As a career medical care professional, you have the expertise to evaluate developments within the Czech healthcare system. How is the system doing? Is it improving, stagnating, or getting worse?
I wouldn’t dare to assess the system based on those three parameters alone because there are simply too many evaluation angles to employ. You could consider health of the population in general, various treatment results, availability of prescription drugs, access to specific methodologies, and so on. I could say, though, that as of late, the situation is at a standstill. If we were to compare our system internationally, Czech healthcare would score very well overall and ‒ a relative lack of adequate funding notwithstanding – is still able to draw from a broad base of high caliber specialists and providers. Even so, the healthcare providers and general population alike sort of milk the fact that for a long while the system has not undergone any significant reform. While they acknowledge that a reform is needed, they disagree on its scope. It’s like trying to solve for volume of a circle using quadratic functions. I often wonder what is going to happen when all of those still-positive parameters start tilting the other way.
Recent news reports stated that in the Czech Republic, one out of ten physicians is a foreigner. At the same time, Czech physicians are moving abroad en masse. How do you stop the exodus? Is it strictly about money alone?
It’s not an issue specific to us alone. A sudden decline in the numbers of healthcare workers is a cyclical process that exists worldwide. Domestically, the current decline is proportional to our recent economic growth. Physicians aside, certain medical professions are finding higher wage opportunities outside of the health-care sector. Our problem is that even in those periods when we are relatively well staffed and are not lacking medical personnel, we still tend to ignore health-care workers’ needs. It’s a matter of correlating specific professional responsibilities and educational achievements with appropriate wage structures. Another thing is the need to take care of our financial administration personnel; we don’t seem to have any knowhow in this area. We literally do not appreciate the work of our management personnel at all. It’s not that our educational system is more demanding than it is elsewhere; it is just more cumbersome, a subject to frequent changes, and unfortunately it is still tied to its origins way back in a different era. Our healthcare system has not been given a chance for a cultivated and appropriate development and growth; furthermore, we have been slow in addressing both ppotential and concrete problems as well.
Have you ever been tempted to accept a position abroad? You must’ve had a plenty of offers.
Well, yes, I’ve had. The first offer came in 1994 from the World Health Organization and was followed, for instance, by another one from the International Council of Nurses and also by one from Brussels. I am not saying that I am a patriot; that sounds almost pathetic. I just simply want to stay here and be available to our people. My work requires across-theboard expertise in complexities of the entire medical field, from hospital wards to legislative matters. Besides, I am not interested in being a bureaucrat, and that’s who I’d be abroad.
As you’ve moved up the professional ladder and stepped up from one level to the next, did you alter your opinion on what could be changed and how to go about it?
At every level I’ve always tried to maximize the positive impact of each respective position. Once I’d ascertained that certain step would result in a change for the better, I’d go ahead and implement that change. The only professional position that did not allow me to do that was my post as a government minister. A single person simply cannot unilaterally change a piece of legislature that impacts the entire sector. Do you know what I found really frustrating, though? There were times when I’d come upon a specific matter that called for a professional solution. I would work up a study and submit it for a peer review – that alone can be a real battle because with each individual expert comes an individual expert opinion. Once I’d get it through all those channels and transfer the matter to the political level, I would inevitably run into this one politician who’d think: “Wow, what a great idea; lets don’t hand it over to this government. Lets stick it in a drawer for now and wait until we alone can get all the credit and score all available political points.”
How about the much discussed co-payment charges? Are you for or against them?
There is not one economy in the world that can bear the costs of the latest in medical treatments and technologies for all its subjects. Obviously, the healthcare field must be allowed to draw from multiple sources of revenues. Our individual behavior is what affects our individual healthiness the most. There are genetics of course, and there isn’t much we can do about that, but genetics contribute to just 15% of our personal health condition. It really comes down to our behavior and our personal responsibility for our well-being. As we all know, we humans seem to respond really well to one single motivator, and that is money. I am convinced that in a long run we would see tangible returns on co-payment and above-standard charges. We certainly have plenty of past experiences and real data to identify specific mistakes that should not be repeated. Personally I consider the elimination of co-payment charges a big mistake. Right now co-payments represent a huge mental hurdle, and it’s going to be difficult to jump over it in a future.
What do you see as the most serious problem faced by the Czech healthcare system?
We need to find our way back to treating a human being. We need to stop discussing money and return to a discussion that addresses why we, the healthcare professionals, are here. We provide medical services, and patients come to us because they need our help. That is why we choose this profession; we are neither tradesmen, or scientists, or pedagogues. Our primary mission is to treat and heal both body and soul. To realize and embrace that would without a doubt reinvigorate our entire healthcare system.
As Director of the General University Hospital in Prague, you have decided to join the Czech Gulf Business Council aimed at commercial cooperation with the countries of the Persian Gulf. What does your participation entail?
In March of this year we have signed a cooperation agreement with the countries of the UAE region and countries like Saudi Arabia, Qatar, Oman, Bahrain, and Kuwait. Since the very first meetings, we’ve been focusing our efforts on offering a number of specialized and highly-specialized services. Hand in hand with that come efforts to identify viable partners and develop effective marketing strategies designed to introduce our team, the scope of services we provide, and results we’ve achieved. In addition to providing medical care services, we are exploring other cooperation potentials. For instance, we are aware that countries in the UAE region struggle with educating and training healthcare providers from among their own citizens. For years they’d practiced hiring qualified medical professionals from the West. Recently they’ve decided to change that approach and cultivate their own providers instead. Our institution has much to offer in this area because of our association with the First Faculty of Medicine of the Charles IV University in Prague; we serve as the medical schools’ teaching hospital and clinical-training base. We can offer a slew of fully-accredited study posts as well as all related clinical-training services. We can also provide invaluable expertise in the development and support of future medicaleducation services in our partners’ respective countries. Our last, but definitely not the least important offering is in the areas of science and scientific research. Both fields require money and funding commitments; our Arab partners have already determined that research investments and subsequent discoveries may result in very attractive investment returns. Our institution is highly motivated to allocate and connect with partners who in addition to funding also enjoy broad support of research efforts in their respective countries. We are not opposed to cooperation in any other area, but for now we are vested in the three I’ve noted. We are convinced that mutual cooperation would bring positive and beneficial results to all partners. Even so, we’ve only just begun.
Which specific specialized services can you provide?
We can go down the line of medical specialties. In cardiology and cardiovascular surgery, the specialized services we offer include surgeries of the heart and the great vessels. In oncology, our hospital is a designated specialized-care center, and we know that it is an area of real interest in the UAE region. Other specialized services we offer include dermatology and related procedures, including treatments of diseases of the skin. We also offer specialized services in treatments of the eye and eyesight defects and, furthermore, services in treatments of genetic defects and genetic illnesses, an area of expertise that is of utmost interest to the entire Eastern world.
You are a mother of adult children. What do they do? Does your daughter, a former med student, still work in the field?
She does, and now even my son is following in our footsteps. I don’t think that I can take any credit for his decision, though, except that we may have talked about our jobs at home and occasionally he’d stopped by my office.
So it just could happen that one of these days you may be a boss of either of the two?
That’s highly unlikely, although here at the General University Hospital you can find three generations of physicians working together; family ties here run deep. It’s wonderful, and the physicians are so very proud of it. However, it’s an entirely different deal having a parent as a colleague versus having a mom as your boss. I could not do that to my kids. We have this quiet understanding that where the two of them are concerned, this particular hospital is completely off limits.
Watch out. They may be your bosses one day.
“Well, you are right,” she laughs out loud. “Actually, it may just happen.”