Tuesday, September 19, 2017

First Hospital Experience

I survived my first hospital experience here in Czechland.  Nothing major, it was just a tonsillectomy.  Everything went well and the staff in the ORL (ENT - Ear, Nose, Throat) department at University Hospital Bohunice were great.  My biggest problem was not knowing what to expect in regards to the differences between a hospital stay in the USA and here.

Bohunice ORL ward waiting area
As a patient you need to bring your own pyjamas and robe.  No American style hospital gowns that tie in the back and never quite fit right.  The good thing about this is that you get to be comfortable wearing your own pj's.  You also need to bring your house shoes.  All of the doctors and nurses wear white sandals with their hospital whites.

Generic hospital TP
You also need to bring your own toiletries - a bar of soap, shampoo, a tooth brush, toothpaste, etc., plus a towel.  I was advised by friends to also bring my own toilet paper.  The hospital does provide it but it is the standard, cheap "Eastern European" variety.  I also brought an extra pillow as a creature comfort as I was going to be in hospital for a week.

One of the first things that struck me was the lack of paperwork.  So much less paperwork.  When checking in, I just had to show my health insurance card.  I had to speak to the anaesthesiologist who did have me sign a form that I was made aware of the risks of general anaesthesia.  I was even given the document in English.  The only form I had to complete with the nurse was for any valuables I may have brought such as a mobile phone, tablet, or laptop.

Standard private room
I've heard stories of having to share a hospital room with up to four or five other people.  For the ORL ward, each room had a maximum of up to three patients with a shared in-room shower and toilet.  There was Wi-Fi and I think that there was a TV in each room.

            Deluxe private room
Each hospital ward has a limited number of private rooms.  The fee for a private room is not covered by health insurance so you pay this for yourself if one is available.  The basic private room cost 500 Kč ($23) per night and the deluxe private room was 1000 Kč per night.  The basic room had a TV and a private shower and toilet.  The deluxe room looked a bit more like a hotel room with art on the walls, a TV, a kettle, a small in-room safe, and a private shower and toilet.  With the private rooms, the nurses are less concerned about the strictness of visiting hours because you're the only patient in the room.

Dinner when I was still allowed solid food.
A friend called the hospital and reserved a private room for me.  I really didn't want to have my tonsils removed and need to make daily small talk, in Czech, with any roomies.  For peace and quiet, a private room was definitely the way to go.

Some people may have outdated misconceptions about post-communist medical care.  Compared to medical facilities in the USA, those here in Czechland may seem a bit worn and outdated.  For example, the food trays and meal containers look like something from the 60s or 70s.  While somethings may seem old, everything is spotless.  However, when you go in to the operating room everything is shiny, new and very high-tech.  They are definitely spending the money where it really counts.

My first visitors
All of the doctors spoke English but the nurses spoke Czech.  The nurses were all pretty patient with my poor Czech.  One of the nurses spoke German with me so when she was around all of the other nurses deferred to her.  There was one nurse who would speak loudly to me in Italian whenever we couldn't understand each other.  What's funny is that I don't speak Italian; just what I can piece together from my Spanish.  I found out that a few of the nurses actually spoke some English but just weren't comfortable trying to use it at work with a patient.  Even the Italian speaking nurse could speak enough English that's way better than my Czech.  Oh well.  In a worst case scenario you can also grab one of the student doctors because they all speak English.

A day on the ward was pretty regimented.  It began at 6 am with the nurses bringing morning meds and taking your temperature.  Breakfast was from 7-7:30.  From 7:30-8:15, every patient had a morning check up with the doctor.  Lunch was from 12-12:30 and then it was time for afternoon meds.  Visiting hours were 2 - 6 pm.  At 2:30-3 pm an afternoon snack of coffee and a rohlik.  Dinner was from 5:30-6 pm with evening rounds from 7-8 pm.  Quiet hours were from 10 pm to 6:30 am.

Having a tonsillectomy means no solid food.  This meant that lunch was always a bowl of potato puree and two soups.  Dinner was, again, a bowl of potato puree and another soup.  The only solid food I was sometimes given were vanilla wafers that came with a custard and flavoured kefirové mléko (basically either strawberry or apricot flavoured acidophilus milk).

In American hospitals, your meals are brought to you.  Here, the nurses announce over the intercom that it is meal time and you go pick up your tray.  You can eat in the common area or take the tray back to your room.  You return your tray when you are finished eating.  The Czech system makes more sense to me because it forces patients to get up and move.  Of course, if you can't move around then they will bring the tray to you.

