There are only ten doctors in the Budva Health Center, half as many as stipulated by the current regulations, and as many as 45 health records are registered - twice as many as the official population.
Doctors examine up to 33 patients per day, instead of the maximum 90 expected, but despite this, no one leaves without adequate service.
This is what the director of the Budva Health Center, Blažo Radoman, said in an interview with "Vijesti".
"The volume of work is best illustrated by the statistical data that in 2022, around 130 services were provided in the department of selected doctors for adults," said Radoman.
Asked how many insured people were registered at the Health Center, if it is known that according to the latest Monstat data from 2021, the city has 22.600 inhabitants, Radoman points out that the reality is completely different.
"Insured persons... we have slightly less than 45 thousand... Also, a large number of displaced persons are not included in that figure. They are waiting for the approval of their stay, so when they regulate it, they will also enter the Fund's system. According to international law, we still provide a complete healthcare service to these displaced persons. Budva is also specific in that, as a tourist municipality, the number of people who need service at the Health Center varies depending on the time of year. In July and August, there are 200 people in the city each, including the local population."
He said that according to the Rulebook on closer conditions in terms of normative standards and ways of providing primary health care through a selected team of doctors or a selected doctor, it is foreseen that a minimum of 1.200 and a maximum of 2.000 insured persons per selected doctor, that is, an average of 1.600.
"If they implemented this in Budva, we should have 23 doctors in the department of selected doctors for adults, but we don't have them. We currently have 12 doctors, two of whom are specializing. The lack of doctors is not only a problem in Cne Gora, but also in many more economically developed countries. It needs to be solved strategically, and three directions are key. The first is definitely earnings, which should be constantly adjusted because the market regulates it. Taking care of their nominal increase is one of the ways for doctors to remain in the public health system. The second direction is the improvement of working conditions, constant training, investment in funds and equipment, monitoring modern achievements, and the third is solving housing issues for doctors and other medical personnel. When these three directions are approached and the problems begin to be solved, the interest of doctors in leaving public health will decrease."
Doctors and medical staff are EU residents
Radoman believes that doctors and other medical personnel are the only citizens of Montenegro who are members of the European Union.
"When I say that, I think that they establish a working relationship in the EU countries without any problem with small administrative procedures and thus try to solve some of their life issues. The doctors at the Health Center have such, as well as the offer of other private health institutions. It is a labor market and it is free".
He estimated that the increase in wages partly amortized the departure of the medical staff.
He pointed out that they did not sit idly by and that it is the duty of the managers of health institutions that, if there is a problem that cannot be solved by the Ministry of Health at once, everyone should contribute individually".
"Let's look for medical personnel, in this case doctors. Through the engagement, I came to the fact that in the following period, three doctors will additionally establish a working relationship in DZ Budva. Yesterday, we received approval for the publication of a public competition for the employment of three doctors for an indefinite period of time, which will strengthen us in terms of personnel.
They examine 90 patients a day
Referring to the current Rulebook, Radoman states that a doctor should receive about 33 patients during one shift.
"However, each of our doctors receives between 80 and 90 patients. That's a really huge figure. Doctors are overburdened. That's why I really thank the doctors and the entire medical staff, because I personally know how burdened they are with work. We had a case of a doctor leaving, so in the pediatrics department we had four doctors, two left the Health Center. Automatically, two pediatricians had to do the entire job. We managed to hire one pediatrician and one comes to help us from another public health institution, so that we can cover Budva. As the public knows, a systematic screening of children for enrollment in kindergartens and schools is underway. It is sufficient information that there are about 600 children for enrollment in Budva schools, and a systematic review should be done for all of them".
He states that they also have seven specialist consultants who come and provide services, so that insured persons do not go from Budva to other specialist institutions.
"When the doctors return from their specialization, and there are four of them in total, we will be one of the better health centers in Montenegro. The staff is the most important resource, the input of any healthcare system, and also the most expensive, because it is necessary to invest in their knowledge and education. The corona pandemic also showed the importance of the health system, where many stronger countries found themselves in trouble in order to deal with the pandemic. Here, little Montenegro really fought successfully. I say this because when some insured people from Western Europe came to us, they said that the service they received in Budva and Montenegro exceeded their expectations. At that time, our doctors and medical staff did not take annual vacations, they were exhausted, but they fought and there is no social reward that they do not deserve".
Five tourist clinics are also introducing hemodialysis for tourists
Radoman points out that the specificity of Budva is that it is a tourist municipality.
"We are obliged, and we have agreed with the municipalities, to traditionally open four tourist clinics - one in DZ Budva, the others in Rafailovići, Pržno and Petrovac. This year, we are opening the fifth tourist clinic within the 'Slovenska plaža' tourist resort. They will be covered by the existing staff, in order to enable the provision of health services to tourists. Precisely those tourist clinics are one type of offer, because when someone chooses a destination, especially serious tour operators, they also ask what kind of health care is available".
He announced that DZ Budva is organizing another service.
"A large number of patients - tourists who need hemodialysis previously contacted us and asked if we have this type of service. We informed the Ministry of Health, we sent the documentation, so that the holiday hemodialysis service will start during this season. I believe that it is a mutual benefit because the health system, the Municipality, the tourism industry should work synergistically. I sincerely wish that as few tourists as possible need to visit DZ, but we are here to provide them with timely services, as in the past period".
An investment of one million euros is underway
Radoman reminds that the existing DZ building was built after the 1979 earthquake as a donation from the people of the USA.
"When it was built, DZ was truly visionary and completely satisfied even more than the needs of Budva at that time. However, Budva experienced a demographic expansion and is one of the most growing cities in terms of population not only in Montenegro but also in the territory of the former Yugoslavia. Spatial capacities are now limited. That's why we want to create adequate working conditions for doctors, because this reflects on the quality of health care, and thus we get more satisfied insured persons. In the past period, we have completely renovated the pediatric department, as well as the general practice department, on the ground floor of the DZ in cooperation with the Municipality of Budva. An epoxy floor was installed everywhere, a modern info point was built, an elevator was built, and a new ceiling was installed."
As he states, it does not stop there, because in cooperation with the Ministry of Health, they started the reconstruction and adaptation of the entire first floor.
"The project has been completed and is being audited. The value of the works will be one million euros, financed by the Ministry of Health. Reconstruction of the roof is planned. These days, the reconstruction of the microbiological service and the chemical epidemiological service is starting. It is a space of 300 square meters, which also includes modern equipment. Also, the physical therapy department is being reconstructed, because we see that the demand is quite high, and by hiring additional staff, the waiting list will also decrease. Specialist offices are also planned on the first floor, bearing in mind that doctors are returning to us from specialization. The adoption of a new law on health care, where primary health care is stronger, is announced. This foresees that a greater number of specialist doctors will be present in health centers. In this way, the health service is brought closer to the insured, and the burden on the secondary and tertiary levels is relieved. I sincerely support it and think it is the right move".
He pointed out that after the reconstruction of the first floor, the institution's accreditation process will begin, which is of great importance for the tourism industry and the Health Center itself.
"We are also restoring the fleet. At the beginning of January, we received a modern medical vehicle and it is a complete investment of the Ministry of Health. It was agreed with the M-tel company, which will be realized in the next month, that the entire DZ will be covered by a wi-fi network, where doctors, and especially insured persons, will have special access".
He concluded that his vision is to, in cooperation with the Ministry, begin the administrative procedure of upgrading one floor at the health center, which would create even better conditions for the work of doctors and medical staff.
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