• Sweden edition

Swedish doctors criticized after botched UK ops

Published: 24 May 2009 16:01 GMT+02:00
Updated: 24 May 2009 16:01 GMT+02:00

A new report has shown that as many as one in three of the patients treated by the so-called "flying doctors" from Scandinavia suffered poor outcomes with one in five needing repeat operations.

Lawyers have been brought in to consider if action can be brought in six cases treated at a clinic in western England by Swedish, Danish and Finnish doctors brought in to ease the high demand for orthopaedic procedures.

The Somerset treatment centre hired surgeons from Scandinavia who flew in to perform the operations with little prior contact with the patients.

"They didn't see their patients postoperatively. They flew in to do the operations, and the doctors in South Wales were left to pick up the pieces," Stephen Cannon, former president of the British Orthopaedic Association said to the newspaper.

An audit, published in the Journal of Bone and Joint Surgery, of more than 200 patients who underwent knee surgery between 2004 and 2006 has revealed that the number of below par operations was ten times the national UK average.

The newspaper reports that the news of the faulty treatments come amid concerns over EU laws, passed in 2004, which allow doctors in EU member states to work across the union without any checks on language skills or competence.

Peter Vinthagen Simpson (news@thelocal.se)

Your comments about this article

20:04 May 24, 2009 by Luke35711
Scarry! I just wonder, if this is because they were a badly chosen subset of Swedish doctors, or if this is indicative of a skill gap, or something went wrong with the "fly in" arrangements... Although, I would have hoped that a good doctor is able to tell if he is, or is not, in position to perform the procedure up to standards, in any circumstances.
21:50 May 24, 2009 by Renfeh Hguh
I have never been confident about Swedish doctors. If they are not treating a text book case they struggle and certainly cannot think on their feet.

I am more comfortable now that I have found a foreigner (Iraqi or Iranian I think) as my house doctor.
05:31 May 25, 2009 by Marley420
Renfeh Hguh, I have to agree, the world tends to ignore that some of the best education in the world lies in Iran. Yet when an Iranian M.D. comes to Sweden, they are unessarily treated like second class citizens.
08:52 May 25, 2009 by Renfeh Hguh
But Marley, remember this is Sweden, they do not want the best, they just want lagom.
10:19 May 25, 2009 by Russ Cobleigh
last year I had to have a heart valve repair operation, the only way I knew to get it was because I asked for a second opinion after my 1st doctor said that there was nothing wrong with me and it was all in my head. If I would have listened to the 1st doc, I would probabley be dead now.
10:51 May 25, 2009 by kaze
How are they even doing this? I thought Sweden had waiting list problems worse than Britains.
11:21 May 25, 2009 by Puffin
A few intersting things to bear in mind.

1. Sweden has a huge shortage of orthopedic surgeons - a few years ago the whole county of Dalarna had just 2 - so it's possible that they are not recruiting the brightest and best - or that this private company is recruiting people to work in their holidays and rest time - dangerous in itself. In 2003 I had to have hand surgery at a private clinic as the Health authority (Landstinget) in Dalarna did not have a hand surgeon on staff at this time ... So where is this private clinic recruiting all these surplus surgeons from???

2. The scheme involved just flying in surgeons to carry out the operations - the way the scheme was set up the foreign doctors were excluded from the pre-operative assessments and post operative patient care - in some cases they never actually spoke to the patient - so perhaps the way in which the scheme was set up is also responsble for the problems encountered. I wonder what the comparative statistics would be for UK doctors who had no patient contacts or involvment in aftercare

3. Many UK hospitals and doctors have also been criticised for allowing patient care to drop by focussing on targets - such as reducing waiting lists - but easier to focus on the "foreigners" especially as the powerful UK doctors lobby are opposed to using foreign doctors.

4. This *new report' is virtually identical to a news article from the Times in 2004 - so if the problem has been known so long - why has it taken the UK health authorities so long to intervene?
12:17 May 25, 2009 by Bender B Rodriquez
Shame on the British hospital for allowing this type of practice. Flying in doctors to perform lots of surgery in short time is never a good idea, no matter where the doctors are from. If they want to shorten waiting lists they should employ more regular surgeons.
23:10 May 25, 2009 by freethinker
that would involve common sense. Clearly that's non exisitant in this case.
23:27 May 25, 2009 by Jamtjim
Us brits are great at making dodgy decisions in order to achieve a short term goal.

