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How do I know whether my doctor is any good?

David Landes · 10 Jul 2009, 17:04

Published: 10 Jul 2009 17:04 GMT+02:00

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As any regular reader of The Local probably knows, doctors in Sweden have committed their fair share of medical blunders over the years.

But as a preface to answering the question of how to find out about a particular doctor’s history, it’s worth providing a bit of background on Sweden’s current medical malpractice system.

Unlike the United States’ professional liability system, for example, which usually relies on courts to settle malpractice complaints, Sweden uses a no-fault compensation system which separates the finding of fault from the process by which compensation is determined.

According to Sweden’s Lex Maria laws, hospitals and care givers are required file a report with the National Board of Health and Welfare (Socialstyrelsen) for cases of malpractice or incidents in which health workers are suspected of injuring or putting a patient at risk.

(The Lex Maria laws are named after the old Maria Hospital in Stockholm where four patients died in 1936 after being injected with disinfectant instead of anesthetic.)

The Board of Health then carries out an independent investigation into the reported case.

If it finds there is cause to believe that a doctor or nurse behaved irresponsibly and disciplinary measures ought to be considered, the agency passes the case along to the Medical Responsibility Board (Hälso- och sjukvårdens ansvarsnämnd – HSAN).

Aggrieved patients can also file their complaints directly with HSAN, which then determines the merits of the complaint, weighing testimony from the patient and doctor in question.

Doctors found at fault are issued warnings or reprimanded, but the Board’s findings have no bearing on the decision to compensate a patient for injury caused by a medical mistake.

Rather, compensation claims are handled separately by one of several patient insurance organizations.

The upshot is that doctors in Sweden are motivated to avoid mistakes, not because they fear getting sued, but because they want to maintain their professional reputation.

Neither HSAN nor Socialstyrelsen publish any central registry of which doctors have been reported or reprimanded, however.

But with a little bit of legwork, it’s actually not too difficult to find out whether your local doc has been reported or ‘prickad’ (reprimanded) by HSAN for possibly misjudging a past patient’s tumour as an inflamed tonsil.

According to Socialstyrelsen spokesperson Anna-Lena How, all one needs to do is make a phone call to the local branch of the agency and provide the name of the doctor in question.

“All of the complaints are on file and readily available,” she told The Local, cautioning however that there’s no guarantee that callers will get immediate answers.

“It all depends on the workload of the person you speak with,” she explained.

While Socialstyrelsen can tell you how many times, if any, that a particular doctor has been reported for possible negligence, you need to get in touch with HSAN in order to find out whether or not your doctor has been officially reprimanded.

All you need to do is send an email to HSAN at hsan@hsan.se with the name of the doctor (or doctors) you’d like to investigate. It’s also possible to call HSAN at 08-786 99 00 (but only between 1pm and 3pm on weekdays, which is when they have qualified staff on telephone duty to handle such inquiries).

And in keeping with so many other aspects of the Swedish healthcare system, getting an answer can take some time.

Story continues below…

An official at HSAN said that it take up to three weeks for the agency to get back to people with answers to their inquiries, depending on the workload.

In its response, HSAN can provide information about the number and type of complaints (if any), filed against a particular doctor, as well as whether or not the cases resulted in an official reprimand.

Another, more general source for information about doctors and healthcare facilities in Sweden can be found at a website launched in 2008 called Doktorsguiden.se.

The site is a private, commercial venture which provides rankings of doctors, clinics, hospitals and county councils based on votes from patients. The site isn’t connected to any official state health agency and remains somewhat limited in scope, with rankings for only 75 doctors as of May 2009.

But awareness of the site is growing, and it does offer at least a dose of additional information for those interested in knowing just how competent or caring a particular doctor or hospital is thought to be.

Related links:

David Landes (david.landes@thelocal.se)

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Your comments about this article

16:25 July 10, 2009 by Alannah
I tend to avoid going to the doctor here unless it is an ABSOLUTE necessity. A few years ago I had a chronic sore throat. After 3 days suffering I booked an appointment with a doctor. When I called they said I could book an appointment for 7 days later or if it was an emergency I could go to the Cityakuten and wait a few hours until a doctor saw me.

