Private Medical Sector in Serbia 2013

special edition

private medical sector in serbia 2013

The state and private medical practice don't have equal treatment in Serbia

Private Practice and Public Policy Despite many promises given by the Serbian authorities, the state and private medical practice in Serbia still do not get equal treatment. At the expense of both medical staff and patients, the private sector still functions in the shadow of the state one

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epresentatives of the Health Ministry and the Republic Health Insurane Fund (RFZO) claim that, in a nutshell, the state doesn't have enough funds, the services rendered by private medical practice are too expensive and that equalizing the two would bring on the collapse of the entire healthcare system. On the other hand, private practice doctors claim that equalizing the private practice with the state one would result in a smaller number of scandals, shorter waiting lists and the rooting out of corruption in healthcare. As always, the truth lies somewhere in the middle.

Undoubtedly, private medical practice in Serbia is mainly functioning in a 'gray zone,' since the state does not deal with it, keeps it at bay and refuses to include it in the existing healthcare system.

Proof of that can be found in the rather sparse and inexact statistical data about the number of private practice institutions, as well as the number and the type of services they offer. Talk about private practice is always in general terms, with across-the-board evaluations.

According to available but unsubstantiated data, close to 30,000 check-ups are performed daily by private practice doctors, and 20 million services are rendered an-

nually. Apart from that, it is the prevailing opinion that patients usually turn to private practice for specialized check-ups and diagnostic methods. It has been estimated that Serbian citizens spend several million euros annually on healthcare services provided other than the state system. This amount includes the money spent on purchasing drugs and medicinal products.

Private practice in Serbia was banned in 1959 and it was re-launched in 1989. Today, after almost a quarter of a century, the state is still not using this segment which operates without direction, clear rules and strict supervision Belgrade tops the list Considering the number of registered doctor's surgeries, clinics and other medical institutions, private practice is most developed in Belgrade, which is expected due to the population density. To be more precise, over one third of private practice institu-

tions are in Belgrade. The capital city has the largest number of doctors’ and dentists’ offices, as well as pharmacies, but there is no precise data available to substantiate that. Not counting municipalities in Kosovo and Metohija, private healthcare is least in demand in Southeast Serbia.

Due to the unfavourable financial situation, the private sector is still not the first choice of patients who usually use the services of private dentists (4.6% out of 9% of the total population that has dental treatments). Only 1.2% of the population chooses private outpatient facilities, while 0.1% are treated in privately run hospitals.

Non-existent control Just like in private practice, doctors also have a lot to complain about, and the patients are right to be angry at the state authorities for not properly supervising private practice. Many of them offer services for which they do not have prop-

Entitled to write prescriptions, but not doing it

Less than 100 private practice doctors are allowed to write prescriptions for drugs funded by RFZO. If more doctors were allowed to do that, they would save money for their patients for therapy since these patients are already paying for diagnostic and specialist medical examinations.

Private practice doctors are mostly not interested in writing prescriptions for drugs that are covered by mandatory health insurance. As they say, the paperwork is so complicated that it only causes them problems.

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er licenses, and they carry out surgical interventions for which they are not properly equipped both technically and in terms of staff. Lack of supervision is also detrimental to those private practice doctors who do their job professionally and in optimal conditions on which they spent a lot of money. Aside from being obligated to protect the patient from malpractice, the state should also try to reduce the medical 'gray zone,' since it is this gray zone that takes money away from the state budget. In order for the entire system to operate properly, private doctors would have to issue their patients with cash register receipts, record the services rendered and reimburse the salaries for their staff via bank accounts and not by cash-in-hand.

In that case, the data on the number of rendered services would be precise and complete.

Half of the MRI devices are located in private doctor's surgeries, which speaks volumes about the private sector being the one to count on. Out of 30,000 doctors in Serbia, 3,100 work in private practice whether as staff or owners.

No jobs for young professionals People who oppose this 'sitting on two chairs' situation rightly ask how can a doctor work in a conscientious, dedicated and responsible manner in two places at once, and have two sets of working hours – one in a staterun health institution and one in private practice as consultants.

Former Health Minister Zoran Stanković often said that people who have their own private practice should not work in the state sector since the citizens object to graphic designer: Meri Ivanovska, m.ivanovska@aim.rs TRANSLATION: Snežana Bjelotomić PHOTO: Zoran Petrović project managers: in serbia medical sector Svetlana Okanović,

EDITOR: Ivan Mišković ART DIRECTOR Ilija Petrović, i.petrovic@aim.rs

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How are things done in Europe?

In Europe, private and state health practices are intertwined and they have been complementing each other for years. In Belgium and Germany, for instance, a health insurance holder can get treatment at any given facility, pay for the services rendered and have between 50% and 75% of that amount refunded to him depending on the insurance policy he has. Health insurance in Belgium is mandatory, and every citizen has to choose one of the insurance formats. The German healthcare system is the oldest in Europe and one of the best, since insurance holders can get treatment at any hospital or general practice surgery which is covered by their insurance policies. it. He also said that each doctor should have only one job, regardless whether that job is in state or private practice. He went on to say that this would create opportunities for hiring young medical professionals who have been knocking on the doors of the National Employment Service for years without much success.

an agreement with the Republic Health Insurance Fund according to which, in 2013, patients will be able to get prescription drugs at private pharmacies too.

