One of the topics discussed at the Healthcare Forum “The Truth” was related to the difficulty of attracting doctors to small, provincial hospitals. In the opinion of doctor Adrian Marinescu, manager of the National Institute of Infectious Diseases Prof. Dr. Matei Balș, the solution is not imposition, but attraction through better conditions: “You have to convince them through the living and professional conditions, because there is no longer an option to send the doctors to a certain place”.
The case of the city hospital in Videle illustrates these difficulties. The facility, which serves about 60,000 residents, is experiencing staff shortages and problems covering guards. Surgeon Ramona Boghianu describes the situation as critical.
The guards are partially covered and the existing staff is overworked
“The human resource is… pitiful. We have four guard lines, the shortages are almost three years old. Out of 30 days, somewhere 18–20 are covered“, said Ramona Boghianu.
This explains the fact that, in the absence of sufficient doctors, other specialties are forced to intervene in situations that do not belong directly to them, which can affect the quality of the medical act. “The patient who can come with other pathologies related to internal medicine cannot be treated by a surgeon”the doctor added.
On the other hand, young doctors are attracted to large university centers, where there is modern infrastructure and more varied professional opportunities.
Simona Mocanu, manager of the Hospital in Videle, emphasizes that young doctors choose large centers.
“Young doctors want high-performance equipment and over 90% say that the exact time in medicine is given in Bucharest. We have some offers from there and we want to start there, maybe later, after experience, we will choose a smaller hospital. Out of 10 promises, hardly one comes true. (..) We have a very large deficit in internal medicine and paediatrics”she said.
Why young doctors choose the big centers
However, the problems are not only professional, but also social and logistical. In the case of small towns, the difficult access to large urban centers and the lack of facilities influence the decision of doctors.
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“What does the city of Videle offer him? Nothing,” pointed out Dr. Ramona Boghianu, highlighting the area’s lack of attractiveness for young specialists.
In addition to professional aspects, living conditions also influence the decision. In small towns, access to large urban centers is more difficult and infrastructure and facilities are limited.
Doctor Ramona Boghianu highlighted this aspect through a relevant comparison: “In the 90s, the train took 35 minutes from Videle to Bucharest. Do you know how long it takes now? An hour and a half. That pretty much says it all. Why we are not attractive to young doctors.”
The doctor Adrian Marinescu, manager of the National Institute of Infectious Diseases Prof. Dr. Matei Balș, explained that the problem reflects wider imbalances in society and that the solution does not consist in coercive measures.
“You can’t have a medical system that works better than society as a whole. You can’t have a system in Kenya that works better than one in Germany. Society as a whole has to develop,” he said.
In his opinion, doctors can no longer be forcibly directed to certain units, but must be attracted by suitable working and living conditions.
“I don’t think it’s right that the doctors you train in a certain hospital in the province wait to go to Bucharest when they can. Because this will lead, first of all, to a problem of overcrowding in large hospitals. Large hospitals and university centers do not lack doctors, but rather nurses, nurses or nurses, and I assume this. The idea is how you convince them, because there is no longer an option, as in the period communist, to send the doctors to a certain place. (…) The difference between urban and rural environments is great. It’s not the size of the hospital that matters, it’s how you get doctors to go to small towns. The part that belongs to the authorities must also be discussed here, more precisely the increase in the standard of living“, explained Dr. Marinescu.
At the same time, he emphasized that large hospitals do not lack doctors, but rather auxiliary staff, while small hospitals face a shortage of specialists.
In conclusion, the difficulty of covering small hospitals is determined by a combination of factors: lack of human resources, limited medical infrastructure, limited professional opportunities and less attractive living conditions in small towns.
