Patients’ best interests should be the primary concern

2021. December 17.

The number of private health care institutions is growing rapidly, and with no end in sight. There is no doubt that this process is mainly driven by growing demand, from within the state healthcare system. But is there enough solvent demand to sustain all the increasingly expensive private clinics? What is the role of public and private care in the current health care system? We sought answers to these questions from Dr. Kornél Papik, Managing Director of Dr. Rose Private Hospital.

Dr. Papik Kornél - 30 százalékkal nőtt a műtétek száma

News is published daily that another private clinic has opened. Do you think there are enough patients who can afford to pay and support so many private institutions?

I think affordable demand depends on two things: how much better the service is than in publicly funded care, and how many people are getting sidelined by public hospitals. Everyone wants to be healed, so if you don’t get treatment in public healthcare, if needs be you will even start saving to get it from a private health service provider. Today, more and more private institutions in Hungary provide inpatient care. I find that while in the past patients were mostly referred to a specialist clinic, more and more people today choose a private hospital, for surgeries too. The growth of solvent demand also depends on health policy decisions, but not much is known about key strategic directions. For example, it is difficult to judge whether they want to maintain public health capacity at its previous level in the period following this pandemic. In the same way, we do not know whether and when they will create the possibility of real supplementary insurance in addition to compulsory health insurance in institutionalized financing. The running of private health care would be much more predictable if these issues were clarified.

If I understand correctly, do you think the demand for private health care could increase even more?

Yes, it is growing currently. In the first instance, the demand for inpatient care is expanding. However, as I mentioned, the future is unpredictable. This is why private health care providers are in trouble, as implementing inpatient care costs huge amounts, billions, but recouping this outlay is uncertain.

Even if the demand is high, I think the competition between private health care providers is not yet so fierce?

There are several exciting processes going on in this area right now. The market is really saturated and is currently reorganizing. A lot of investors see opportunities in private healthcare and new entrants are also entering the market. Alongside this, a lot of money is spent, for example, on high medical salaries that may not be sustainable in the long run. The state is also taking back areas, as artificial insemination has returned to the state and some centralization of imaging diagnostics or lab diagnostics has also been discussed. Meanwhile, there is a centralization in the market: larger private players such as TritonLife, Doktor24, Affidea are buying up smaller businesses and trying to create larger networks.

In this ever-changing, expanding sector, what is it that you can stand out for, or offer more of?

In many private institutions, we see that they focus primarily on quantity and size. However, the ever-increasing volume may not be able to follow the high-, or standard-quality service. In addition, after acquisitions, it is not easy to build a service network based on the same protocol system from many small companies - one where clients get the same service under one brand name for different institutions. Dr. Rose Private Hospital has been aiming to provide uniquely high-quality services to patients for 15 years, ever since it opened. After a change of ownership three years ago now, this goal only intensified. Entering our Private Hospital does not remind us that we are in a hospital. The design of our client spaces is more like the lobby of a hotel. We strive to create a soothing atmosphere and thus release the tension. The pleasant atmosphere has a good effect not only on our patients but also on the doctors, who can work in conditions where they only have to focus on the patients. We take the necessary time for examinations and communication. Our patients need to feel that everyone is solely focusing on them and working towards their recovery. In addition, our services are no longer at all more expensive than the competition’s.

How is it possible to maintain the high standard?

We are constantly growing, but not by leaps and bounds, so new employees have time to integrate into our system. In addition, we do not hire just anyone, we screen applicants as well as specialists, and we only employ those who our professional management considers to be suitable for high-quality care, both professionally and personally. It is no coincidence that our team of staff is constant, with hardly any fluctuation, our close to 50 employees have been working here for more than 10 years. We also differ in that firstly the doctor does not bring their own patient to us, and we only provide a place for treatment, but most of our patients come to us because of the Dr. Rose Private Hospital brand name.

It is known that, mainly the doctors who work at Dr. Rose, also practise elsewhere. Were any problems caused by the new legal status making it a condition for doctors working in public care subject to authorization when taking a second job?

Those who had previously worked here easily obtained permission, but this was initially a great difficulty for newcomers. In any case, it is not so much the new law, but rather the obligation that private health service providers have to upload everything to the EESZT (National eHealth Infrastructure). Today, it is no longer possible for a doctor working in a public institution to consult in a private hospital during their working hours, because this also came to light from the EESZT.