The private sector is growing. With the deterioration of the state healthcare sector and pronounced shortage of budget money, private surgeries, clinics and hospitals have been springing up left and right The current health minister, Dr. Slavica Đukić Dejanović, has decided to make a first step in fusing the private healthcare institutions into one unique system. Private pharmacies will be the first to do that. They have already concluded s.okanovic@aim.rs Biljana Dević, b.devic@aim.rs Nataša Popović, n.popovic@aim.rs Jelena Bulić j.bulic@aim.rs executive DIRECTOR: Ruža Ristanović,

r.ristanovic@aim.rs GENERAL MANAGER: Ivan Novčić, i.novcic@cma.rs FINANCIAL DIRECTOR: Ana Besedić, a.besedic@aim.rs EDITORIAL MANAGER: Tanja Banković,

Patients at loss And what do doctors, who work both in the state and private sectors, have to say about this topic? Cardiologist Dr. Višeslav Hadži Tanović says that, 21 years ago, when he quit his job at a hospital in Bežanijska Kosa and set up his 'Klinika za Srce' ('Heart Clinic'), he knew exactly what he was doing.

“A huge number of doctors work in state hospitals in the morning and in private ones in the afternoon. These private hospitals are usually registered to somebody else's name or they usually work unreported which is totally unacceptable. Since the day one, I was against such work which is detrimental to patients who have been going back and forth from the state sector to the private one for years. We all know that doctors often tell their patients that there is a shortage of a certain drug, that the equipment is not working, and that they should wait for months to have a check-up and then instruct them to go to their private practices where they can do everything they need to do in a space of just one afternoon. There are even cases when patients pick up the results of their ultrasound or labora-

t.bankovic@aim.rs PRINTING: Rotografika d.o.o.

“Private Medical Sector in Serbia 2013.” alliance international media Makenzijeva 67, 11000 Belgrade, Serbia Tel:+(381 11) 2450 508 Fax: +(381 11) 2450 122

ISSN no: 1451-7833 All rights reserved alliance international media 2013.

tory analyses, which were done in a state health institution, at a private doctor's offices where 'their' doctors work in the afternoon. This is a classic case of misleading the patient and breaching his rights.

It's downright criminal. Because this is a good breeding ground for corruption, I have always been advocating making a clear distinction between the work that doctors do in state practice and the one that they do privately. If a doctor thinks that he will fare better in private practice, he should quit his state job and work privately,” Dr Hadži Tanović underlines.

Still, despite plans, nobody knows as yet when the private practice doctors are going to be allowed to write referrals for hospital treatments or send patients to sick leave. Private doctors say that it doesn't make sense for patients, who are treated in the private sector, to be robbed off

When it comes to the private sector, the patients usually choose known doctors who have managed to make a brand out of their own names. If they unable to reach them in the state sector, they usually track them down in private clinics or are willing to pay to avoid waiting lists all together

these rights, since private healthcare institutions also have operating licenses, just like the state ones. They also say that exercising these rights would not cost RFZO a penny, but would mean a lot for patients who, after all, pay from their salaries for mandatory health insurance. «

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INTERVIEW

Professor Dr. Slavica Đukić Dejanović, Health Minister

Diagnosing the System

We should raise all public health aspects to a higher level, meaning that 80% of all medical problems should be treated in local health clinics instead of referring patients immediately to higher medical levels

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rofessor Dr Slavica Đukić Dejanović was appointed as Health Minister in Serbian government at a very difficult point in time. The debts generated by the healthcare system are high, but, as she says in an interview for CorD, she is confident that we are going to enjoy better healthcare. She is concerned with the pronounced dissatisfaction of patients and medical staff alike, but she thinks that this can be remedied. ● What health care reforms do you plan to execute in the coming period?

- The most important reforms that the Serbian healthcare system will undergo pertain to the implementation of existing legislation. We should raise all public health aspects to a higher level, meaning that 80% of all medical problems should be treated in local health clinics instead of referring patients immediately to higher medical levels. In this way, the capacity of the secondary and tertiary level medical facilities, such as hospitals and clinical centres, will be freed up. In the near future, we plan to change the way in which

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Primary health care physicians are underutilized and that is a big problem.

Over 80% of medical services should be carried out at the primary health care level, and the rest should be carried out in hospitals and clinical centres

hospitals and clinical centres charge for their services. We are talking about “DRG”, meaning that hospitals receive a lump sum for a particular patient's diagnosis, reimbursed for the costs they incurred in treating that patient. In 2013, DRG will be implemented as a pilot project, and, in 2014, it will be used in hospitals much more. ● Are private and state practice going to become equal and, if the answer is ‘yes’, when is that going to happen?