My favorite example was a few years back when the government was under fire for falling education standards. How did they address this problem? Well they made the exams easier. Hey presto, over night grades had improved and everyone was happy again. It got even more ludicrus when faced with complaints from the more able students that their extra ability was not being recognised, they added a new grade A*, to the top of the scale... aaaggghhh!

Why do you think that we are the nation of Monty Python?
15:22 May 26, 2009 by skane refugee
I like the smart way of thinking illustrated by Puffin in point 3 above looking for a lobby group behind a news story (in this case Puffin suggests UK Orthopedic Surgeons with an obvious vested interest in keeping out foreign competition) ...

... but in this case the telegraph article refers to a full audit and 2 year investigation of 224 patients published in a peer-reviewed academic journal, presumably in response to complaints against, and counter-arguments advanced by, the Scandinavian surgeons concerned.

Here's a link to the actual article: http://www.telegraph.co.uk/health/healthne...sh-doctors.html

Although the weston-super-mere centre is mentioned in both the times and telegraph articles, the telegraph article is based around something much more substantial than the controversial doctors letter in the times.

The results appear fairly damning, in that something like 10x the UK average of problems with the surgery occured. This must be way beyond the realms of statistical error or anything to do with pre- or post-operative care.

It initially occured to me that the doctors concerned probably just saw the whole exercise as a smash and grab cash raid on the taxpayers of Britain and had little or no interest in patient outcomes, but surely if the doctors were responsible professionals they would not have agreed to perform the surgery requested, on the terms set out, if they had considered patients to be at risk?!?

More interestingly for neutral readers of TL discuss, some of the previous postings on this thread IMHO illustrate the heavy inherent bias of TL as Swedophile and Anglophobe (can you imagine the reaction here if the nationalities were reversed?!?! ;o) ;o) )

... wonder if the Swedish doctors were anglophobes themselves?! ;o)
16:12 May 26, 2009 by High Priestess Kang - Slut
I'm not excusing what has happened here in the least. However, you assume that there are regular surgeons in the UK looking for work.
16:32 May 26, 2009 by Bender B Rodriquez
By regular I mean long-time employed. As long as you offer the right salary package there is no problem to find skilled doctors, in the UK or from abroad.

The matter of the issue is not the nationality of the doctors, but the fact that hiring doctors for short time work in general gives worse results. We have the same problem in Sweden with "stafettläkare", i.e. due to fincancial constraints the hospitals cannot employ doctors, but to shorten the waiting lists they still have to fly in expensive doctors for lots of work during a short time. In the end it becomes more expensive for the hospital and worse for the patients.
17:07 May 26, 2009 by High Priestess Kang - Slut
Bender -

Your comment regarding the, "right" salary package is a bit off the mark from a hospital administrator's perspective. As in any instance of low supply and high demand, the price can be artificially inflated so comp & ben expectations may not only be unrealistic but cost prohibitive for a facility. The sad fact of the matter is that resources in healthcare (be it equipment or staffing) are severely limited.

Hospitals struggle, daily, with the conundrum of trying to staff according to need while staying within the budgetary constraints. The unfortunate thing about, "travellers" (physicians and nurses) is that they are basically playing in a whore's market and can (and will) demand exorbitant rates for minimum service.

If there was an immediate solution to the problem, I'm fairly certain the consumer wouldn't have to deal with this piss-poor level of service. Unfortunately, administrators can only be so creative when attracting candidates and managing budgets.

17:42 May 26, 2009 by skane refugee
By the way, I came across a blog on this thread topic by a US expat in Stockholm ...


... this bit made me smile :-) ...

"Are we to assume then that the best surgeon in Sweden is ten times worse than an average surgeon in the UK? It would not surprise me. In fact, if medical schools in this country are run like the rest of the educational system (stress-free zones pandering to the dimmest and least likely to achieve), then I’d say 10 times worse sounds about right."

