Linas Jegelevičius for the BNN
To get a doctor‘s appointment has become so hard in Lithuania that the head of state, Dalia Grybauskaitė, stepped in, urging the Parliament to pass in autumn legislative amendments which would bind Lithuanian doctors to see patients «in a timely fashion».
A month or so to see a general practitioner and up to a half-year in queue to get consulted by a narrow-field specialist? That is how bad the healthcare has gotten in Lithuania.
Long waiting-lists to see doctor
In reality, the excruciating waiting translates in tons of stories, soaked with tears, distress and even lethal demise.
«As a diabetic patient I am prone to higher health risks, therefore I signed up with a free breast cancer programme in January this year. But only next week, i.e. after more than half-year I will get to see the doctor in Santariškės Clinics in Vilnius,» Vida Augustinienė, who is also the chair of Lithuania’s Patient Organizations Representative Council (LPORC), told BNN. «This is how bad the situation is.»
Another patient, a four-month pregnant woman from hinterlands complained to Lithuanian media she’s been unable to see a gynecologist for entire four months now.
A bunch of them.
«Some of them are on holidays, others are about to leave for them – no one cares about us at the end of the day,» Neda, the to-be mom, tells.
Expectant mom lives in constant fear
Financially unable to pay visit to a private doctor, she lives in constant fear of the fetus’ life and her own, too.
«The first months of pregnancy are the most dangerous. I really cannot grasp how it is possible to deal with the patients, especially pregnant women, that way. I understand that summer is a holiday season, but someone has to be still working. Sometimes I am so overwhelmed with anxiety that it seems sometimes that I don’t feel the baby- I fear he’s dead in the womb. The wait has exhausted me,» the expectant woman confessed.
She found out of her pregnancy two months ago when her spouse took her, all throwing up and nausea-ridden, to a local hospital in Klaipėda region.
After Neda got discharged a few days later, she has been waiting for a gynaecologist’s appointment ever since.
But no one is available, unfortunately.
How it is possible?
Neda’s husband just cannot get how it could be possible in Lithuania?
«This is insane. What kind of a health care do we have if pregnant women cannot get to see a doctor? My wife is four-month pregnant and she still is not in the registry because the gynaecologists are on holidays and the health care system stinks. We still do not know whether the baby is well and health complications-free,» the fretted husband poured out his heart.
President wants medics’ accountability
Swamped with the complaints of the kind, Dalia Grybauskaitė, the President, has decided to act- pass on the parliamentarians proposals aimed to improve the plight.
Among the dozen of them is shortening the time one needs to get to see a doctor.
«Now, the length of patients’ waiting-list varies several times in different medical establishments. Besides, it happens that the queues to see doctors are set artificially,» the President’s Office says in statement.
The President is also determined, the statement says, to raise the requirements for medics’ accountability.
Autumn parliamentary session is to begin on September 10.
Improper medical records
Lithuanian Parliament Speaker Loreta Graužinienė also hailed the head’s-of-state initiative aimed to cut the lines in local healthcare centres and regretted that it has not come from the Health minister, Rimantė Šalaševičiūtė.
To the exasperation of many, the minister is blaming not the system for all the shortcomings, but the patients’ medical records which, according to the minister, are in disarray or improperly prepared.
«Around 43 percent of all the patients come to see third-level specialists without properly prepared medical documentation, i.e. without required tests. Therefore, the large hospitals constantly deal with the same problem –do the work that has to be done by lower-tier medical establishments, usually the policlinics,» Šalaševičiūtė told a Lithuanian radio station.
She insists because of that, instead of paying one visit, many patients have to see the narrow-field specialist twice or thrice.
«If all the preparatory works were done ahead of the visit, the waiting time would get shorter from three or four months to a month or two (months),» she suggested.
It’s not about medical records
The Health Ministry, the minister says, is drawing up instructions which following will be mandatory for the first-level doctors, known as family physicians in Lithuania. The draft sets out what steps general practitioners will have to take locally before sending the patient for consultation of a medical specialist.
But the problems of Lithuanian healthcare may be rooting way deeper, suggest many Lithuanian medics that BNN talked to.
«We should be addressing the issue of doctors’ age and their numbers out there. The research shows that only a mere 6.2 percent of cardiologists and 14 percent of surgeons at the age of 66 years are already in retirement as the most of medics, who have reached a venerable age, are still toiling. And this problem is likely to exacerbate as their positions after retirement will likely remain unfilled,» Vygantas Sudaris, the head of Lithuania’s Regional Hospital Association (LRHA) and director of Pakruojis Hospital, says.
Tip of iceberg
Agreeing, Onutė Kajutienė, a senior nurse at a hospital in southern Lithuania, says aging medical staff poses «a serious problem, especially in the provinces”, but it’s only the tip of iceberg.
«Regretfully, most of the medicine school graduates decamp in search for a better life. I believe the graduates should be legislatively obligated to stay and work in Lithuanian medical centers at least for a couple of years after the graduation,» Kajutienė told BNN.
With few local doctors, visiting doctors from larger cities may be patching up the gap for now, but this solution is short-term, she says.
«What is going on now in health care establishments in the provinces is total disarray. On one side we have few doctors, the majority of whom are pensioners, constantly overworked and tired. And behind the door there are throngs of patients, demanding and often with chronic diseases,» she tells.
Digitization of medical records and prescribing, Kajutienė believes, could partly assuage the situation, but for visceral changes, a thorough overhaul of the current healthcare system is needed, she is convinced.
Overhaul from top to bottom is needed
Importantly, she insists, the population should be oriented to a healthy lifestyle and the awareness of illness preventions should be stepped up.
«We have a lot of patients who can barely walk on their own after letting their ailments go untreated for long,» she notices.
Both Sudaris and Kajutienė disagree with the Health Minister’s rebukes on patients’ improper medical documentation.
«It is a two-way street,» the medics insist.
Augustinienė, of LPORC, also believes that no single measure will better the precarious situation in Lithuanian health care system.
«It has to be looked through from the top to the bottom,» she is convinced.
Hardly it is only about the financing, but the system is underfinanced, she says.
Healthcare digitalization, simplification of access to medical specialists, which could be achieved through allowing patients seek their help directly, bypassing family doctors, eradication of bureaucracy and following the best Western practices can improve functioning of system, the representative of Patient Organizations believes.
Still, she admits she doubts whether it would suffice to resuscitate the ailing system.