Letter to the Editor

Abstract

To the Editor:Distinguished guests, ladies and gentlemen, dear colleagues!Allow me, as a retired Czech surgeon and also as a Czech organizer of 2 European International College of Surgeons congresses in my country (in the years 1999 and 2005), to inform you about the contemporary status of Czech surgery, its successes, and its directions for further development.The Czech Republic is a free country with a population of 10 million people located in the middle of Europe, and it is a member of the European Union. Its medical care is highly developed, and for the last two centuries it has traditionally been tied to German and Austrian medical systems, because 100 years ago our country was still part of the Austro-Hungarian Empire. In the new, independent Czechoslovakia born after the First World War in 1918, our medical system was developing in a promising way. And after the Second World War, we were influenced by the development of the medical system of the Soviet Union. Joining the Soviet bloc after 1948 caused a big regression in the development of Czech surgical branches until 1990, when we became free again. In 1993, Slovakia separated from us and became an independent state. Contemporary Czech surgery largely follows the trends of Anglo-American surgery.As far as the organization of medical services is concerned, we have a public, state medical system represented by health insurance companies that are financially supported by the Czech state. Following the law, all of our citizens are insured for illness, injury, and old age care. Apart from that, we also have many private medical facilities that complete public state medical service on the one hand and improve its quality with their standards on the other.Surgical service is provided by both public and private hospitals as well as in public and private medical organizations. Accessibility for these services is quite good with respect to the dense traffic network and citizens' needs. There are more than 100 state and public hospitals, with most of them having well-organized surgical departments with nonstop service. Policlinics and private surgical ordinations are open only during the day; only hospitals work at night and on weekends.Our state has 8 medical faculties spread over the Czech Republic, from which more than 1300 new doctors graduate every year. Medical study in our country lasts 6 years, and surgical specialization can take 5 to 7 years depending on the branch a doctor chooses. Surgical specializations are identical to those in surrounding Europe and the United States: Our inhabitants get the same medical care that is provided in Germany, France, or Great Britain. We do not offer traditional East (Asian) medicine. Most of our citizens do not have to pay for surgical operations at all because the cost of surgery is taken care of by hospital insurance companies. People have to pay extra fees only for some above-standard hospital services, for more expensive medication, and for some medical aids. Within the last 20 years, our surgery has specialized in general surgery, traumatology, and plastic and reconstructive surgery. For more than 75 years, we have performed all other surgical specializations, such as orthopedics, urology, neurosurgery, cardiac surgery, plastic and reconstructive surgery, and pediatric surgery. We also have specialized departments for pediatric cardiac surgery and pediatric neurosurgery, transplantation and injury centers, burn stations, and rehabilitation centers. The amount of surgical services provided is sufficient for our citizens. Research in all of those branches, governed and subsidized by the Czech health ministry, is also good. Minimum invasive surgery is growing, and robotic surgery is being introduced into more and more workplaces, albeit without any great professional enthusiasm thus far.In the entire country, there are about 1500 surgeons working. About half of them are employed in hospitals, and the other half includes surgeons in a combination of hospital services and private practice. We have enough surgical and traumatology beds for the number of our inhabitants and for the size of our state. Therefore, we are able to cure all of our ill and injured patients on time and properly. Also, over the last few years some patients from Europe and Asia have come to our country for medical treatment because of the financial benefits and also because we have specialized centers, such as pediatric cardiac surgery or plastic surgery.To conclude, we can say that our doctors fulfill their duties in all respects and fully meet the expectations of our people in all surgical specializations, including transplantation services. The standard of surgical treatment is controlled by medical insurance companies as well as by the medical chamber, which represents an obligatory union organized for doctors who perform medical practice. Therefore, surgical services today in the Czech Republic are on the same level as those in surrounding Europe.