The Gatekeepers of the Swedish Healthcare System

I grew up "going to the doctor". Throwing up, doctor. Fever, doctor. Bad cold, doctor. Annual physical, doctor. Left ear lobe ache, doctor.

Well no freakn' wonder we have to wait like 2 hours past our appointment times to get in to see "the doctor".

Here, it's different. Much different.

Gotta problem, any or all of the above? Call the local clinic, enter your number followed by the pound sign at the sound of the beep. "We will call you back before X time." And they do.

It's a nurse or a doctor, not sure. Describe your problem. All the symptoms. Then answer questions about said symptoms. And if it's your kid you're calling about, do your best to provide your own diagnosis. "I'm really worried here. His snot isn't quite green and more clogged than runny and he didn't even want to watch his favourite tv program this morning. He hugged me for twice as long as he normally does and I'm pretty sure his left eye is twitching. He needs antibiotics. I need to see a doctor."

And the hand goes up, so that I slam forehead-first into the virtual doorway. Access denied. The Gatekeeper has spoken. "It sounds just like a viral infection. There is no medication we can provide for this. He has to wait it out. Lots of fluids and blah-dee-blah."

"Ok, so what's the difference between a bacterial infection requiring antibiotics and a viral infection?" In other words, I can always change the symptoms to match the bad one!

Very detailed explanation ensues.

Damn it. This doctorish person of a gatekeeper has one over on me. I try a few more lame attempts at sneaking through the yellow tape but to no avail.

Wait it out. Call us back if anything changes.

Thanks. Damn.

On a serious and more objective note, this screening works quite well. Whenever I have made it past the gatekeeper (like twice), I'm kept waiting for a maximum of 10 minutes.

It's awesome.

But when explaining my conundrum to fellow Swedes, or expats who are in the know, I get the following answer: "Lie." If you're really worried, lie through your teeth.

I wonder how well this sytem of diagnosis-over-the-phone would work in North America. Heaven forbid the doctorish person was wrong. Hello Lawsuit!

"Antibiotics for everything" was the only solution in my uhmmm, day. And even though I realize that was due to paranoia and general ignorance and we are so much smarter now, it's still pretty heavily engrained in my psyche. I miss those pieces of yellow paper that confirmed everything was going to be alright.

I also miss waiting with a bunch of coughers and hackers in a too-full waiting room with years-old magazines to pass the hours and germy, used for decades kids toys. NOT.

From East to West Part 1: Healthcare

We moved to Sweden in January, after a 2.5 year adventure in the Adriatic Beauty that is Montenegro. Bordering the jewel of the Adriatic, Croatia, Montenegro really is the best kept secret of the former Yugloslavia and in 2007 was named the fastest growing tourist destination in the world by the World Travel & Tourism Council.

Snow-capped mountains, blue waters and lush green vegetation abound. We packed up our life in Canada at the request of our dear Swedish property developer friend and headed to a country we knew virtually nothing about, excluding compulsory Internet searches of course. I was 7 months pregnant at the time but had sense and opportunity enough to fly back to Canada to give birth to the little guy.

I digress. I'll save the long story of our life in the Wild Beauty (cue Montenegro tourism commercial as seen on CNN) for another post. But after spending almost six months as a resident of Sweden, I thought it was about time to compare life in this Eastern European country (freshly independent from Serbia circa 2006) to life in one of the richest Western European countries. This will be a weekly series I believe, because there's too much to say and I don't know when to stop typing. So here goes,

From East to West Part 1: Healthcare
Montenegro
Highlights:
- If your employer will pay for it, you have access to free healthcare, though some specialists have private practices if you can afford it
-For 30 euro (well it was 20, then went up when she figured we were rich), we got a private pediatrician to make home visits for Joseph. Perfect. No waiting around in archaic waiting rooms with dozens of other sick and screaming kids. And when we were forced to go into the local health center for vaccinations, we were always first in line!

Lowlights:
-7 months pregnant and must undergo (and pass) full physical in order to get work permit. After running around all over the health center and various places in town to receive paperwork and stamps on said paperwork, we're ushered into the doc with the final say. We take our seats, look up to see this Santa Claus of a doctor lighting a fresh cigarette. In front of me. 7 months pregnant me. In a hospital. -When it was time to renew our work permits and undergo another physical, we each slipped $20 into our passports and voila! Clean bill of health. No tests necessary (maybe that's also a highlight?)
-Pediatrician once strongly urged us to use our vacuum cleaner to clean out kid's snotty nose.
The bottom line: If you have money, you get the treatment for better or worse.

Sweden
Highlights:
- Modern, state-of-the-art facilities and highly trained doctors. THE place to get sick.
- Free healthcare to every citizen (paid for by ginormous taxes). Though you do have to pay a "processing fee" of about 70 SEK up front for appointments.
- Short wait times: Caveat: Apparently, there's a lot of disussion in Sweden about long wait times but I personally have waited no more than 10 minutes, which could be explained by one of the lowlights (keep reading)or luck.
- When I've managed to get my son in to see a doctor (a rare occassion, keep reading), the doctor greets us BOTH with a handshake. Seriously..even my two+-year old. So cute and respectful.

Lowlights:
-Gestapo-like checkpoints are set up to prevent mostly everybody from getting an actual doctor's appointment. It's called 1177 and it's a number you call if you're sick. You explain your symptoms and the call usually ends with, "Oh, you don't have to see a doctor. It's just the flu. It's just a cold. If there's blood coming out of his ears, call us back." I come from a culture where we go to the doctor at the least sign of trouble, which likely contributes to the long wait times. "Take him to the doctor". But I can't. Oh I've begged and pleaded but the few times I've actually passed through the gates have been because I've blatantly exagerrated. And sure enough, nothing ends up being wrong. Go figure.
-I've gotten some MAJOR shit from Swedish friends over taking my son to the doctor too. "Jenn, he doesn't NEED to see a doctor!" Geez, Let the damn DOCTOR tell me that ok?!
Bottom line: They don't care who you are or who you know or how much money you have. We're all the same and receive the same.