SHARE
COPY LINK
PRESENTED BY SOPHIAHEMMET

A doctor answers: Is private healthcare in Sweden worth it?

There’s nothing scarier than a health scare. It’s even scarier if you’re living abroad and don’t speak the local language or understand how the healthcare system works.

A doctor answers: Is private healthcare in Sweden worth it?
Photo: Dr. Markus Björkström

There are a few things to get to grips with when you move to Sweden. Skatteverket and Migrationsverket can be a walk in the park compared to figuring out how the healthcare system works.

For expats in Sweden who are used to the continuity of a GP-style service, it can be a culture shock to see a different doctor each time you visit your local vårdcentral (healthcare centre).

While the ambition is for patients to always be treated by the same doctor, the demand on public healthcare often means this isn’t the case.

Continuity of care

At Hälsocentralen in Sophiahemmet, the oldest independently-run hospital in Stockholm, patients always see the same doctor — unless they request otherwise. This continuity creates a better experience for both doctor and patient, believes Hälsocentralen’s Dr. Markus Björkström.

“It becomes easier to evaluate what’s wrong if I know a patient and the status of their health from the beginning,” he told The Local. “From the patient’s side I think it’s better too, they have more confidence in me and what I say.”

Find out more on Hälsocentralen’s website

Privately-funded healthcare has traditionally been a taboo topic in Sweden. Swedes pay high taxes and therefore many see it as only fair that in return the state covers their health. But with doctors in demand and a predicted shortage of medical professionals in coming years, Sweden’s public healthcare service, like many around the world, is under pressure. More patients are beginning to turn to private healthcare if they need to see a doctor urgently or want a single doctor to care for their health.

Photo: Sophiahemmet Hospital

Dr. Björkström explains that patients at Hälsocentralen usually get an appointment on the day or the day after, as well as a longer appointment time. Patients get up to 30 minutes with the doctors, all who speak English, so they can feel confident they’ve been properly examined and heard. For many expat patients, this is reassuringly similar to what they knew ‘back home’.

While Dr. Björkström has every faith in Sweden’s public healthcare system, working himself a day a week in the emergency room, he admits the continuity and longer appointments are a boon for both doctor and patient.

“We can get to know each other. They don’t have to start from the beginning every time, telling the same story,” he says, adding that this helps the doctor to really understand the intricacies of a patient’s file. “There are no distractions during those thirty minutes, I have my time and that time I can give to the patient.”

Depending on the diagnosis, patients are then either treated at Hälsocentralen or referred on to a specialist. Many chronic diseases, such as diabetes or hypertension, can be treated without needing to send a patient elsewhere. Even minor surgeries for ailments like skin lesions can be handled entirely onsite.

Preventative care

As well as its GP service, Hälsocentralen offers a regular healthcare assessment, a preventative service available annually or every other year that isn’t offered by the public healthcare system.

The initial appointment involves a number of tests carried out by a registered nurse to detect health risks like high blood pressure, elevated blood glucose and stress. This is followed by a physical examination with a GP who also runs through any test results. Depending on the outcome, the patient can then be seen by a nurse at Hälsocentralen’s Health Advice Centre, who can advise them how to manage their health.

Find out more on Hälsocentralen’s website

This yearly touchpoint maintains the patient-doctor relationship in-between GP appointments as well as “finding some illnesses early”, explains Dr. Björkström.

There’s an additional layer of trust that all of Hälsocentralen’s doctors are senior with many who have thirty or forty years of experience.

“I think I’m the most junior here and I have at least ten years of experience working in medicine!” says Dr. Björkström.

The question is: as a Swede himself, does Dr. Björkström believe that private healthcare is worth it?

“It can be, absolutely. Health is a really important matter. And I think you get a lot of value for your money because of what we can offer here.”

This article was produced by The Local Creative Studio and sponsored by Sophiahemmet.

For members

HEALTH

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

Sweden theoretically has a "healthcare guarantee" limiting your wait to see a GP to three days, and to see a consultant to three months. The reality is somewhat different. Here's what you can do if you face a long wait.

EXPLAINED: What to do if you face a long wait for healthcare in Sweden

What is Sweden’s ‘healthcare guarantee’? 

Sweden’s “National Guaranteed Access to Healthcare” or vårdgaranti, is a right to care, protected by law, that has applied in Sweden since 2005. You can see the latest version of the relevant laws here and here. Here is a summary of the guarantee on the website of the Swedish Association of Local Authorities and Regions (SKR).

Under the system, all patients are guaranteed:

  • contact with a primary care centre by phone, in-person, or by video-link on the day they seek care 
  • an appointment with a doctor, nurse, physio, or psychotherapist within three days of seeking help 
  • an appointment with a specialist doctor or consultant within 90 days of seeking help 
  • treatment or operation within 90 days, if the specialist considers this necessary 

Does the guarantee mean I have a right to treatment? 

No. If the doctor at the primary care centre, after examining you and questioning you, decides that there is no reason to refer you to a specialist doctor, they do not need to do so. 

Similarly, if the specialist doctor, after examining you, decides that no treatment is necessary, then your case is considered completed.  

Can the waiting times to see a specialist or to get treatment be longer than 90 days? 

Absolutely. In fact, they very often are. 