The speaker was also used to tell people when it was time to go visit the doctor for your morning check up.  Bohunice is a teaching hospital so every day a group of students would come by with a senior doctor to perform rounds.  It felt like a scene from a Czech episode of Grey's Anatomy.

Another difference is that when I left the hospital I got to walk out.  In the USA, hospitals make you leave in a wheelchair even if you can walk.  Basically, the hospitals are afraid of someone falling as they leave and that the hospital will be liable.  Americans love lawsuits.  Here's a scene from the 1994 movie Guarding Tess that I found on YouTube.


When I was discharged from the hospital the only bill I received was for the cost of the private room which I paid at the cashier on my way.  That's it.  Even with health insurance who knows what I would have had to pay in the USA?  The Czech healthcare system is excellent!  I just don't get why people back home freak out about socialised health care.  Here I pay taxes and my healthcare is covered.  Very simple.   

Friday, September 15, 2017

Czech Healthcare Basics

Going to the doctor is never a fun thing to do.  It can be even less fun when it's in a different country, and in a different language, than you're used to.  Here are few basics when it comes to seeing a doctor in Czechland.

First of all, everyone is required to have health insurance.  The largest provider of public health insurance is VZP.

Everyone is also required to have a primary care doctor or GP and you can choose whatever doctor you want as long as the doctor is taking on new patients.  Most doctors accept VZP so as long as your doctor takes VZP then your appointment and treatment are normally free.

There used to be a 30 Kč co-payment but this was done away several years ago.

I believe that the only charge is a 90 Kč ($4.20) fee for after-hours urgent care at hospitals or clinics.

If you need a specialist then that's ok.  You are not required to have a referral from your GP.  Some specialists don't take appointments as they see patients on a first-come first-serve system based on urgency.

There is far less paperwork here than there is in the USA.  Here, you just show your health insurance card and that's it.  No co-payments.  The insurance companies pay the treatment providers directly so there's no need for claim forms or reimbursement services.

Arriving to a closed door
One thing that took some getting used to is going to the doctor and finding a closed door instead of a reception or nurse's station.  Don't knock on the closed door!  They hate that.  When the door is closed it means that the doctor is with a patient.  You just need to wait outside until a nurse comes out and asks who's recently arrived.  You will give the nurse your referral slip and wait until you are called in to the see the doctor.

Overall Czech healthcare is really good.  According to the 2016 Euro health consumer index, Czechland was ranked #13 (out of 35 European countries).  It is the best in "Eastern Europe", ranked after Sweden and two spots above the UK.  This is one of the world's fastest-growing destinations for medical tourism.

Czechs trust their doctors and usually don't ask too many questions.  It's not common for people here to ask for second or third opinions.  In general, doctors don't ask patients if they have any questions because, again, patients trust their doctors. 

Sunday, September 10, 2017

Spejbl and Hurvínek

Josef Skupa, Spejbl and Hurvínek
Josef Skupa (1892 - 1957) was a Czech puppeteer whose characters have been entertaining children for over 100 years.  In 1930 he founded a travelling theatre in Plzeň which was the first professional puppet theatre in Czechoslovakia.

In 1943, the Gestapo closed the theatre and he was arrested for anti-fascist resistance.  In 1945, his Nazi prison in Dresden burned down and he escaped.  Following the war in 1945 he opened the Spejbl and Hurvínek Theatre in Prague which is still open to this day.

Skupa's most famous characters are Spejbl and Hurvínek which were created in 1920 and 1926 respectively.  Spejbl is the foolish father and Hurvínek is his mischievous son.  They also have a dog, Žeryk, who is able to bark out words.  Other characters include Hurvínek's friend Mánička and her granny Mrs. Kateřina Hovorková.

Spejbl and Hurvínek have travelled to over 30 countries.  Albums, television shows and movies have been released.  Despite being over a century years old, the show still does a great job of showing the generation gap between parents and children.

Here's an episode I found on YouTube called Únor bílý, pole sílí (White February, Fields Grow).  Spejbl, Hurvínek, and Mánička compete for the best snowman and first prize is a cake.


In August 2017, a 3-D animated film called Hurvínek a kouzelné muzeum (Hurvínek and the Magic Museum) was released.  Of course Tünde wanted to go see it.

Too bad kid's movies aren't subtitled.  Here's the movie trailer.


©Total Film 

Saturday, September 9, 2017

Jakub Kryštof Rad

Jakub Kryštof Rad was a Swiss-born physician and industrial manager who became one of Czechland's most famous inventors.  He was born Jakob Christof Rad in 1799 and he died in 1871 in Vienna.

