Tuesday, June 9, 2009

I blame it all on George Clooney

My last post was going to be about Medicine and Med school, but "Greek parents" appeared out of nowhere and monopolised the conversation - after all, it was to be expected. Hopefully, this time there won't be any more surprises. We'll see...

As I wrote last time, I chose to be a doctor pretty much because I was an ER fanatic (and of course I mean the tv show, not the actual Emergency Room!). I was so carried away by the stories, that I ended up believing that real - life doctors would be like this:

Instead, I was terrified to discover that they actually look like this:

So I will some inside info today - dirty things that I didn't know when I applied for Med school. Had I known them, maybe I would have chosen a different profession altogether. Or at least I would have gotten a second job, trying to save money for therapy sessions, right from the start!

This post is not meant to be funny. Some of the things that I will describe are actually tragic. Any similarity to real facts or people is NOT a coincidence. So if you are easily upset and don't want to end up avoiding all hospitals and doctors just because you don't trust them anymore, please don't read any further. Oh, and if you choose to think that these things only happen in Greece because in reality it is a third - world country, feel free to do so. Whatever helps you sleep at night...

1) Taking the Hippocrates oath to heart (as long as my heart is where my wallet is)

The first thing you swear to do as a doctor, is to provide your help without asking for a reward. This is pretty cool, but doctors are people too, and they too need to eat, have a safe place to spend the night, and generally meet their biological needs - so they need to get paid for their work. The real problem arises when having a 197-inch plasma screen is considered a biological need, and the fact that you definitely have to get one forces the patient out of his own place!

In Greece, healthcare is public. This means that hospital care is provided for free, as long as your are insured. Fear not of the mighty term "insured", my friends. In Greece it is very easy to get insurance, and it covers pretty much everything. So basically, hospitals are open for everybody, free of charge.

In theory, at least. Because in the hypothetical case you need an operation, for example, doctors' implications become quite nasty: "There is a great waiting list", and "your operation should take place after 3 months or so and not earlier", and "it is a fairly difficult procedure that needs the utmost care and dedication from the physician", and so on.

If you fail to take a hint, you are likely to be banished to the worst room, with a broken bed or something, while the medical staff weirdly doesn't notice you very much, and your operation somehow takes forever to schedule. Unless you manage to produce some pocket money, say 500 or 1,000 dollars to the physician in charge. Not out in the open, of course. You need to be discreet, put them in an envelope, and carefully slide them into the doctor's pocket.

If you perform this trick, you almost instantly get an upgrade, the staff becomes very tentative of you, and your operation is due for the very next day. All goes well in the end, you recover quickly and go home, satisfied with the excellent medical care you received. It is a win - win situation.

The problem? You spent 1,000 dollars to get medical care that is supposed to be provided for free!

And this, my friends, is the number one pain in the booty in the Greek medical system. "The envelope situation". Money you are not obliged to give, but you give anyway. Money that is not taxed, and just fill the attending doctor's pocket. Money you may not even have - and what happens then, if you are in desperate need of an operation?

Please don't tell me that in the USA a tonsilectomy, for example, would cost far more money than only 1,000 dollars, so we should be happy for not paying as much. The problem is that you cannot have public and free healthcare and then demand "black" money from the patients! It is illegal to do so, and yet, most doctors do it and nobody EVER gets prosecuted! It is a secret that everybody knows, and nobody takes action against. It is a practice that encourages corruption and exploitation of the patients. THIS makes us a third - world country, and not one less metro station, or one less overpriced stadium.

But, to be absolutely fair, this is the opposite opinion...

Greek doctors are the worst paid doctors in Europe. Not only is it painfully difficult to find a job here (I described the situation with the waiting lists and the fact that you may need to wait for 10 years from the moment you graduate, until you start your residency in an earlier post), but the salary is a joke. We get paid 2,000 dollars per month - approximately 25,000 dollars per year. Our salary is the same as the nurses', school teachers', and even civil cervants' working in the tax department. By no means do I mean that we are better than all these people. It's just that our work hours are incredibly more.

While I am on call, 5 different shifts of nurses come and go. That means that I work as much as 5 different nurses, (starting on Monday morning, for example, and going home on Tuesday afternoon) and somehow I am paid the same as each one of them! And I don't even need to stress the fact that our time of studies is not the same, and our accountability in case something goes wrong is anything but similar.

What's more disturbing, is that the government fails to pay us even this small salary in time. All through 2008, doctors in Greece went on strike, because the extra money they legally deserved for being on-call and working overtime wasn't given. According to European Union laws, it is now obligatory to work only 4 days overtime per month. This is what you are paid for. Unfortunately, there are not enough doctors in the hospital to meet the patients' needs, and if each one of us worked overtime only 4 days per month, the emergency department would be empty and unstaffed!

So what are the idiotic doctors forced to do? Work 10 days per month overtime (or else patients would need a bounty hunter to search for a doctor at weekends, for example), and get paid for 4! What kind of country does that to its citizens? Isn't slavery supposed to have been abolished centuries ago?

This horrible situation is the excuse many doctors give for getting the notorious "envelope money". But this excuse is a lame one, in my opinion. I agree that we are underpaid, and in many cases, non-paid. I agree that the government treats us like fools. I agree that we have worked our @sses off and don't deserve this situation.

But exploiting patients is not the answer. We took an oath, remember? An oath to help them, as much as possible, no matter what. We are the victims in this, but victimising patients too is not the solution. We should fight for more. We should ask for more. But we are turning to the wrong people to ask for money.

That's it for now. Hit me with your comments and tranquilizers, people! And imagine this - we are still on #1! A long way to go...


  1. Wow, I had no idea!

    My mom is always talking about how health care should be free for everyone in the US, and while I believe with that in theory, there are still a lot of problems with a free health care system, just like there are problems with our system.

  2. I think it would be a miracle if someone, somewhere could come up with a health care system that works for everyone, everywhere. I just thank God that my family has good health insurance and that we are fairly healthy people.

  3. THAT, my friend, is the problem with a government run health care system. I rue the day when it becomes the norm in this country. I will tell you that as of now, at least at the hospitals I have had the pleasure to work at, what you described is NOT the norm. We treat all of our patients with the utmost care and respect...no one is denied care because of inablity to pay or lack of insurance. I'm sorry it is that way in Greece. You appear to be a wonderful, caring physician who took the Hippocratic oath to heart...that's the kind of physician I want to have. Take care Gracey!

  4. OK after getting over the shudders from the gallom (spelled right?) picture, that is insane! It was interesting to read though, we hear alot about how other countries like yours have "free" health care but this is the first I have read about how it works. That seems like a hard situation for everyone.

  5. Hey Gracey, you still out there???!!! or has the Medical Grecian Mob got a hold of you, sunk you in that beautiful blue water with cement shoes to keep your mouth quiet???!! And it was all funded by those little white envelopes!! Looking forward to the next post..... if there is one... :)

  6. What if you just exploit rich, jerky, fat smoker patients? I'm sure there are a few. And treat kids for free.

  7. Wow, Gracey! Very interesting post, and I understand your frustration! Some people hear the words "Free Healthcare" and think, oh GREAT! THAT's the answer, it's FREE, right? If only it were that simple...Thanks for a great post!

  8. That is eye-opening. I wish everyone knew this before we mess our health care system up even more.

  9. I just cannot WAIT until we get our free health care here in the US...Oh, wait....yes I can.