... not saying I agree with the points in the linked blog ... but feel strongly that this thread needs more balance ;o) ... so I'm cheating and bringing in contributions from elsewhere! ;o)

19:11 May 26, 2009 by Luke35711
If we are to look for balance, then one should probably also recall that the US system, despite being extremely expensive, intense and competitive does not, actually, deliver better results for the nation...

perhaps being more relaxed keeps Swedes healthier, so they don't need to get surgery in the first place! ;))
23:19 May 26, 2009 by Mamoshka
My brother is working in the United States. He is a doctor he loves it there! he laughed when i told him i called for an appointment to the dentist and now i'm on a waiting list (ten years). Yes believe it or not!

Anyhow not all Swedish doctors are bad that is very judgemental

but the over the average doctors are outside Sweden

sad but true!
01:05 May 27, 2009 by Omaro
I will tell you my story, I am an Iraqi doctor living in sweden since 2 years I finished the Swedish language courses and applied to an exam for doctors from outside the european union, it seems ok till now.

well, 2 other doctors and me are looking to get a practice or just be in a Swedish hospital or clinic like most of other cities in Sweden for a short period of time maybe one month or less to see how the system here goes, do u know what we were told by the person who is responsible for that? doctors who come from outside the european union lie in the bottom and they don`t have any priority !!!!!!!!!!!!!

I have many doctor friends in the US and they are very appreciated there to get all their way through to begin working.

All i want to say that there is a big defect in the health system in Sweden, low salaries, killing routine for both the health staff and the patient, and the discrimination in some cities not only against doctors but almost everyone has no Sven Svensson name, everybody knows how it is going when applying for a job without a Sven Svensson name, it seems that Sweden needs only people who are living on social aids and not highly educated people and that is why Sweden`s rank jumps down in the countries rank especially regarding health system.
01:15 May 27, 2009 by Mamoshka
where are you living Omaro? actually we are looking for a doctor for our kids. What is your speciality?

The United States is one of the best countries in the world they usually pick high educated people doctors, scientists!

If i were you i would apply to the US!

You will love it there! nobody will ask you where you come from

if i was not married to a Swedish man i would think of moving my company there.
01:44 May 27, 2009 by Bender B Rodriquez
Since dentists are private there is usually no waiting lists at all, and definitely not ten years (more like 10 days if you are unlucky)... so I really wonder where you actually booked your appointment...
09:17 May 27, 2009 by Mamoshka
Bender, i live in vastmanland. Dentist are not private there are at the vårdcentral! it is sad that sweds cannot confess this!

yes i'am on a waiting list of 10 years! i called västerås. You can call Västerås and check it out!

09:41 May 27, 2009 by Bender B Rodriquez
Eh, 103 dentists found in Västerås...


In general you don't handle dentist appointments at the vårdcentral since dentistry is not fully covered by the NHS; you book an appointment with your closest private dentist. The only reason I can find why you have done this through a vårdcentral is because you have a special medical condition that requires odonthological surgery; then it will be fully covered by the NHS and performed at a hospital.

If, on the other hand you are trying to convince me that you are on a 10 year waiting list for a regular check-up the you are just full of it... In fact, no medical procedure in Västmanland has a waiting time for longer than 1 year. You can check it up on http://www.vantetider.se
10:26 May 27, 2009 by Omaro
Thank u Mamoshka for the reply, I am a general physician and still have no speciality because first i have to do that exam in next September to go all the way in the health system in Sweden but I have to get a practice in the swedish hospitals or clinic at least for 1 month and u knew what happened but I won`t let that sick minded woman get me down, thank you again for your reply and words, well yes you are absolutely right about the united states, in the united states man is to be or not to be depending on his ambition and hard work not like here where one thinks of changing his name ( there was a program on the radio yesterday about the increasing no of immigrants who are changing their names to have a better chance to work) if i tell this to my American friends they will laugh crazily, I wonder why many ppl think here about my hair color and my name more than my qualifications? really i want to know why?