- That is something that the Republic of Serbia’s Constitution guarantees. However, it hasn’t happened in practice as yet. To start off with, we have decided to include privately owned pharmacies into the state system since there is no reason for patients not to be able to buy prescription drugs from the nearest pharmacy. In order for pharmacies to join the state system, they need to fulfil the same terms and conditions as state ones: to have appropriate premises, have at least one employee

Weak interest in radiology

with a university degree in pharmacology and be networked.

In the beginning, the Republic Health Insurance Fund (RFZO) will conclude agreements with pharmacies that fulfil the required conditions. I expect that there will be pharmacies, at least in bigger towns, that will be eligible to conclude agreements with the RFZO. What is reassuring for private pharmacies is that, as of next year, the RFZO will have to settle its financial obligations towards pharmacies within a 150day period. In 2014, this period will be shortened to 120 days and, in 2015, to 90 days. All of this will motivate the majority of pharmacies to join the system. ● Is the Ministry of Health going to change its attitude toward the pharmaceutical industry?

- I think that all medicine should be legalized. It is up to the state to decide which drugs can be included in the “positive list”, which ones should be partially paid by patients and what will the patients get if they pay a full price for a particular drug.

The way that the pharmaceutical

- I was shocked to see the data and I am afraid that we are going to be in a situation where good specialists will retire and young people are not going to manage to finish their specialization on time. Still, not all postgraduate medical studies are equally popular, even when we endorse them.

Only 26 doctors decided to do radiology specializations this year. In order to deal with the problem of the insufficient number of postgraduate studies much faster, we have decided that graduate doctors now don’t need to complete two years of residency.

industry is treated now has its flaws, and sometimes you can’t buy cheaper medicines that are very important. I think that it would be bad idea to cut down on the number and range of available drugs. For instance, I specialize in psychiatry, and I can tell you that each patient uses an anti-depressant that suits him or her best. It is up to us to make those drugs available.

2013. We are not going to jump the legislative gun here, and we are definitely going to consult trade unions and patient associations.

● What needs to be done urgently so our healthcare system can finally operate to suit the citizens’ needs?

- First and foremost, the citizens need to take care of their health to the best of ● When is the renovation of clinical cen- their abilities. The healthcare system’s tres in Belgrade, Niš, Kragujevac and Novi task is early detection of disease through screening programmes. You have to bear Sad going to really take off?

- Truth be told, that is a painful and diffi- in mind that the average annual healthcult issue. I talked recently to the Italian care spend in Serbia is only EUR 250 per ambassador about that subject, since it capita with EUR 47 of that money going towas the Italian companies that were com- wards the salaries of medical workers. This missioned to draw up the project but which gives you a good idea of how little monjust dragged on and is still not done. I ex- ey there is for medical treatment. That’s pect work on the Niš Clinical Centre to start why prevention is so important, since if in the first half of 2013, with the renova- there is no prevention, all of the available money will be spent on expensive treattion of clinical centres in Novi Sad and and there wouldn’t Kragujevac starting in two Patients want good doctors ments be enough to go around. and four months’ time after that respectively. Work to work in private practice. Prevention is the best inAll other professions are vestment in health and on the Clinical Centre of Serbia should begin in the entitled to do that. Of course only a healthy individual first half of 2014. I have there is the question of ethics can sustain and contribbeen wholeheartedly inand whether what they do is ute to the economy. volved in resolving this isethically correct, but that will ● Is the enrolment policy sue since I don’t want to keep EUR 150 million in come up even if they work of Serbian medical facloans for this project sit- illegally. Hence, I think that ulties going to change? ting in a Brussels bank legalization is necessary What are we going to do with so many unemmuch longer. ployed young doctors? ● What do you think about state doctors - We have already talked about this with the education minister, Žarko Obradović. working in private practice?

- We need to change and amend the The Association of Faculties of Medicine Labour Law in collaboration with the needs to have a say about the enrolment Ministry of Labour, Employment and Social policy and the optimal enrolment quotas Policy. Additional work needs to be reg- and we need to talk about that. The logic ulated very precisely and in agreement that states “if there is no work, at least let with the relevant trade unions. We need people educate themselves” will take us to take into consideration that doctors are nowhere, and the data on the brain drain not adequately paid for doing a very dif- is worrying. We are going to deal with this ficult and responsible job, and we should topic very seriously before the 2013-2014 school year starts. not stop them from earning extra money in their spare time. Of course, they should not do that while on-call in state medical ● Do you think that centralized public acinstitutions and while using state resourc- quisitions in the health sector will imes. There should be a clear distinction be- prove the situation? tween the two. Only in that way we are go- - Economic experts claim that we are going to able to protect the reputation of eve- ing to save between 20% and 40% in ry single medical worker. This is a very im- that way. That is a hefty sum of money portant issue that I am going to tackle in for the health care sector. Centralized

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public acquisitions are also an anti-corruption move. The perception that the citizens have is that there is a lot of corruption in hiring and acquisitions, and this is the only way that we can achieve transparency. ● What will the relegation of patient advocates to local levels bring and when do you expect the first results to show?

