
Polish clinics: Another kind of health tourism (2013) - cturner
http://www.economist.com/news/britain/21579018-health-clinics-immigrant-poles-reveal-nhss-shortcomings-another-kind-health-tourism
======
lucaspiller
> More simply want better customer service than British GPs tend to provide,
> with their brief consultations and frustrating systems for booking
> appointments

I can definitely sympathise with this, although it isn't a UK wide problem. My
local surgery (in a remote part of the country) consists of a couple of GPs
who both know me personally and making an appointment involves a quick phone
call (and chat to the receptionist who I also know personally).

When I was living in London it was completely different, getting an
appointment involved phoning up the surgery the morning you wanted an
appointment and hopping somebody hadn't done so before hand so they had space.
There was no way to book an appointment in advance. It was easier to go to an
NHS walk in centre, wait for a few hours, see a nurse, and have them refer me
to A&E to see a doctor if need be.

~~~
mjn
One thing that's quite improved it in Denmark is that a company came out with
a whitelabel hosted-health-portal SaaS product
([http://www.mithelbred.dk/](http://www.mithelbred.dk/)) that has really
caught on. Doctors can sign up with it and reskin it on their clinic's
website, and the product handles the backend interaction. You can book
appointments, cancel or move them, send/receive notes to the doctor (if you
have a question/worry but aren't sure you really need to go in person), check
and renew prescriptions, etc. There are even mobile apps! They claim to have
>50% of all doctors in the country signed up with them. I think it's caught on
to such an extent because from the doctor's perspective it lets them outsource
the patient-management / administrative part of their clinic's work for a
price that's lower than it'd cost to do in-house, and the fact that patients
now get some online convenience is just an added bonus.

~~~
dzhiurgis
Not entirely related, but UK's NHS holds a crown for (probably) biggest IT
project failure ever. It took 11 years and £9.8b to reinvent patient record
system.

At least they can finally sell the patient history to third parties.

~~~
bodski
"At least they can finally sell the patient history to third parties"

Not sure your sarcasm is all that clear. To those not aware the UK government
is passing this off as a way to improve your care within the NHS via
centralised records. They have made it opt-out and have sent out a confusing
leaflet that leads the reader to believe their care will suffer if they opt-
out of selling patient records.

Records are already centralised within the NHS. What is happening is the
government is setting up a free for all with easily de-anonymised records
being sold off to third parties (read: private health providers and insurance
companies).

------
_random_
You have a better chance of getting free liposuction then e.g. a modern
medicine for your flu-related complications: "Just take some ibuprofen".

------
wslh
I can add Argentina as a good location, where there are many excellent doctors
and very good clinics. If you are looking for international "karma" many of
them publish in top journals.

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altero
UK health care is disgrace. Patients dying by starvation in hospitals
corridors. Waiting period for some operations is months. Even simple xray took
6 hours of waiting at emergency. My polish friends in case of problems head to
airport, not British hospital (insurance would cover it).

Also SS wolfs are on hunt and it is serious risk to bring children to UK
doctor. GP broke hand to Slovak baby during vaccination, parents took it to
hospital, where doctors called social services. Couple had to run from country
to keep baby.

Also France with exceent health system is just few kilometers away.

~~~
lafar6502
Public health system in Poland has same problems as its UK counterpart. It's
free, but public hospitals and clinics have notorious problems with service
limits, wait times, financing, care level etc. But at the same time
qualifications of doctors and other medical staff are quite high so they
somehow make up for the shortcomings of the system (however, the long wait
problem is unsolvable). I hope medical tourism improves the situation a bit by
stimulating growth of non-public specialized clinics.

~~~
gedrap
Don't know about Poland but back in Lithuania solving that by a little bribe
was a common way around, judging from what I've heard. Once I had to get off
the dentists (private not public) chair because someone came in and gave a
'bribe' of... $8 (20LTL).

~~~
guard-of-terra
That's weird isn't it? I always imagined private dentists to work more like
shops: you get your service for a list price. The idea of giving bribes during
shopping baffles me.

Russia here, which isn't known as being bribe free.

Maybe it is extra regulated or price-controlled so non-market forces kick in?
You needing them more than they needing to retain you as a customer, because
supply becomes limited.

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wozniacki
Without implying too much other than what can be directly inferred from this
line

    
    
      Private health care is sold as a luxury for the affluent
      and usually only covers hospital treatment, not primary
      care—that is, visits to a doctor.
    

I'd like to reiterate that this is where the American model of healthcare
delivery is headed.

The Affordable Care Act just made this abundantly inevitable.

We will soon have a tiered system - if it already isn't here - where the
wealthy shall be catered to by doctors and health professionals, who have
completely removed themselves from the insurance model and thus only serve in
a Direct-Pay model.

The best surgeons and experts will exclusively cater in a on-demand model,
flying down to multiple locations a day to offer their premium services to
wealthy clients. Concierge medicine is already here. [1]

Even with things like Telemedicine and Remote surgery, I don't see why the
doctors will behave any differently in how they choose to split their precious
hours.

[1]

[http://en.wikipedia.org/wiki/Concierge_medicine](http://en.wikipedia.org/wiki/Concierge_medicine)

[http://stanfordhospital.org/clinicsmedServices/clinics/prima...](http://stanfordhospital.org/clinicsmedServices/clinics/primaryCare/conciergeMedicine/)

~~~
vidarh
In the UK, while there are _some_ that provide only direct-pay services, most
of the private healthcare is operated by, or contracted by, large private
insurance companies, that offers quite cheap "add-on" insurance offered as
perks by companies, or which you can buy separately.

Most of the private health-care offerings are also deeply incestuous with the
NHS. Large part of the surgeons are NHS surgeons that offer additional
services on their own time. Many of the surgeries happens in NHS facilities
that make excess capacity available to help offset operating costs, and so on.

Additional private cover in the UK is well within reach for most people that
are not that far below a median salary.

~~~
fidotron
Private stuff in the UK is also reasonably common in employment contracts for
anyone above middle manager level, since you effectively get the same
treatment as the NHS for the reasons mentioned, but with a much shorter
waiting period, so companies can get their employees back to work faster.

~~~
guard-of-terra
"anyone above middle manager level"

That meaning top management? :)

I guess it's some UK thing but I expected "middle manager" to be something
pretty exclusive with not many people above. And this is where it loses
relevancy to many people on HN.

Maybe you call shop clerks middle managers or something.

------
b0rsuk
For Polish doctors it's also a chance to work for tolerable wages, escape
paperwork and underfunded hospitals. In Poland, a doctor is a subcategory of
bureaucrat who is primarily concerned with health and occasionally glances at
you over a pile of papers.

