HealthManagement, Volume 11 - Issue 3, 2011
Interviewee
Please Give Us an Overview of the Department of Radiology Where You Work.
Our hospital is the largest in the north eastern part of Romania, with 1,200 beds. In the radiology clinic we perform almost every type of imaging examination – conventional, ultrasound, CT, MR and interventional radiology (abdomen and periphery, except for cardio and neuro). In 2010 we performed 37,000 radiographies, 30,000 ultrasound examinations, 1,200 mammographies, 400 angiographies, 4,500 CT and 3,000 MR examinations.
Are Radiologists and Technologists Adequately Financially Compensated in Romania in Comparison With Other European Countries?
Unfortunately, the answer is no. We joined the European Union in 2007 but we are still far off concerning salaries in our healthcare system. In my opinion, the real problem is that our politicians are not able to understand that it is important to invest much more in medicine in order to have a competitive system. Radiology is an extremely expensive specialty and health is not for free.
What Impact Did the Worldwide Recession Have on Romania's Spending on Health?
At the start of 2009 the healthcare budget was dramatically cut, and now represents less than 3.6 percent of Romania's GDP. In 2010 it was the same situation and we don't see any improvement for this year. Major new medical developments are in doubt today. Budgeting for radiological equipment is not based on a clear model and therefore replacement of old machines is not planned. This is the subject of controversy. We are still seeing the negative side effects of the global financial crisis. Solutions? The healthcare system's management must be honest, visionary and follow efficiency guidelines.
Are Waiting Lists for Certain Imaging Exams a Challenge in Romania?
Yes, today in Romania we have waiting lists, especially in university medical centres. In our department there are waiting lists for US, CT and MR examinations. Emergencies are examined the same day, no matter the modality. For US the waiting time is up to three days, in CT and MR for up to three weeks. As long as the Ministry of Health isn't buying new machines and we can't appoint new doctors in our department, I unfortunately don't see any solution in the public sector. How is growth in the private imaging sector impacting radiology service provision and what regulations are needed to better organise this? The private imaging sector is growing rapidly in Romania and this could be a viable solution for the provision of efficient services, so long as the state does not understand that investments in radiology ought to be mandatory. In our country, radiologists are allowed to work both in the public and private sector. It is a tough battle and in my opinion the private sector will win due to its ability to offer better conditions, new machines and better salaries. As usual, the market will decide the rules. Finally medicine is a business, despite the fact that I do not completely agree with this philosophy.
How is Quality Control of Romania's Departments of Radiology Carried Out?
Every year the National House of Medical Insurances audits imaging departments in order for them to continue to receive financing. The criteria were modified last year and are still subject to change. I really hope these criteria will be modified according to the rise in the quality level of our work. On the other hand, last year the Ministry of Health approved guidelines in every specialty and we are waiting, in the near future, to release control modalities.
What Role Does the National Radiology Society Play in Promoting Education and Training?
According to its statutes, the aim of SRIM is to increase the scientific level of its members by giving access to facilities and organisational, functional and material requirements. The national structure of the society consists of six local branches, founded in the traditional university centres: Bucharest, Iasi, Cluj, Timisoara, Craiova and Targu-Mures, each led by a local committee. These branches coordinate scientific activity in their area and have autonomy in developing scientific projects. SRIM organises a biennial congress and edits a journal entitled "Imaging" four times yearly. According to European trends in subspecialties, since 2003 we developed the Group of Sectional Imaging (CT and MRI), the Romanian Society of Breast Imaging, the Romanian Society of Musculoskeletal Imaging, the Romanian Society of Neuroradiology and Interventional Radiology and the Romanian Society of Paediatric Radiology, all of them affiliated to the Romanian Society of Radiology and Medical Imaging. These societies are totally autonomous, led by their own boards and their Presidents included in the Board of the SRIM. The Romanian Society of Radiology and Medical Imaging is the body responsible for provision of postgraduate training in diagnostic radiology in Romania. The Board of the Romanian Society of Radiology and medical imaging last year adopted the European curricula for training in our specialty. After completion of four years of training, having passed the final exam, the resident becomes a radio-diagnostic specialist and is eligible to apply for a post as radiologist in the public or private sector.
What is the Romanian Approach to Dose Management & Patient Safety?
Since we joined the EU, it is mandatory to give each patient a paper in which we fill in the DAP and DLP for conventional radiology and CT exams respectively. According to Romanian law, it is the duty of the radiologist to accept or reject patient examinations depending on dose management criteria.
What are the Most Difficult Challenges You Experience in Your Professional Life?
We, as radiologists, must seek greater cooperation with our colleagues from other clinical specialties. To improve practice it's extremely important to have clear and honest feedback from our colleagues. This is a real challenge and communication is the key to its success. In addition, due to the low salaries here, many of our radiologists are choosing to go to work abroad. I am extremely proud of my team and very lucky that no one wants to leave it. It is a challenge to keep this team together, but by learning every day from one another and offering respect we will succeed. As head of the department, the medical and administrative activities intermingle every day. This is sometimes difficult as long as we try to make things work properly. By having a good team and a very strict schedule we can solve almost every problem.
Find out more about radiology in Romania by visiting www.srim.ro.
