Normally, I do not particularly enjoy lowering the standards of writing this blog in order to tackle more mundane matters, but every so often a certain dispute catches my eye and if it touches on subjects of great interest for me or if it crosses over into discourse and rhetoric of arguments, I decide to tackle it.
A person has a neurosurgical problem. In Romania, you have a choice, you may go to any specialist you like or have heard of or think that is good enough to tackle your problem. So you go and pay 1/4, yes one quarter, of the minimum wage in order to see a most esteemed professor. This man is of poor reputation as a human being but is known to be above average as a professional. He has, naturally, as every slave master in history, a horde of apostles which praise him as the messiah of neurosurgery and then you have the former patients which again view him as a messiah, perfectly understandable attitude. You go see the professor. You wait for the better part of an hour. You are called in. No courtesy, no respect, not so much as a simple greeting. You tell him the problem. Your MRI is too old. Yes, but you're in pain. He looks at you with contempt and undisguised disgust. He tells you to do what you've done up to this point and then yells "Neeext!". You go pay 1/4 of the minimum wage at the front desk. The next steps, if you wish to solve your problem are to first pay another 1/4 or 1/3 of the minimum wage for a new MRI and then the exact same sum once again for a new consult. That, in order to get a diagnosis. If you've successfully completed these steps, you have a whole new adventure coming up, the surgery itself. And it will be much, much more expensive.
I naturally felt sorry for the person who had to live through this, and, having seen a lot of patients with vertebral column complaints this month, I know how painful and irritating it is. It came as no surprise to me, however, knowing the professor in question, the concept of "professor" in Romania and the Romanian healthcare system in general.
What flabbergasted me was a fervent opposition and incredible reactions from literate, some even medically literate individuals who were actually trying to persuade us that the reaction was somehow understandable, and that it is perfectly all right for the professor to act like that, as long as the operations go well. I strongly oppose this idea. There should not be a difference in Mentality between Romania and the "healthcare of the west". Because until the mentality changes, until it is profoundly and completely altered, all the money, the technology and the specialists in the world won't save the rotten system from swiveling helplessly in its own muck.
One of the points raised was that in Romania you may go to the professor directly if you so see fit, as opposed to the western countries wherein the GP arranges these matters on your behalf. A western physician will now ask: why do I want to go directly to the professor? We don't want to discuss the latest findings in the genetics of glioblastoma multiforme, we want to establish a relationship and I, as a patient, want a surgery. In the west the professor is not necessarily the best surgeon, he is an esteemed scientist and is at the forefront of his field. It is obvious that in Romania you want to go to the professor in order to maximize your chances of recovery, because in Romania professors, especially in surgical fields, are irreverential twats with a strong appetite for money who have the most experience because, especially in neurosurgery, and I speak this knowing full well what the situation is, they do not let others do the surgeries, thereby profoundly hindering their chances of gaining experience. There is no clear separation between subspecialties in Romania, spinal, skull base, vascular, oncological, there are but meagre attempts. Usually, the professor does everything. Except opening and closing, those are beyond his dignity. This is the root of the problem and it also explains why "he has to do 6, maybe 10 surgeries a day"- a bit of an overestimation, but let's assume it's true. That happens because he lets nobody else operate and acquire experience. It is not a singular case, though, don't imagine he's the only one doing it and that is precisely why I am not using names.
Another point raised was that it was not expensive. 1/4 of the minimum wage for a consult in a country with a social system of health insurance. I don't want to hear that that is an acceptable price for other countries, for other systems. No. It's a lot for Romania. If the system is bad, change it, don't charge 1/4 of the minimum wage for a consult lest I be forced to call hypocrisy. The extremists among the professor's gang were practically yelling that this is the system nowadays and that if you do not like it, you can die. This is an actual quote "This happens everywhere in the world. If you have the money, you pay, if you don't, you die". First of all, this is not the case "all over the world" as I doubt the person in question had seen even 1/100 of the world in order to assess the healthcare system. Secondly, I think certain U.S. courts would be more than happy to offer a considerable amount of money as compensation for such a failed attempt at practicing medicine. I don't care that we are talking about Romania. You are a doctor first, surgeon second. It's common sense. If you curse at everybody you meet while walking in Hyde Park on a Sunday afternoon because you were so taught in your family and that is the system, don't use this as an argument to make me think it is acceptable. It is not. And it is you, who are swearing, who is the antisocial individual, and not the everybody else for not understanding your "system". If you have nothing but disdain for your patients, find another job. It's quite simple, really. If you're incapable of bedside manner, you Fail at half of the job. Romania is no exception.
And above all, detractors of the victim complained that the matter should have not been made public. Yes it should have. Public awareness is the first stop to ever having any hope of changing something. I must stress this once more, I don't care what kind of surgeon you are if you fail at half of that which is your job. The fact that you are a professor does not rattle me in any way, nobody is above the law and neither are you. I was most disappointed to see that this lesson is still not learned. Not to mention that when you have an idea and you wish to raise arguments to support it, you need to know what you're doing. Otherwise, you're simply stating one senseless bit after another. And people need to know. Even if it's Romania and it's a professor with experience in a complicated field, it is still not acceptable. Just like you wouldn't have him swearing at you in the street.
No comments:
Post a Comment