- One of the laws which has been the subject of a public debate recently is the draft Law on the Protection of Patients’ Rights and People with Mental Disabilities.

What is certain is that the patient advocate is going to be a lawyer and that they are not going to work in a medical facility. That wouldn’t be good since, if they did, they would be protecting the institution’s rather than the patient’s rights. Our idea is to have them work in local municipal offices. By doing this, we want to help patients in becoming partners in the treatment process.

We are still looking for a proper name for patient advocates. ● Setting up reproductive cell banks is a topic that first emerged in 2009. Although there are proper conditions for legally conducting fertilization, still this procedure is done illegally. When to do you think a first reproductive cell bank will be opened?

- A Republic expert committee was formed with the purpose of dealing with this issue. This is an intersectoral issue. Anyhow, we are going to listen to what the medical profession has to say, but I cannot give you any information about concrete steps and dates. ● What about the stem cell bank?

- A location for this bank was supposed to be selected already, and the plan has been to

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open it in Kragujevac. Opening such a bank is a big financial undertaking, but the agreements concluded with the World Bank about setting up a stem cell bank are binding, and they need to be implemented. We are talking about a science and research project for which Science Ministry is in charge. ● Do you think that the capitation formula, paying physicians a set amount for each patient assigned to them, is good?

The average annual healthcare spend in Serbia is only EUR 250 per capita with EUR 47 of that money going towards the salaries of medical workers - Capitation in primary health care has been in effect since October 1 this year. The amount of money that has been set aside as an additional incentive for physicians, who work a lot and work well, is not big, but I do hope that it will grow in the future. Once the economy picks up and unemployment drops, the health budget will get more money. The capitation formula entails scoring a doctors’ work, taking into account how many

patients they treat, how many they refer to higher medical levels, how many prevention checkups they do, and so forth. For instance, a general practitioner can treat inflamed tonsils without immediately sending the patient to an ear, nose, and throat specialist and such a doctor certainly deserves to be rewarded, and this is what the capitation formula is all about. We haven’t reduced anybody’s salary, and we have set aside 2% for pay rise for medical workers who do good job and work more. ● When are all medical facilities going to be networked?

- Next year, healthcare facilities in Serbia are going to be networked and will have a general database containing medical files of all patients in the country. This database will contain the relevant information, laboratory tests and medical treatment results for each individual patient, whether these were conducted in a private or state facility. I am sure that this will prevent duplication of procedures, shorten the time needed to obtain timely healthcare and facilitate patient treatment, as well as save money for the Serbian healthcare sector. We are going to arrange the system in a way that everybody will be treated where they need to and we are going to raise health care to a higher level. Our plan is also to make an electronic filing system, a centralized software system that will connect all health facilities and will contain every single medical file. When patients are admitted to hospitals, they are not going to have to do laboratory tests all over again since the system will contain the results of all diagnoses and tests no matter where they have been done. At a click of a button, doctors will be able to peruse through a patient's complete medical history. «

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INTERVIEW

Darko Jelić, Development Director at the Jedro Health Clinic

Providing Expertise You Can Trust Top medical team and state of the art equipment are the best recommendation for a private health clinic significantly contribute to both prevention and patient treatment. The competence of medical staff, state of the art medical equipment and fast services are good enough reasons for patients to choose private healthcare facilities. The fact remains that every third patient chooses treatment in privately run health facilities.

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he modern privately-run health clinic Jedro was founded in 2010 by the renowned insurance company, Delta Generali. The Clinic spans 1,500 square metres, it has two levels, and it employs distinguished medical professionals who provide all kinds of primary healthcare services. The Clinic’s director, Darko Jelić talks for CorD magazine about the Clinic’s future plans and why the number of the Clinic’s patients keeps on growing. ● How important are privately run health clinics for patients?

- Considering their organizational, financial and human resources, private health clinics

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● Do you consider yourself competition to the state health clinics?

- Providing health care services, regardless of the structural ownership of a medical facility, should not be viewed as competition but rather as working to-

Our biggest advantage is our team of top doctors and consultants with extensive clinical experience gained at the most eminent health institutions

wards the same goal - the better health of our nation. In that respect, both private and state health clinics should contribute to this goal, and it is up to the patients to recognize and decide in whose hands they are going to put their health. Private medical facilities have a special advantage in their flexibility and readiness to meet specific demands of patients. ● Why do patients choose your facility? What are your trump cards?

- The Jedro Health Clinic is a contemporary medical facility which offers a wide range of diagnostic and therapeutic procedures through a well-organized general practice and a series of specialist and sub-specialist services. Our biggest advantage is our team of top doctors and consult-

ants with extensive clinical experience gained at the most eminent health institutions like the Clinical Centre of Serbia, Military Medical Academy, University Children Clinic in Tiršova Street, Oncology and Radiology Institute of Serbia, and other health clinics in Belgrade. Our advantage in patient treatment comes from having a call centre that is opened 24/7, 365 days a year. By calling 011-715-0-715 you can schedule an appointment or receive free medical advice at any time of the day.

number of corporate clients in the biggest domestic and foreign companies that operate in Serbia which have decided to enable their staff to use Jedro’s medical services. ● Do you think that people will pay as much as it takes to be treated at a facility like yours in order to avoid having to wait for a long time for treatment at state hospitals?