The shortage of skilled workers is one of the biggest problems in public healthcare. Even among private clinics, there is a rumor that nurses are being headhunted. Do you experience this problem?

Since the ruling came into being because of the pandemic, and while there is currently no ban on employee resignation, far more people are applying than before. Now, most of the time finding the right professionals is the difficulty. But it also raises an ethical dilemma, if we find, for example, an excellent, highly trained intensive care nurse who would apply to us. It would be unbelievably good for us if such a professional would work for us, but in the public health service their knowledge would be put to much better use.

It is rare to hear from a private health care representative that on certin issues they prefer public healthcare….

As a physician and a responsible health service director, the patients’ best interests should be the primary concern. I will give other, perhaps surprising, examples. If someone needs some kind of specialist care, which can only be solved with a brand new technological, expensive device, you will often find this sooner in public healthcare. This is because these new innovations often do not first appear in private care due to the size of the investment. And maybe I’m speaking against myself now, but in my opinion waiting lists should also be worked through primarily in public health care and not, as many would like, in private care. There are no fewer operating rooms or beds, so the infrastructure is close to supply in both Budapest and the countryside, only the human resources are lacking. But of course, if decision makers involve private providers in working through the waiting lists, we will be happy to get involved and provide the best service to patients.

One of the cornerstones of health policy decisions in recent years has been the need to separate private and public care. How much do you agree with that?

This is a very complex question. For example, why would a private doctor not be able to tell a patient who is responding to his or her complaints what examinations or treatment that patient needs, be it an examination in a public or a private care institution. However, you cannot give a referral to a public hospital because it is assumed that you are making your decision not on a professional but on a business basis. Yet with precise regulation and a strong inspectoral system, this problem could be eliminated. So, these artificial boundaries are not really in the best interests of the patient but point to shortcomings in proper regulation and control of patient referral.

In your opinion, therefore, there would be a role for both public and private care in a system of cooperation. What about private clinics?

I think that the primary task of private clinics and thus of our Private Hospital is still to provide patients with a very high quality, extremely safe environment in the shortest possible time. Let the prosthesis be of the best quality, the operating room must be equipped so that it does not arise during an operation that something is missing, and the hygiene is always perfect. Let’s create a relaxed environment for the selected doctors and outstanding nurses to feel there is enough time for everything, and no need to hurry. Let there be enough time for care, rehabilitation, and to be available after that for as long as the patient needs us. Provide services that make it easier for patients to find their way around. For example, we have a lot of care organizers, call centers and receptionists, employees whose job it is to manage the care of patients, help them, guide them, and answer any questions they may have. We try to facilitate and speed up the treatment process with the latest techniques. For example, we no longer give patients x-rays, CT or MRI images on a CD, instead we email a link where they can be opened, downloaded, and sent on to their doctor.

Certainly, patients recognize this since there is a full inpatient ward at the moment. Which test or treatment is most popular in your private hospital?

We are very pleased that an increasing number of our customers are buying an annual card. This is the best indication that they want to heal all their illnesses with us because they trust our services. Our complex screening programs, which serve to prevent and detect diseases early, are very successful. We can safely perform increasingly complex orthopedic and surgical surgeries in our inpatient ward. We perform more than a thousand surgeries a year at our plastic surgery department, thanks to four excellent plastic surgeons who have been working for us for a long time. We are also proud of our family-friendly, intimate obstetrics department.

In outpatient care, we work with excellent specialists in all medical professions and strive to obtain the most up-to-date equipment. A good example of this is videodermatoscopic mole screening. This gives a very accurate picture of the moles, plus the image can be stored for years to track changes in a patch of skin. Many also come to us because, at least within our group, all imaging diagnostic methods are available, from x-rays to MRI and PET/CT scans. Others come to us because they know that we have the most advanced mammography equipment that allows us to perform a 3-dimensional, stereotactic biopsy.

Is patient satisfaction measured in any way?

Naturally. After leaving, all our patients receive an online questionnaire where they can evaluate the care they received based on various parameters. We usually get a very high rating, but we can never be satisfied with that. What we can really learn from is the written evaluations of the less satisfied. We always investigate such comments thoroughly and continually improve our operations.

What are your plans for the future?

We are also keeping pace with the growing demand. Currently we are investigating whether we can increase our capacity with a larger investment or in smaller steps. For us the most important thing is that the quality of our services is even better after the improvements.