In the 1840s he was the director of a sugar refinery in Dačice.  In 1843 he invented the sugar cube and took out a patent for it.  

Dačice is in Moravia and only 109 km (68 miles) from Brno.  At some point I need to plan a visit, if for no other reason than, to see the sugar cube monument there.  

Friday, September 8, 2017

Sick Notes - Part Two

A parent will be issued a sick note when they need to stay at home to take care of a sick child.  When taking care of a family member up to 60% of a person's salary is covered by the state from the 1st to the 9th calendar day.  So no complete loss of salary for the first three days.

The payment from the state is for when you take care of someone at home.  If the family member is hospitalised then the payment is interrupted.

Taking care of a family member used to pertain to only one person but the law was recently changed so that parents can replace each other.

Single parents in Czechland are covered up to the 16th calendar day.

In Germany, parents get 10 days to look after sick kids.  While single parents get up to 20 days.

Wednesday, September 6, 2017

Sick Notes

It's never fun getting sick.  Here's what one can expect if it happens here in Czechland.

Let's assume that you have Czech health insurance and you go to the doctor.  If you are too sick to work then the doctor will issue a sick note so that you can stay home.  This note must be delivered to your employer within 3 working days.

The sick note is actually a several page form and each page has a different coloured stripe.

Part II is the Rozhodnutí o yzniku docasné pracovní - the yellow stripe.  This is the illness card and you have to keep it for the duration of your illness.  At the end of your illness you give this back to the doctor.

Part III is Hlášení zamestnavateli o vzniku docasné pracovní neschopnosti - the blue stripe.  This is the page that you have to give to your employer within 3 working days from the beginning of your illness.

Part IV is Rozhodnutí o vzniku docasné pracovní neschopnosti pro uplatnení nároku na nemocenské - the pink stripe.  This page is only used if the illness is longer than 14 days.  The backside of the form is signed by the patient and it needs to contain your bank account number.

Part V is Rozhodnutí o ukoncení docasné pracovní neschopnosti - also a pink stripe.  This is the form that you have to deliver to your employer at the end of your illness.  The patient has to sign the backside.

There's also a part of the pink form that you have to submit when your illness continues from one month to the next month.

As per Czech law, you don't get paid for the first three days that you are sick.  From day 4 to day 14, the employer pays 60% of the salary.  The state does not contribute any money.

From day 15, the employer no longer pays anything.  Instead the Czech government pays the 60% salary.  This is why part IV of the form is so important because if you don't deliver the forms on time then the state may not be able to deposit the partial salary to your bank account on time.

If you are home sick then you are expected to be at home.  On part II of the form, the doctor will provide some time that you can be out in public.  For example, so you can go to the market for groceries.  Perhaps from 10 am to Noon, and again from 2 pm to 4 pm.

The employer is entitled to check if the employee on sick leave is actually home sick when they are supposed to be.  The employer can contact the municipal social security administration and both parties will come knock on your door.  If you're supposed to be home sick and you're away then you can be fined.  I'm not sure what the amount of the fine is.  I suppose it depends on how long a person has been on sick leave for.  

One of the very cool things about IBM here in Czechland is that the company supplements the 60% salary payment required by law.  For high level positions, IBM actually pays 90% salary for days 4 - 60.  Then for all employees, they pay 75% salary for days 61 - 120.

Monday, September 4, 2017

University Hospital Brno

University Hospital Brno, Fakultní Nemocnice Brno, is the largest hospital in Moravia and one of the biggest in Czechland.  It is located in the Bohunice district.

The hospital was established in 1998 and it is managed by the Czech Health Ministry.  It's a teaching hospital in cooperation with Masaryk University.

There are three main departments.  The main hospital in Bohunice, plus a children's hospital in Černá Pole and the maternity hospital at Obilní Trh.

All together there are 1100 doctors and 2100 nurses for 1888 beds.  I've heard nothing but good things about this hospital.

Saturday, September 2, 2017

Czech Billboards

There's a new law in Czechland that took effect yesterday.  Apparently billboard advertising has been banned.  Billboards can not be displayed within 250 meters of the highway or within 50 meters of 1st class roads.

The thinking is that the billboards can pose a safety issue as drivers can be distracted by the advertising.  

The billboards must be removed by a certain time or pay fines up to 300,000 Kč (close to $14,000).  About 3,000 billboards across the country are impacted.

One company is fighting back and it has replaced the advertising with Czech flags.  Apparently state symbols can not be removed.

I don't know how long this will go on for but at least for a while you can see Czech flags all along the highway.