A healthy profit

I recently tripped on a stone and shattered my ankle in the tiny Greek village of Mani, on the Peloponnese peninsula. In order to get to the nearest hospital, in Kalamata, I had to change ambulances at a border between administrative districts. Later, in Berlin, friends had to pick me up at Schönefeld Airport in the middle of the night and take me to the hospital themselves because the capital's ambulances are not allowed to drive to the airport, which is located in the state of Brandenburg. Within the European Union, it seems like international borders are easier to cross than the boundaries between administrative districts inside individual countries.

Three days in a Greek hospital had convinced me that I should undergo my operation in Germany. Despite well-educated and competent doctors, of whom I heard nothing but good things, the effects of austerity on Greece's health sector scared me. The scant personnel at the hospital were responsible for everything that went on there, from medical care to cleaning, and workers were stretched beyond their capacity.

There was a lack of simple equipment such as wheelchairs, crutches and bandages. Patients unable to walk were automatically given catheters and antibiotics if they did not have relatives who could help them to the bathrooms. One bright spot was the food. Twice a day we were served warm and tasty meals that approached home cooking in their quality.

In Greece, family members sleep on wobbly folding beds and sit in uncomfortable chairs while caring for hospitalized relatives around the clock; they purchase medicine and other necessities in town. The overtaxed nursing staff was frustrated, impatient and not especially friendly. The situation reminded me of what I had experienced a few years back when my father became ill in Romania. Only, in Romania, one was required to bribe hospital staff in order to get service.

Turning a profit

When I arrived at the hospital in Berlin, I felt like I had gone to heaven. Staff members were friendly, helpful and patient. Highly specialized surgeons came for bedside visits twice daily. Nurses gave great care to patients despite a lack of junior staff. And there were physiotherapists, masseuses, janitors and other personnel: fresh nightgowns, bedding, towels and washcloths were delivered daily. Each patient had a telephone and television and a wheelchair and crutches if necessary. Coffee and tea were available around the clock, and there was even a cafeteria nearby.

The problems didn't start until the food came. Meals were delivered by a catering service. The company didn't seem to understand the basic rules of patient nutrition, nor did it seem excited about cooking. It regularly delivered gluten-laden meals to patients with celiac conditions, sometimes even putting a question mark on the delivery label. The food did little to further the healing process.

When asked about such issues, nurses advised patients to lodge complaints. Patients are customers, and the customer is king. As businesses, hospitals need to turn a profit. Hospitals are often publicly traded on the stock market. Flat-rate payments to stockholders are not based on the health of patients, but on the profitability of the institution. The sooner a patient is released, the higher the profit.

So, what to do with a patient who cannot take care of herself at home after a serious leg operation? I fell through the cracks in the system and became a patient who refused to leave the hospital until a solution could be found. A short-term fix was found in the end: I was moved to transitional care. Hospitals must take heed of patient evaluations, and, if patients insist, special solutions can always be found for exceptional cases.

To their credit, it seems to me that doctors, nurses and other personnel would rather not treat patients as customers or turn hospitals into profit-motivated businesses. Perhaps it would be helpful to strengthen communication, cooperation and solidarity among patients in need of medical help and the professionals entrusted with delivering it. Ultimately, patients should feel that they are being taken seriously and that the priority is their full recovery. In health care and other sectors, efficiency and profit are major motivators throughout the European Union. But people's well-being must never be sacrificed to achieve those.

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