- When your health is at issue, money doesn’t play a big role.

Hence, I think that having to wait to be seen by a state practice doctor is not the reason why patients come to us. It is our expertise and comprehensive health care, provided by our medical staff, as well as top of the line medical equipment, which are the main reasons why patients turn to us.

● Do you think that doctors in private health clinics will be allowed to send patients on sick leave or give hospital referrals?

- The relevant state authorities are due to make a decision about those issues soon. They are also probably going to consider the possibility of patients having a private practice doctor assigned to them. What I can confirm is that the Jedro Health Clinic is absolutely ready to provide all of the aforementioned services to our patients.

We have a substantial number of corporate clients in the biggest domestic and foreign companies that operate in Serbia which have decided to enable their staff to use Jedro’s medical services

● Could you tell us something about your patients? Do you think that the fees you charge are affordable?

- Our patients are of different age and professional background. We should also underline that we have a substantial

● Does the future of private health clinics lie in the hands of private companies which are going to enable private medical treatments for their employees?

- That is certainly an important resource for private health clin-

ics, but I think that individual patients, their satisfaction and trust are also very important for success of any private medical institution. ● Following a check-up in your facility, do you help patients with being admitted to other hospitals and have distinguished doctors treat them if the need arises?

- The excellent reputation of our doctors and their services are certainly the best recommendation for secondary and tertiary healthcare treatments. Our doctors are in touch with the management and distinguished doctors at the country’s most acclaimed hospitals on a daily basis, so consultations and assistance are certainly possible. «

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INTERVIEW

Professor Dr. Vladimir Đukić, State Secretary in the Ministry of Health

Better Days for Serbian Healthcare Are Coming

Professor Dr Vladimir Đukić has been the state secretary in the Ministry of Health since August this year. Prior to this appointment, he was the director of the Clinical Centre of Serbia’s ER with the great desire to expedite the implementation of the heart transplant project in Serbian hospitals

A

nother great undertaking in which he is involved is renovating four clinical centres in Serbia where certain progress has already been made. Still, he adds, his biggest wish is for Serbia to join Eurotransplant – an organization responsible for allocation of donor organs all over Europe.

“Some people have mentioned legal obstacles when it comes to re-launching heart transplants in Serbian hospitals. There are no legal obstacles. I will attend a Eurotransplant conference in Austria in late January next year at which we are going to receive direct support for concluding an agreement between the renowned Austrian hospital AKH and the Clinical Centre of Serbia. The agreement will be signed with the support of Dr Ferdinand Mühlbacher, the head of Department of Transplant Surgery at AKH. After that is done, our surgeons will undergo additional training there. By concluding this agreement, our citizens will be able to have these demanding and expensive interventions together with Austrian citizens. The agreement stipulates us sending complicated liver and kidney transplant cases to Austria,” says Dr. Đukić.

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● What about the logistics of the donor hospitals in Serbia. Do you have enough money to see that through?

- The money for extending the network of donor hospitals and transplant teams in Clinical Centre of Serbia, Military Medical Academy, clinical centres in Niš and Kragujevac and the Institute of Cardiovascular Diseases Vojvodina in Sremska Kamenica has already been secured.

Doctors at local health clinics are doing a good job, but they need to do less paperwork. They also need to get to know their patients better and improve home visits ● Still, primary healthcare, i.e. doctors at local health clinics, will have to do most of the work. The Ministry of Health wants these doctors to treat up to 80% patients without referring them to higher medical instances. Do you think that doctors in local health clinics are up for the job and do they have required equipment?

- Doctors at local health clinics have too much to do and, on top of that, they have to deal with excessive paperwork. These people were trained to treat patients, not

write referrals and many other documents. I am confident that general practitioners can treat over 80% of all medical conditions. They can certainly help patients with simple cardiovascular conditions, control diabetes and treat gastrointestinal problems which do not require hospitalization. They can do all of that, but they are up to their necks in paperwork. In terms of the needed equipment, local health clinics are mostly well-equipped, especially the clinics in Belgrade and other bigger towns. ● So, what stops them from working more and better?

- The problem is that health clinics don’t work to their full capacity on Saturdays and Sundays. Also, after 7 pm, there are no doctors available.

There is a lot of room for improvement especially when we are talking about home visits. Local doctors should visit their patients, get thoroughly acquainted with their medical problems, monitor treatment results and not immediately refer the patients to higher medical instances. We need to define precisely a set of services that patients must get at the primary health care level. Based on that, health insurance reform is possible.

● Are you familiar with how well-equipped Serbian hospitals are? Have you reviewed the needs and the current situation with diagnostic and other medical devices?

