The financial planners act as our ears and eyes for the executive board. Another thing that helps is the Meeting of Delegates. It includes about seventy medical specialists from all hospitals and independent clinics, both active and retired. These seventy people have all received thorough pension training and act as a solid bridge to our members.”

SPMS has a high funding ratio of no less than 143 percent, but indexation is only 4.25 percent. So, with high inflation, full price compensation is out of the question. How do you explain that to the participants?

“We index 3 percent annually, which is a fixed percentage. So, we also did this in recent years, when many other pension funds were not able to index. Because of the fund’s good financial situation, we are adding another 1.25 percent indexation this year. With our funding ratio, we could index even more, but the tax authorities don’t allow pensions to get too high. So, it has to stay at that 4.25 percent; very annoying for our participants. But we clearly explained this and fortunately, people understood. Soon, in the new pension system, it will be possible to pay out a larger part of the buffer to the participants and increase indexation. We would therefore like to switch to the new system as soon as possible, which we hope will happen on January 1, 2026.”

How will you be taking your participants into the new pension system?

“We went on a roadshow to the hospitals with the executive board. Time and again we noticed that our participants preferred the solidary-based premium scheme (in addition to individual pension pots, there is a collective solidary reserve for absorbing shocks in the financial markets, ed.). That clear choice has everything to do with the strong sense of solidarity in our profession. It’s in our DNA: helping people and taking care of each other.”


GPs showed up at Malieveld last year to protest the increasing work pressure. What is that like for medical specialists?

“There is increasing pressure on healthcare. Because of the aging population, not only the demand for care but also the shortage of personnel is increasing, especially among nurses and other care personnel. But among young specialists and doctors-in-training we are also seeing more burn-outs than before: the work-life balance is disturbed more often. As a fund, we are currently looking at how we can help our participants cope with this workload. For example, by providing a sleep coach to ensure that specialists with many evening and night shifts still get sufficient rest. We are not only concerned with the financial health of our participants, but also with their physical and mental well-being.”


Health Minister Kuipers may soon require all medical specialists to be salaried. What would that mean for SPMS as a pension fund?

“That possible obligation hangs over our heads as independent medical specialists and therefore also over the fund. If the government decides that we have to be salaried, there will be no new entrants and we will have to continue as a closed pension fund (no more pension premiums will be paid into the fund, only the existing pension monies will continue to be managed and paid out, ed.). So that issue is on our minds: not only as a pension fund board, but also as a profession. As independent medical specialists, we have drawn up a manifesto. In it, we state that mandatory salaried employment is not the solution to making healthcare more affordable and manageable, as the politicians believe. On the contrary.”


On a personal note, you wrote an article in which you stated, “The fact that we are being portrayed [in the media] as greedy people who allow themselves to be controlled by perverse incentives is completely wrong and does not do justice to the efforts of independent medical specialists to keep healthcare affordable.”

“Our cooperatives and partnerships contain a lot of creativity and brainpower, and they invest in all kinds of innovative applications to keep healthcare affordable and to do more with fewer people. That is really helping us to get healthcare back on track together. And, as independent entrepreneurs, we can not only contribute ideas, but we also have the freedom to be critical of the management of the hospitals and clinics where we work, if necessary. This is more difficult for salaried physicians, as they are in a dependency relationship. We also need countervailing power in the healthcare sector, especially in these times.”


As pension administrators yourselves, how do you keep tabs on what’s going on in society?

“We are a special pension fund board: there are no professional pension administrators in it; we are all medical specialists ourselves or have been. I also mentioned the Meeting of Delegates, which gives us a good picture of what is going on among our members. But also in society itself. We are not only pension administrators; we are also doctors. We are not on an island; we are at the heart of society. It comes into our consulting rooms every day: contact with our patients is a reality check every time.”


What is your goal as the new CEO?

“The life expectancy of medical specialists is around 88, which is higher than the average person in the Netherlands. They can often enjoy their retirement for a long time, and as a fund, we want to help ensure that they can do so without worry. But we also want to be of significance earlier in their lives: for example, at important moments, such as joining a partnership, buying a house, in the event of divorce or the death of one of the partners, or in the event of an inheritance. What financial choices do these require and what consequences do they have for future income? We can help clarify that. We also want to help our participants stay fit and vital, throughout their working life and beyond. In short, as pension administrators, we want to unburden our participants financially, physically and mentally. And that is, again, very similar to our role as doctors.”

Who is Amber Goedkoop?

In addition to her work as a dermatologist, Amber Goedkoop also has an MBA. “As a doctor, if you want to participate in policy making at the hospital where you work, you also need to know something about financial organization and management. A new world opened up for me.” Literally, too, because a fellow student alerted her to a vacancy on the board of SPMS, the Medical Specialists Pension Fund Foundation. She joined the board in April 2017 and became CEO on March 1 of this year.


After completing her medical studies, Goedkoop (49) specialized in dermatology. She has been working as a dermatologist at St. Antonius Hospital in Utrecht since 2007. She also performs a variety of administrative tasks. Among other things, she is a board member (and former chair person) of the cooperative Medical Specialist Company (MSB) of St. Antonius Hospital, which unites all independent medical specialists working there and makes agreements with the hospital about the services they provide.