Illustrative stock photo (source: Sme)
The latest report of the Financial Policy Institute (IFP), the analytical unit of the Slovak Finance Ministry, concludes that Slovakia has been losing in great numbers the most talented and educated young citizens. Medical faculties are ranked at the top when it comes to the number of university graduates leaving Slovakia, followed by technical ones. For example, between 2010 and 2013, one in five fresh holders of the MUDr title left this country. I still remember a post on Facebook from last year of an association of medical students which hired a bus for those from the medical faculty in Košice to come to Bratislava for a job fair organised by an agency recruiting mainly for German hospitals.
The consequences have been visible for some time already.The consequences have been visible for some time already.
The Slovak Medical Chamber estimates that Slovakia has a shortfall of about 3,000 doctors and if those who have already reached retirement age but are still practising are counted, then the deficit reaches 5,000. The fact that the total number of doctors increased in 2015 by 145 year on year according to the Health Ministry’s most recent data, has little impact on the shortage. A look at doctors’ ages shows that the largest group working in Slovakia’s health care is between 40 and 44 years old, followed very closely by the 60 to 64 category. There is also a demographic detail that contributes to this ranking: the early to mid-1970s was a period of baby boom- these babies have been since known as Husákove deti after the name of then-leader Gustav Husák. Then there is another detail hidden in the official statistics: not all of these doctors are providing direct care to patients, some are managers, educators, researchers, etc. That’s why in its, Health at a Glance 2016 report, the OECD cautioned that, in reality, Slovakia’s number of practising doctors per 1,000 inhabitants is in fact about 5 to 10 percent lower.
A day after the IFP’s analysis was published the Association for the Protection of Patients’ Rights, an umbrella organisation for dozens of patients’ organisations, released the results of a survey about long waiting times for a doctor appointment. It concludes that in some cases people can even wait longer than a month to see a neurologist, endocrinologist or orthopaedic surgeon; while long waiting times affect both state and private facilities. In fact, if I have to insert a personal note here, the worst experience I have had with waiting for an appointment in Slovakia was at a well-known private network of clinics in Bratislava. And yes, I have been following my gastroenterologist through three facilities in eight years and I have begun secretly praying for her to stay healthy and practice well past her retirement age.
Not only higher salaries motivate doctors to leave abroad, but also the possibility to choose a certain specialisation they cannot practice in Slovakia due to various reasons. Many are pushed away by the mentality in the Slovak healthcare system where being an active and progressive doctor is not always welcome. In a profession in which mentoring is crucial, a junior physician in Slovakia who feels passionate about medicine needs, more than everything else, the lucky chance to work with those handful or more of senior doctors who are “different”. The medical profession tends to be a complex and rather hierarchical one everywhere in the world, but Slovakia is a country where often the titles on somebody’s card or door “count” more than her or his real contributions to medicine. I have become increasingly allergic to statements such as “The doctor has to listen to his or her patient”. What a wonderful piece of advice when most Slovak doctors often do not listen well to each other or to their co-workers, apart from when they blame health insurance companies, politicians, other colleagues and even patients for something.
In case you are wondering if foreign doctors would be interested in working in Slovakia, the answer is “not really”. Even if salaries here might be higher than in the neighboring Ukraine for example, Slovakia has recently introduced new administrative measures for those who studied outside the EU that prolong the whole process of professional qualification recognition to one year. Then those who pass it will probably have to start at the level of…a fresh graduate.
Anca Dragu is a journalist with Radio Slovakia International, which is available in Bratislava in English on 98.9 FM at 6:30pm and 8:30pm and at www.rsi.sk. The opinions expressed in this blog are her own.