- The Dr Milan Jovanovic Batut Public Health Institute has a database with such information. Also, there is the Commission for Evaluation and Introduction of New Technologies. Based on the collected field data, strategic decisions about the acquisition of major equipment are made. We plan to increase radiationtherapy capacities. To that end, the state has allocated EUR 10 million for purchasing a radiation device to be used in treating cancer patients. In early 2013, we are going to launch a tender for acquisition of these devices for five radiation centres

As of next week, Serbian patients will be able to undergo organ transplants at AKH Hospital in Vienna. We are talking about heart, liver and kidney transplants for the most severely ill patients in Serbia. For instance, a scanner simulator, which localizes the problem that needs to be treated with radiation, will be sent to Kragujevac. That is what we call radiation preparation. Niš needs more radio-therapists and that problem also has to be solved. ● Do you think that involving private practice in the system could resolve some of the said problems?

- Private practice should be given the same opportunities

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as the state practice. I absolutely agree that private doctors should conclude agreements with the Republic Health Insurance Fund (RFZO) and, by doing so, become a part of the system. Of course, in order for that to happen, they need to meet certain standards and agree to the financial terms offered by the RFZO. If private pharmacies are becoming a part of the system, why not do the same with private clinics and hospitals? ● Are you working on hiring young medical professionals?

- We plan to hire 73 doctors to work in health institutions all over Serbia on a ten-month basis. They will be involved in a screening programme for early detection of breast, colon and uterine cancer. Their engagement is a part of the programme called “Improving Local Health Care Services” which is funded by the state of Serbia and the World Bank. These doctors will be hired early next year.

These are all indications that the Serbian health system will see better days. ● How much did you do on good medical practice guides?

- The Serbian Ministry of Health’s Republic Expert Commission for Development and Implementation of the Good Clinical Practice Guides has prepared nine guides in 2012. They are written with the

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Expert in liver surgery Professor Dr. Vladimir Đukić is widely known as an expert for liver, pancreas and bile duct surgery. Before becoming the head of the ER, he was the head of the Surgery Department at the Clinical Centre of Serbia.

He is a member of the Serbian Medical Association and the European Association of Digestive Surgery. aim of helping medical professionals with detecting, evaluating and applying best practice information, experiences and stances.

They reflect and support the evidence based philosophy of the entire medical movement, i.e. the healthcare movement. These

tice, serve as an instrument made by professionals for professionals, and help to reduce uncertainty in medical practice. The basic criteria in selecting the guide topics was the high rate of morbidity and mortality in Serbia, i.e. the problems identified in a study called ‘Burden of Disease in Serbia’. ● Do you miss working in the ER bearing in mind that you were at the head of it from 2008 to 2012?

- Since I am in surgery every Wednesday and Friday and I manage to stop into the ER every morning, I don’t really miss it. I kept in touch with my department and I have my office waiting for me. I do attend “consilium” meetings, and, as of March, I will be oncall again.

We plan to hire 73 doctors to work in health institutions all over Serbia on a ten-month basis guides also help our medical professionals with keeping up with fast scientific development and intertwining of science and practice, as well as help in decisionmaking, reduce variations in prac-

● Is your working day now longer?

- It is definitely longer now that I am a state secretary. Things are done longer and slower in the Ministry, and I am used to sorting things out quickly, on the go. I rarely leave my office before 7 pm.

I don’t have a problem with that since I have a lot of drive to move the things forward. «

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delta generali

Your Health Deserves the Best!

Healthcare starts with prevention – Delta Generali voluntary health insurance

H

ow much do you really care about your health?

Do you have regular preventive check-ups? Do you agree that health should be the no. 1 priority for all of us? And, lastly, do you know that prevention is a medicine with the strongest effect?

Healthcare should be the first priority for all of us.

Unfortunately, due to our fast pace of living, the demands put before us every day and our many chores, our days have become shorter and we start to deal with our health only at the onset of medical problems.

Prevention is the most efficient way of caring for oneself and entails regular health checkups in order to prevent, detect or cure an illness. Hence, regular phyisical examinations and specialist check-ups are considered to be basic health hygiene.

With Delta Generali, you have the best partner on the path to safeguarding your health!

As the leader in the vol-

untary health insurance segment and an insurance company with the longest experience in this area, Delta Generali has developed the widest range of voluntary health insurance policies on the market. Deeply convinced that investing in health insurance is actually investing in a healthier and happier life, Delta Generali would like to invite you to do what is good for you and try a higher level of healthcare.

As the leader in the voluntary health insurance segment and an insurance company with the longest experience in this area, Delta Generali has developed the widest range of voluntary health insurance policies on the market Through its volunatary health insurance programme, the company will provide you with top of the line services and privileged treatments in all kinds of prevention and health protection. You will enjoy support when scheduling medical check-ups for yourself, your family or your employees, help in

choosing the rigth medical facility and doctors and special treatment when coming in for a check-up. You will be entitled to have medical examination and treatment in nealry three hundred medical facilities of all profiles across Serbia, which is yet another advantage of choosing Delta Generali’s health insurance.