Realizing I needed antibiotics, I sat in the Cityakuten for 5 hours before seeing a doctor. The doctor refused to give me antibiotics and told me to go home and eat apples and sleep a lot. I explained I had done this for three days and still had a chronic sore throat. He replied "buy some Vicks throat lozenges."


Now, I never go to the doctor here unless I have no other choice. And medical care here is not free despite what the Swedes say. It's around SEK 200 for an appointment plus medicine. In Germany if you are an EU citizen, you show your passport and you get GOOD professional healthcare for free. Medicine is extra.
16:40 July 10, 2009 by BUSHGIRLSGONEWILD
At least you Swedes get to see you doctor; here in the U.S., people bleed to death in the Emergency Rooms waiting for treatment. For most Americans, one serious health issue, like cancer in one of their children, will cost them everything, including their home (if they still have one after the recent scams). The biggest reason for bankruptcies in America is an illness.
12:41 July 12, 2009 by Tennin
This article didn't make me feel any safer about the medical doctors and staff in Sweden. To me it seems the doctors are not really held liable for any mistakes they make, and someone trying to find out information about their doctor will have to go through a world tour before finding anything out.

Oh well, I guess at least in Sweden people don't have to loose their house, car, and everything they have because someone in their family has an illness.
15:36 July 12, 2009 by voiceofreason
Theason my wife, brother and mother each spent 6 years in medical school is to make damn sure they master the subject. I don't expect easy mistakes from them because they know the drill like the backs of their hands.

I come from a "3rd world country" but its easier and cheaper for me to see a doctor their tha in the west. Mind you, we don't have health insurance.
17:58 July 12, 2009 by robertsmandresh
I question comment # 2. People don't bleed to death in US emergency rooms. I am a podiatrist(foot surgeon) I have for the past 15 years worked part time in clinics specifically built for the working poor. People without insurance get care here. I have done ingrown toenail surgeries using very expensive 30 gauge needles for anessthesia. It is an almost painless injection. I would compare that with my only patient from britain who had a 3 month wait to get her nail surgery. My patients wait up to an hour to see me.Patients who need an mri to rule out bone infection are generally seen within one day . Socialized care and the US model have positive and negative attributes. Personally, I would prefer the US model. In the long run I get the most up to date care . I am not beholding to any politician for what facilities are available in my voting district . (I have read that in certain areas of britain they pull there own teeth rather than wait for their free dentist.)
19:25 July 12, 2009 by Omidn
In completion and agree to what Alannah mentioned here, I heard so many stories about some Swedish Drs. that they do inaccurate diagnosis and clinical procedures which I assume they have been trained in medical schools. I have been even heard also some bad stories in Denmark.

Swedish medical associations should get into these problems in order to validate Drs. and Surgeons to avoid bad repetitions.
03:57 July 13, 2009 by BUSHGIRLSGONEWILD
You can question comment #2, but....

Wed., June 13, 2007

LOS ANGELES - A woman who lay bleeding on the emergency room floor of a troubled inner-city hospital died after 911 dispatchers refused to contact paramedics or an ambulance to take her to another facility, newly released tapes of the emergency calls reveal.

Edith Isabel Rodriguez, 43, died of a perforated bowel on May 9 at Martin Luther King Jr.-Harbor Hospital. Her death was ruled accidental by the Los Angeles County coroner's office.

Relatives said Rodriguez was bleeding from the mouth and writhing in pain for 45 minutes while she was at a hospital waiting area. Experts have said she could have survived had she been treated early enough.

05:18 July 13, 2009 by robertsmandresh
In response to bushgirlsgonewild. I stand by my comment. Comment #2, to me, implied in the US model of health care that people without money do not get care. I googled the case you mention. The hospital seems to be guilty of malpractice. They assumed she had a gall stone and wanted more pain medicaion secondary due to her drug addiction. The clinics I have worked in , here in Indianapolis, do well in geting patients seen, and by medical doctors. Noone is turned away.
07:39 July 13, 2009 by BUSHGIRLSGONEWILD
I didn't imply poor people in the U.S. do not get care, I said people bleed to death waiting for care.

Monday, October 06, 2008 | FoxNews.com

A 58-year-old man died of cardiac arrest after waiting 19 hours in the emergency room, the Dallas Morning News reported Monday.

There were 164 people ahead of him. Another 180 new patients would walk through the ER doors during the next 19 hours.

