Small hospitals should represent a stable pillar for the access to medical services of the small urban and rural population. However, it operates in a fragile balance, marked above all by the lack of staff, but also of funding. This is also the case of Videle City Hospital, from Teleorman county. In order to better understand the challenges they face, we talked to both Simona Mocanu, the manager of the health unit, and Dr. Ramona Boghianu, a surgeon.
Gaps in the healthcare system, a major theme at Healthcare Forum 2026
The problems faced by small hospitals, gaps in the system and what is the cost paid by patients are just some of the topics that will be discussed at the Healthcare Forum 2026. The truth about Romania’s health, in the panel “Gaps. Patient access to hospitals and treatments”. The topic will be debated by Valentin-Florin Ciocan (president of the National Authority for Health Quality Management – ANMCS), Simona Mocanu (manager of Videle City Hospital), Dr. Ramona Boghianu (surgeon, Videle City Hospital) and Dr. Adrian Marinescu, Manager of the “Matei Balș” Institute.
At the event that will take place on March 24, in Bucharest, the Minister of Health, Alexandru Rogobete, announced his participation
Avevarul is an impartial mediator, which aims to facilitate a balanced and constructive dialogue between those who can bring changes in the direction of the health system: governors, doctors, hospital directors, investors, managers of companies in the field, patients and experts.
Simona Mocanu: “Videle Hospital is facing an acute shortage of specialist doctors”
The Videle City Hospital officially serves 60,000 patients, both from the city and from the 19 municipalities of Teleorman, but also from neighboring towns in Giurgiu County. Last year, more than 18,000 patients were cared for in the medical unit, and the number of admissions exceeded 3,000.
The truth: What are the biggest difficulties in a city hospital?
Simona Mocanu (manager of Videle City Hospital): I will answer concretely, with examples from the Videle Hospital, but from the existing statistics, most of the small, level IV hospitals face the same problems. At Videle, three large categories of problems are precisely identified:
The biggest problem, at the moment, and which creates real difficulties in carrying out the medical act, is the shortage of medical personnel. Like many other small hospitals, Videle Hospital also faces an acute shortage of specialist doctors. Although our hospital is only 60 km from Bucharest and there are vacancies, put out for constant competition, young doctors (and not only) often prefer large university centers, because they have better facilities and career opportunities. This vulnerability forces small hospitals to operate with a minimum number of doctors, as well as with specialties approved in the structure, not covered by qualified staff, these aspects invariably lead to a decrease in the addressability of patients to the hospital and, implicitly, to the impossibility of realizing the contract with CAS Teleorman, the only source of funding for the health unit.
There is an acute lack of doctors in specialties such as ATI, Internal Medicine, Paediatrics, Neurology, Diabetology, etc., which puts enormous pressure on the entire activity of the hospital.
The second problem is related to major financial difficulties. The hospital operates under constant budgetary pressure, being exclusively dependent on the contract with the County Health Insurance Company. The non-fulfillment of the contract with CJAS, due to the lack of doctors, generated over time much higher expenses than income, leading to the recording of significant debts to suppliers of medicines, reagents, food, utilities, etc.
Due to its status as an LLC, Videle Hospital could not conclude an additional act for the payment of the value of the food norm for the sick, because the amended legislation provided that only public hospitals can conclude such additional acts with the health insurance companies. Also, after the Alexandria County Hospital abolished the Empty Emergency Department, the medical services offered in the on-call rooms are not covered by the contract with the County Insurance House, generating a very large financial deficit.
In this context, what is the situation of the guards?
QIn the organizational structure of the hospital, four emergency lines are approved, in the specialties of General Surgery, Internal Medicine, Obstetrics-Gynecology and Pediatrics. Guards are provided by the employed doctors and collaborating doctors with a contract for the guards.
At the moment, there is a major shortage of specialist doctors to ensure the activity of the Internal Medicine and Pediatrics ward.
How do you think doctors could be convinced to come and work in a small hospital?
In the current context – considering the impossibility of covering the approved medical specialties in the organizational structure and the requirements that doctors interested in being part of the Videle Hospital team have in the discussions preceding the conclusion of an employment contract – the City Council, the Board of Directors and the Steering Committee consider it essential to identify financial resources for the loyalty of doctors and staff. This is the major strategic objective, essential for the stability and development of the hospital.
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The main requirements of the doctors with whom there were discussions regarding the collaboration were:
- high-performance equipment to help them diagnose as accurately and quickly as possible;
- ensuring that guards are paid on time and in full;
- access to training courses and professional training provided by the employer;
- settlement of transport and accommodation;
- the permission for the doctor to work, for example, 4 days at Videle and one day in a large hospital in the Capital, to keep his skills up to date and stay connected to the latest in the field;
- payment of salary on time;
- ensuring sufficient staff to assist the doctor in carrying out the medical act.
How are you doing in terms of hardware?
The purchase of new equipment is a strategic investment that solves three major problems: patient safety, physician efficiency, and hospital financial stability.
Thus, in an attempt to increase the quality of the medical act and the addressability of patients to our hospital, the need for modern equipment is not only a technical preference, but a critical necessity to stop the migration of patients to hospitals in Alexandria or Bucharest.
In order to solve this situation, the hospital must constantly ensure that it is equipped with high-performance medical equipment. At the moment, the zero priority is equipping the operating theater with new generation anesthesia machines.
The main reasons why replacing old equipment and equipping it with new modern equipment are necessary: increasing the accuracy and speed of diagnosis; increasing the quality of the medical act by shortening the diagnosis time and reducing the risks for the patient; operational efficiency and cost containment; attracting and retaining qualified personnel; compliance with ANMCS standards.
Patients go to the hospital for conditions that could be treated by family medicine
Ramona Boghianu has been a surgeon at Videle Hospital for 17 years. He chose the medical facility a year after becoming a specialist, because Videle is the city where he was born and raised, and his parents live there. The doctor commutes from Bucharest.
The Truth: What are the biggest needs you’ve identified among patients?
Dr. Ramona Boghianu: It is a deprived and very aging area, where patients are mostly left alone, their families having gone to work either in bigger cities or abroad due to the lack of jobs.
Resident in Romania. What are the main problems faced by doctors at the beginning of their careers
Primary medicine and social care leave much to be desired, and for this reason patients go to the hospital for ailments that could be treated by family medicine. The county has a lot of uninsured people, who unjustifiably crowd the emergency rooms. We also found a very high incidence of TB cases.
As such, from my point of view, one of the main needs would be the provision of primary medicine and social assistance, as well as community involvement for the integration of these social categories.
Regarding the hospital, it would be necessary to equip it with new generation medical equipment, complete the medical personnel scheme in all existing specialties, the existence of an Emergency Department, the development of palliative care and, possibly, home care.
What else would be needed to be able to carry out your activity better?
Ensuring medical personnel for existing specialties; the establishment of a cardiology department and a neurology department within the Department of Internal Medicine; equipping with the necessary equipment; involving local authorities and attracting funds to modernize what we have.
What motivates you?
First of all, the fact that I like my job. For the rest…