Apart from that, you will be able to enjoy fast and efficient assitance, whether by phone or when meeting with a doctor, the shortest possible waiting time for scheduling checkups and, if needed, help with treatment.

Don’t wait when your health is at stake. Do something good for yourself and allow the people with the mosy experience to help you with that. «

general information For over a decade, Delta Generali has been the leader in the voluntary health insurance segment in Serbia. With over sixty offices across the country, Delta Generali offers all types of insurance whether personal or family insurance. For more detailed information please call our Contact Centre on 0800/222 555 or visit our website www.deltagenerali.rs

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medical sector

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Nikole Tesle 8/8, Zemun, Belgrade +381 (0) 11 2691 800 kvantnamedicinalife@gmail.com www.kvantnamedicina.rs Quantum medicine for athletes

Bioresonance therapy

Food intolerance Homeopathy Quantum medicine - the combination of medicine and quantum physics

Arheus Surgical hospital taking care of patients for ten years The Arheus Surgical Hospital in Požarevac was founded ten years ago by renowned surgeons all of whom are experts in general laparoscopic surgery

F

or the past ten years, over 4,500 outpa tients were treated and over 2,400 surgeries performed in the hospital.

The top surgeons who work in this hospital perform all sorts of outpatient proce dures such as wound care, removal of adipose tissue, sebaceous glands, and in grown nails, and laparo scopic surgery of appen dix, hernia, and gallbladder.

They also perform ‘classi cal’ operations like breast and colon tumour surgery.

The patients can al -

so have acupuncture treatments here, as well as the HBO treatments, which can be done as a separate therapy or additional therapy with general treatment of certain conditions.

The hospital is located in downtown Požarevac, 2, Gradsko Sokače Street, next to the Hotel Dunav. The hospital is located in a quiet and pleasant part of the town which suits both the patients and the staff.

For more information about the hospital, please visit www.arheus.rs.

Stomatološka ordinacija

Bulevar kralja Aleksandra 87, Beograd Tel: 2425-619 Mob: 063/288 511 www.drneda.rs

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A Team of Top Urologists and Gynaecologists at Uromedica Polyclinic Uromedica Polyclinic specializes in treatment of urological and gynaecological conditions

U

romedica Polyclinic specializes in treatment of urological and gynaecological conditions.

The medical specialists that work at the polyclinic are experts in conducting abdominal ultrasonography, ultrasonography of the genitals, TRUS prostate biopsy, cystoscopy, ureteroscopia, echo gl. mammae, frenulotomy, circumcision, scrotal surgery, operations on the penis, ECT condyloma, urodynamic testing and uroflowmetry.

The polyclinic pays a lot of attention to patients

This condition is now easily detected, and one of the reasons for that is a longer life expectancy. One condition, closely related to andropause, is prostate enlargement – or Benign Prostatic Hyperplasia. The hyperplasia is found in men whose amount of active testosterone, the male sex hormone, in the blood decreases, leaving a higher proportion of estrogen, the female sex hormone. This condition is often found in older men and can cause a variety of health problems. The team of Uromedica’s doctors is

This condition is now easily detected, and one of the reasons for that is a longer life expectancy over 50 years of age, or men entering andropause. This concept was introduced to indicate certain changes in functional and organic capacities of men. Andropause entails the reduction of androgen levels in males, and is called a syndrome of reduced androgen levels, i.e. the male sex hormones in older men.

dedicated to treating this problem and has recorded significant results in treating older patients which resulted in a noticeable improvement of the quality of their life.

Uromedica Polyclinic is located in Belgrade, 79, Knez Miloš Street.

For more information, please visit www.uromedica.org.

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Atomic Spa - Clinic for rehabilitation The spa is characteristic for its thermal mineral values, water rich on macro and micro levels, chemical and radioactive elements in safe medicinal concentrations, dissolved (in ionic form) so as to be easily absorbed through the skin into deeper tissues, with a temperature of 27-31 C.

T

The Clinic for Rehabilitation includes use, under medical supervision, rehabilihe Atomic Spa provides ideal condiseveral buildings with a total of 122 actation treatments. Complete balneophystions for the healing and recovery of commodation units and 277 beds. ical treatments are carried out in therapatients with neurological and rheuSurrounded by wooded hills and mounpeutic blocks that are equipped with the matic afflictions, gastrointestinal tract and tains at an altitude of 460 feet, the Gornja latest medical equipment. This includes blood vessels.

Trepca Atomic Spa represents a unique oahydrotherapy, kinesitherapy, electrotherSingular results are obtained in the resis of peace and tranquility. It is characterapy and manual massage. habilitation of multiple sclerosis for which ized by moderate continental the spa is unique in Europe.

The Atomic Spa provides ideal conditions for the climate, which gradually turns Research, led by the Institute of Neurology, Clinical Centre of healing and recovery of patients with neurological into mountain climate making Serbia, showed remarkable effects and rheumatic afflictions, gastrointestinal tract it very comfortable and enjoyable all year round. ÂŤ on rehabilitation patients. and blood vessels Rheumatic diseases or degenerative conditions (such as arthrosis, discarthrosis, spondylosis, disk herniation) or inflammation (rheumatoid arthritis, spondyloarthropathies) are also treated very successfully in this spa.