But since you bring it up, it is true that people without money or insurance are denied care. As CNN reported on hospials in Los Angeles:




09:14 July 13, 2009 by Soapbubbles
Hi there. Don´t know if this is to any help, but at least you can search for your doctor and see how people thought of him/her...

09:27 July 13, 2009 by Holecutter > The Howl From He
I should imagine with these kind of statistics, we would all want to know who we are dealing with when it comes to doctors and hospitals here in Sweden. There is something very wrong with a medical service where 3000 patients die each year fro malpractice, and only now we are getting to hear about it.

09:42 July 13, 2009 by jack sprat
Having noticed quite a few cut-backs recently in my area and heard from a few less than satisfied locals, I get the impression that the health service is under huge pressure here and struggling to make ends meet.

Regarding mistakes etc.a very sad and shocking case was reported two days ago with the death of the wife of ex Blackburn,Rangers and Scotland football captain,Colin Hendry.

She had been in hospital in the UK for what was expected to be a fairly routine liposuction op.by a Swedish cosmetic surgeon.

Her small intestine and colon were perforated no fewer than nine times, as a result of which she suffered blood poisoning,kidney failure,a heart attack and a collapsed lung.

She was in a coma for quite a while and many attempts were made to repair the damage over a long period, but to no avail and she eventually died.

The Swedish surgeon was branded reckless and incompetant by an enquiry.

He was also struck of the UK medical register.

Whether or not he is free to continue elsewhere, I do not know, but would only hope it is not the case.

In view of the numerous sad cases coming to light and also an exceptionally high number of failed ops being reported from recently qualified surgeons maybe questions should be raised regarding the standard of training here.
10:11 July 13, 2009 by Holecutter > The Howl From He
And what is the health minister doing about it, is she a he or a women ?. What is more important, is the PM ready to get off his ass and sort out these political appointees that seem to screw up all the time...these stats are shocking.

It is time to name and shame these Doctors....Dr Gustaf Aniansson, who is practicing in Swede, with the emphasis on the practicing.

20:11 July 14, 2009 by svensson1982
Please read this link

20:39 July 14, 2009 by jack sprat
So Dr Gustaf is still practising,now on Swedish patients and giving further cause for serious concern.

Contrary to last weeks report,it seems he removed himself from the UK register to avoid being blacklisted.

However in serious cases like this I would have thought there would be more co-operation and communication between medical authorities within the EU at least to ensure better protection for potential guinea pig patients.

In any event I would be amazed if the Swedish medical authorities were not aware of his previous record.
14:27 July 25, 2009 by Tutu
ask if the doctor is invandrare or swedish
21:09 July 25, 2009 by Calumet

Please explain to me how you knew that you need antibiotics for your sore throat? Did you test positive for Group A Strep or did they tell you that you had a peritonsillar abscess? Just because someone has a painful sore throat does not mean that they need antibiotics. This misconception, along with patients demanding antibiotics when they are not indicated and doctors “giving in”, is why we have such a problem with antibiotic resistance.

Now if you test positive for Group A strep, then you should be on an antibiotic. However, the antibiotic is given so that you do not develop rheumatic fever rather than because your body is not capable of fighting off your Strep throat infection. Rheumatic fever can damage the heart valves, which can then cause heart problems.

As for the peritonsillar abscess, they do occur, but are far less common than strep throat or other common viral or bacterial infections of the throat. There are certain findings that would lead a practitioner to be concerned a patient has a peritonsillar abscess

BTW. I am a physician assistant in the US and if you came to me for your sore throat and had a negative Strep test and no findings that made me think you had a peritonsillar abscess, you would not have received an antibiotic.
13:33 July 27, 2009 by Pacey
Its a sad lady who tries her own perfume!!

Ask youd doc where they go when they need medical help!! If the answer is DIM( Do it Myself) then you should be fine!
12:45 August 2, 2009 by refugee
The problem may be in my view on the systems and procedures to handle the patient .. which means that probems r moslty managemnt problems that hinder the patient to acess the dr easily ... as some one said above i am also refquently a victm to acess drs , i mostly stayed on varage around 6 hrs to acess the GP for ...

otherwise i don't see lack of quality in Swedish Drs .. u have to remeber also the patient has to describe his feeing very well .. and infact medical managemnt had better design the new medical system that helps the patinet to acess drs easily ...
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