And you are right mamoshka about dentists appointments, my friend had an acute pain in his tooth, he went to the nearest dentist clinic, they book for him a time after 2 years, when they told him so, he couldn`t help himself from laughing loud in the clinic, he phoned someone in the health system in his city wondering about that... do u know what happened next? the same dentists clinic phoned him a day later and told him that he can come today for checking ????????????

My dentist is a polish smart guy, he came to Sweden since 1 year, after only that 1 year, he packed his bags and left to Norway.

What is going on? I think there is a missing piece in the health system here, I have to know it quickly, I will inform u when I get it.

Until that time, wish u all good health and may god keep u away from the health system. LOL
10:39 May 27, 2009 by Mamoshka
Bender those are private dentists. No i have not called them. My Swedish husband called for an appointment to the vårdcentral i do not live in Västerås but in a city near by!

Yes we are waiting on a waiting list (ten years).

My husband, me, my son who is three years old.

Actually it was an appointment schedule for him

not for us, he is three years old.

It is only a check up nothing else!

please don't lie it is called folktändvården

you want the number too! i can give it to you i will mail it to you privately!
11:01 May 27, 2009 by Bender B Rodriquez
It is called Folktandvården, not Folktändvården. Folktandvården charges about the same rates as private dentists, except for children, who have free dentistry up to the age of 20.

Try to book an appointment with another Folktandvården clinic instead. You are free to choose within the whole county of Västmanland.

The best option is to just pay and go to a private dentist. For you the cost will not differ, but you of course have to pay for your son, who otherwise would have gotten a free visit at Folktandvården.
11:14 May 27, 2009 by Mamoshka
Bender you are very wrong about folktandvården (if i make mistakes in swedish grammer it is not the end of the world, sometimes i do make mistakes but i correct them ugually on my blogg for ex)

their number is 021-176880

we called västerås but the advised us to stick to our city unless we have also to wait in a list.

call for yourself

why defend a bad medical system! i dont get it!
11:20 May 27, 2009 by Bender B Rodriquez
Care to explain exactly what am I wrong about?

I am Swedish and have never experienced any of the problems you are talking about, nor has anyone of my firends or family.
11:22 May 27, 2009 by Mamoshka
Omaro add me to your list and mail me privately

Nice meeting you!
11:25 May 27, 2009 by Bender B Rodriquez
You are still free to choose. If you own city has a 10 year waiting list it is better to phone around until you find someone with a shorter waiting list, no matter what they tell you.
11:29 May 27, 2009 by Mamoshka
Bender thank you i will. My husband is Swedish too!

We thought to support our local community which we always do even when we buy things ect.

Maybe it is not the case here
11:30 May 27, 2009 by Puffin
Your child gets called automatically to folktandvården for check ups
11:35 May 27, 2009 by Mamoshka
i know puff this is what i told too! i called my husband he corrected this information for me. My son Viktor will get automatic folktandvården next week he is going.

But it seems that we me and my husband on the list for ten years!
11:50 May 27, 2009 by Mamoshka
Omaro i sent you a message. You are welcome to mail me anytime.

My husband is Swedish, he can also help you.

I have no contacts here no family or relatives. All on my own.

I know about the name changing my son was Mohammad now he is Viktor.

We actually named him Mohammad not because of religious reasons only for my brother his name is Mohammad. I love my brother dearly.

He is working in Chicago with his wife Sarah she is a doctor and working there too. He is extremly happy there. No one asks him about his name or where he comes from.
12:44 May 27, 2009 by Bender B Rodriquez
Ok, good.

Ok, but since you and your husband will not get free dental care anyway (I assume you are over 20), there is not much advantage of choosing Folktandvården over a private dentist.

Here is the prices at Folktandvården: http://www.ltvastmanland.se/upload/Filarki...02008-07-01.pdf

You may compare those to the prices at private dentists. They will cost almost the same, sometimes even cheaper.
12:51 May 27, 2009 by Omaro
Thanks a lot Mamoshka, I have already sent u a message.

Send your son my salam. And I wish him good luck in the US, US is the best country when it comes to non discrimination society. I hope I can visit it someday.

It is so sad to change one`s name to begin a life, sad but true.
14:25 May 27, 2009 by Mamoshka
Bender thank you

and Omaro welcome to my friendlist, i sent you a reply

see you
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