Being a private greenfield hospital is demanding

THE SITUATION in Slovakia’s health-care system is not a pretty one, with a constant lack of funds, the exodus of Slovak doctors and nurses abroad, and patients accustomed to free health care from the previous regime. So, at first sight, the decision to build a hospital as a private investment looks neither profitable nor easy. But, so far, the experience of the Medissimo Polyclinic Hospital shows that there is demand for medical facilities where people are treated without having to wait, by experienced specialists using modern equipment, and that people are also willing to pay for this.

The Slovak Spectator spoke to Slavomír Maličkay, director of the Medissimo Polyclinic Hospital and found out what inspired the establishment of Medissimo, who its target group is and how he views the health-care insurance system in Slovakia.

The Slovak Spectator (TSS): What was behind the decision to build the Medissimo Polyclinic Hospital?

Slavomír Maličkay (SM): There are the private as well as commercial interests of investors behind the construction of the Medissimo private hospital and polyclinic. Everybody, at least once in their life, has been afraid for his or her health or the health of a close relative. At moments such as these, you look for a hospital where you are treated by the best physician, with the best equipment and immediately, without needing to wait. We realised that such a facility was lacking here. Thus, Slovintegra decided to build it. Medissimo is the biggest private investment in health care that’s been made in the last 20 years. The total investment came to almost €30 million.

We are pleased that we can provide Slovak patients with what, according to us, has been missing here for so long – experienced specialists, the most modern equipment, a personal approach and health care provided without patients having to wait. In addition, we offer a bonus – a philosophy focused on the satisfaction of the client. Often they are tiny things that distinguish a private hospital from a state one. For example, these include extended surgery hours and a 24-hour non-stop phone line to the physician on duty, a reception and call centre with a German and English speaking team, and the possibility to make an appointment for an exact time – by phone, e-mail or through our website.

On the other hand, to be the first private greenfield hospital is demanding. Health care in Slovakia still bears a certain legacy from the past. Slovak patients have gotten used to the idea that a visit to a physician is 'free of charge'. Indeed, they do not like having to wait for examinations, a wait that can sometimes last even for months, and that cutting-edge technology is not always available, but we here in Slovakia are only now learning to pay for health care and invest in ourselves. It will take a while until we realise that money invested in this way is the best invested and capitalised money.

TSS: What is Medissimo’s target group? Do you also focus on foreign clientele?

SM: Medissimo has been in operation since May 2009. When we started, we formulated a potential profile of our main client – we expected large companies that would offer a membership in our hospital’s health-care programmes as a benefit to their employees. But the financial and economic crisis has not bypassed Slovakia either and it has significantly changed our expected clientele base.

Our number of ‘corporate clients’ is lower than we originally expected, but, on the other hand, our number of individual clients has been constantly increasing.

At the moment, individuals who have subscribed to any of our annual membership programmes make up as much as 40 percent of our clients. Corporate clients make up 30 percent and the remaining 30 percent are clients that pay for treatment provided on a case-by-case basis. This group of clients has been growing.

We also offer health care to foreign clients. Our doctors speak English and German and many of them have worked in European or American clinics. We have signed contracts with several foreign health insurance companies. We are also preparing special products that we want to offer especially to clients from Great Britain or the US.

TSS: What kind health care does Medissimo focus on?

SM: Comprehensive and without waiting, which is a huge advantage for clients. Unlike other private polyclinics, patients find everything here under one roof – a paediatrician, two general practitioners, 21 specialty outpatient clinics, a modern radiology centre, operating rooms, an anaesthesiology and intensive-care medicine unit, post-surgery treatment, physiotherapy and an inpatient department with hotel-style rooms, among other things.

A quick diagnosis and the following surgery are of key importance in many serious diagnoses. The fact that everything is in one place at Medissimo and that the clinics are digitally connected is a guarantee of immediate action. This increases the chances that an early treatment of a patient’s problem will be also successful.

We consider long waiting periods, which have gotten even longer as compared to last year in state facilities, to be a problem. Women are waiting 36 days on average for a mammograph, and in some cases up to several months or even a year. As a paying client, at Medissimo you have almost immediate access to health care.

TSS: In Slovakia, medical treatments are either covered by compulsory health insurance or a patient can pay for it out of their own pocket. Has Medissimo signed contracts with health insurance companies or will you be negotiating such contracts?

SM: Of course, we are already holding negotiations. The aim of each private facility is to have contracts with all existing health insurers. Currently, Medissimo has signed contracts with both private health insurers in Slovakia – Dôvera and Union. Clients of these insurance companies pay Medissimo for services that exceed the framework of these contracts. They can choose from 14 different health ‘packages’ and, moreover, can flexibly adjust them according to the kind of health care that they think is important for them.

We also offer all our services to patients who pay for them on their own. Health care in Slovakia is very advantageous for our foreign clients. Prices in Medissimo are often around 30-50 percent lower than at clinics in Germany or Austria. Medissimo is the first hospital in Slovakia that has made its complete price list public on its website.

TSS: What is your opinion of the current system of health insurance, outside the framework of the compulsory health insurance in Slovakia?

SM: The adoption of a law on supplemental health insurance would be a great contribution for patients as well as health-care providers. An additional monthly payment, paid along with the compulsory monthly health insurance premium would secure its payer a higher standard of services. Austria is a good example of a well functioning system of supplemental health insurance.

TSS: According to the media, a lot of doctors and nurses have been leaving Slovakia to find better wages and working conditions abroad. Does Medissimo feel a lack of qualified medical staff?

SM: The satisfaction or dissatisfaction of doctors does not depend only on financial rewards. When we were forming our team of doctors, we were looking for experienced specialists. However, the financial reward itself did not persuade them to change their place of work. In general, a person needs good working conditions in order to be satisfied at the workplace. In the medical environment this translates to being in a top technological environment, one in which a doctor can use the most modern equipment available when diagnosing and treating a patient. In Medissimo, doctors have this opportunity.