Doctor on physician earnings: 'Effect of a broken system. Culprits sought where there are none'

Dr. Jarosław Mijas, head of the Pediatric Clinic in Strzelce Opolskie, argues that Poland's healthcare system is suffering from years of populist reforms and a fundamentally broken funding structure. He believes that current political efforts to find blame are misplaced, as the system's issues stem from decisions made over time, often driven by electoral considerations.

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It is another political team that ruined the system – reforms were populist, done for elections. Today, they are looking for culprits where there are none.

Mijas explains that the high earnings of certain specialists are a direct result of how medical services are priced. Less profitable departments, such as obstetrics and internal medicine, incur losses because the National Health Fund (NFZ) reimbursement rates do not cover the costs of staff and on-call duties. These deficits are then offset by profits from highly specialized procedures in fields like orthopedics, cardiac surgery, and neurosurgery, which necessitates employing scarce specialists and drives up their rates. Strict NFZ staffing norms further complicate matters, as hospitals face funding suspension for non-compliance, leading them to compete fiercely for doctors and inflate salaries.

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It has become a lottery: poaching, escalating rates. It is difficult to accept the situation where a doctor without adequate experience is paid 180 zloty per hour for an on-call shift.

The situation has created a "lottery" of poaching and escalating rates, with Mijas noting the difficulty in accepting that doctors without significant experience can earn 180 Polish zloty per hour for on-call shifts, with rates potentially much higher during holidays. He also points to an overburdened primary care system as a major source of trouble. Doctors seeing dozens of patients daily lack the time for genuine patient management, leading primary care facilities to primarily issue referrals.

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You cannot create a system where a doctor sees 50 people a day – I see 10 and leave drenched in sweat. Only a system where a doctor sees 10-15 people can cure someone.

Mijas emphasizes the need for a system where doctors see a manageable number of patients, ideally 10-15, to effectively treat them. He contrasts this with the current reality of multi-day queues for appointments, where clinics accept as many patients as possible due to the funding structure. He advocates for a "bottom-up" reform, starting with a robust primary care system that rewards effective treatment, a rational hospital map, realistic service valuations, and the integration of residents into clinical work.

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The most important thing is the necessity to regulate primary healthcare.