According to the Swedish Association of Local Authorities and Regions (SKR), in February, 32 percent of patients had been waiting 90 days or more to see a specialist, and 43 percent of those who had seen a specialist had been waiting for treatment for more than 90 days.  

The situation in primary care was a little better, with 80 percent of those seeking care in contact with their primary care centre on the same day, and 83 percent having their case assessed by a doctor or nurse within three days. 

In addition, if you agree with your specialist doctor that you are willing to wait longer for an operation, then that wait doesn’t get counted in the statistics. 

So what can I do if I’ve been waiting longer than the guaranteed time? 

In reality, it’s actually less a guarantee than a target.

In primary care, there is no way for individual patients to complain that they have had to wait too long to see a doctor or nurse, or to cut their waiting times by citing the guarantee. 

“There’s no system for enforcing that guarantee,” says Emma Spak, the primary care doctor who doubles as section chief for SKR’s healthcare division. 

It would make no sense to set up a complaints line for those who have had to wait too long for phone contact with their primary care centre, she points out, when they could instead talk to patients seeking a primary care appointment in the first place. 

“It’s more of an incentive system for the regions,” she explains.

Every primary care unit and every region reports their waiting times to the national waiting time register, and then as part of the access agreement between SKR and the government, the regional health authorities receive a bonus if they meet their waiting times goal, or if they improve their waiting times. “That’s one way of sort of enforcing this guarantee,” she says. 

When it comes to specialist treatment, though, patients do have the right to demand to be examined or treated by an alternative specialist or hospital if they’ve had to wait longer than 90 days.

If your primary care centre issues you a referral to a specialist, and the specialist cannot then offer you an appointment within 90 days, the specialist, at the same time as offering you a later appointment, will often put you in contact with a unit at the regional health authority who will offer to find you an alternative specialist, either within the region or elsewhere in Sweden. 

The regional health authority will then have to reimburse any extra travel or hotel costs incurred by the patient.  

Similarly, if after examining you, a specialist cannot offer you treatment within 90 days, they will normally put you in contact with the same unit. 

Some regions have a phone line for people who have been waiting too long, or else you can contact your specialist or primary care centre and ask for information on seeking an alternative specialist. 

What happens if I don’t want to travel to see a specialist or get treatment? 

If your regional health authority offers you an alternative specialist, either within your region or in another region, so that you can get treated within the 90 day period, and you are unwilling to travel, then you lose your rights under the guarantee. . 

“If you’re in Gothenburg, and they say you have to go to Stockholm to get your treatment, and you say, ‘no, I want to go here, then then you’ve sort of forfeited your right, and you have to take what’s on offer,” Spak says. 

What happens if I agree with my specialist to wait longer? 

If your specialist says that they can treat you in four months, but also offers you treatment elsewhere within the guaranteed 90 days, and you choose to be treated by your specialist, then that counts as a patient choice, which will not then be counted in the statistics. 

“The specialist might say, ‘I don’t think you will get any worse for waiting two months extra, and if you wait five months, then I can make sure that you get your surgery done here, and we can make sure that you get all the aftercare and everything here as well,” Spak says. 

But these patient decisions are also counted in the statistics, and if a region sees a sharp rise in patients choosing to wait, SKR will tend to investigate. 

“If some region all of a sudden has a lot of patients choosing a longer waiting time, then we will call them and ask what’s going on here, because patients don’t tend to want to wait extra,” Spak says.  

Can I get financial compensation if I’ve been waiting too long? 

No. 

What other ways are there of speeding up the wait for treatment? 

Don’t underplay your symptoms

When drawing up their timetable for treatment and assessment, specialists will tend to give different patients different wait times depending on the urgency of their case.

For this reason, it’s important not to underplay your symptoms when visiting a primary care doctor, as they will tend to include a few lines on the urgency of your case when they write their referral. 

Stress your flexibility 

If you are unemployed, a student, retired, or have a very flexible job, it is worth telling your primary care doctor about this, because they may write in your referral that you are able to make appointments at very short notice. The specialist may then put you on their list of people to ring if one of their patients cancels. 

“Sometimes I write in my referrals that this patient could easily come at short notice, so please put the patient on the list for people you can call if there’s a time slot available,” Spak says. 

If you haven’t told your primary care doctor this, it’s not too late. You can ring the specialist yourself and tell their receptionist that you are very flexible, and ask to be put on the back-up list. This is particularly useful if you’re waiting for a scan, but you could also potentially work even if you’re waiting for heart surgery or a hip replacement. 

“If they’ve accepted you as a patient, and they’ve made sure that you fulfil the criteria for having that scan or whatever, then you can call them and say, ‘I have a really flexible job, I can come anytime if you have a gap,'” Spak says.

“A lot of people do that, because they can have [back-up] waiting lists. If you tell them ‘I work around the corner and I only need 15 minutes to be there’, then they might call you if someone doesn’t show up.” 

Ring up your specialist 

The queue system tends to be quite ad hoc, with no strict rules over who should be treated first, so it is often possible to reduce your wait by ringing up your specialist a few times a month, just to bring your case to their attention. Sometimes the receptionist will remember a slot that has just come free and bring forward your treatment while you are still on the telephone. 

SHOW COMMENTS