The water temperature allows for people with cardiovascular disease to

Dr. Sladjana Radan

specijalista oralne hirurgije i implantologije

Makedonska 32/II, 11000 Beograd tel: +381 1132-29-582, 33-74-095 +381 63 30-36-56, 65 33-03-655 e-mail: dr.osmeh@eunet.rs

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INTERVIEW Professor Doctor Miodrag Colić, the Colić Specialized Hospital for Plastic, Reconstructive and Aesthetic Surgery, vice president of the ISAPS (International Society of Aesthetic Plastic Surgery)

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Integrative Satisfied Patients: Medicine Experts

the Best Reference

The Nova Vita Special Internal Medicine Hospital was founded ten years ago and is the largest privately owned hospital in Serbia

patients, men make between five and ten percent. They usually come for rhinoplasty, hair transplants and surgical interventions on their genitals.

S

ince 1989, the Colić Specialized Hospital has been successfully conducting plastic, reconstructive and aesthetic surgical interventions. Two brothers, Professor Doctor Miodrag Colić and chief physician Milan Colić, own the hospital. They say that the hospital’s success is reflected in its thousands of satisfied patients and its excellent reputation both in Serbia and abroad.

● Are you able to meet some of the more unrealistic patient demands?

- No, we are not. We try to talk to the patients and to make them understand what realistic desires and possibilities are. For instance, we are not going to create a short nose on a round or long face. We are always mindful of facial and bodily proportions as defined by old masters Michelangelo and Leonardo.

● You have also launched a new brand, Dr Colić Beauty Therapy.

- Our patients have been of● Could you tell us something ten asking us to give them about current trends in cosadvice on skin care in order metic surgery? to achieve the best possible - General cosmetic surgery is post-operative effects, as well a trend now, especially lip and as to prepare for surgical interbreast augmentation. However, ventions, which is very imporsome surgical interventions tant. We couldn’t are considered seawhat sonal and are usual- We have invested d e c i d e ly done just before a lot of effort and to recommend the summer like li- research into the them in terms of good quality posuction or corbeauty line skin care prodrection of body conucts so we decided to develop tours following major weight Dr Colić Beauty Therapy which loss. Also, gastric balloon suris a result of extensive expegery is very popular. What we rience in formulating and credo is insert a balloon in the paating skin care products. We tient’s stomach which results in have invested a lot of effort significant loss of appetite and, and research into the beauty consequently, weight loss. line. We used the top quality ingredients to make high qual● Do you have male patients? ity affordable cosmetics. « - Out of the total number of our

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he vision and the work carried out by the hospital doctors are based on a multidisciplinary approach to advancing and improving health with a unique individual medical approach to each patient.

Significant results in treating various chronic diseases have been accomplished with a combination of contemporary and traditional medical methods, as well as with the application of immune system stimulators. By utilising this treatment patients wich exhausted all oncological treatment options will have a better and longer life. Nova

Significant results in treating various chronic diseases have been accomplished with a combination of contemporary and traditional medical methods Vita's medical team is consists up of doctors who specialize in internal medicine, immunology, radiology, neurology and neuropsychiatry, as well as specially trained medical staff of nurses and medical technicians. If the need arises, the staff collaborates with other renowned experts. By applying their knowledge and investing a collaborative effort, the hospital’s physicians are constantly fighting for a new, better and longer life of their patients. Nova Vita cooperates with regional science and research institutions like the Immunology Institute of the Kragujevac Faculty of Medicine and the Vinča Nuclear Institute.

The results obtained during pre-clinical trials have shown that natural products, which are an integral part of the therapy prescribed by the doctors from the Nova Vita hospital, decimal point, have an immunomodulatory, antitumor, and radioprotective effect.

This synergistic effect of a multidisciplinary approach to the patient provides more opportunities for healing and improvement of health. «

policlinic

Belgrade, Kneza Miloša 79, Serbia Tel: 011 3615 716, 3615 717, 2656 119 Fax: 011 3615 718 Urology and gynecology: Specialized checkups Abdominal ultrasonography Ultrasonography of the genitals TRUS prostate biopsy Cystoscopy Ureteroscopia Echo gl. mammae Frenulotomy Circumcision Scrotal surgery Operations on the penis ECT condyloma Urodynamic testing Uroflowmetry

www.uromedica.org

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Delta Generali Osiguranje, a leader in voluntary health insurance for the past 10 years, provides all of its customers with a first-rate service and privileged treatment in all areas of illness prevention and heath care.

Delta Generali Osiguranje, a leader in voluntary health insurance for the past 10 years, provides all of its customers with a first-rate service and privileged treatment in all areas of illness prevention and heath care.

Therefore, the question is: Can you afford a life without insurance? It is important to know the choice is always yours.

Therefore, the question is: Can you afford a life without insurance? It is important to know the choice is always Choose insurance… yours.

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