Healthcare institutions must share responsibilities,

Healthcare institutions must share responsibilities, says Dr. Andrey Kehayov, President of the Bulgarian Physician Association and President of the Southeast European Medical Forum (SEEMF)

Introduction:
Andrey Kehayov is born on December 23, 1964. He graduated in Surgery from the Medical University – Plovdiv. He was awarded a PhD degree. In 2000, he was elected Vice-President of the Bulgarian Medical Association (BMA), and in 2002, the 36th convention of the BMA elected him President. He was re-elected in April 2005 and served his term until 2008. In 2005, he completed a Master’s of Health Management degree at the Faculty of Public Health of the Medical University – Sofia. Since April 2005, he is the President of the Southeast European Medical Forum (SEEMF). He is also President of the Bulgarian Physician Association.
May you introduce the Bulgarian Physician Association and the Southeast European Medical Forum, as you preside both?

What are their main priorities?
The Bulgarian Physician Association was founded four years ago by decisions of the ex-Board of Directors of the BMA. Its objective is to provide additional support of Bulgarian physicians, as well as the possibility to perform activities that are otherwise not permitted by the Professional Organizations Act.
The Association provides logistic and legal support to healthcare establishments, physicians, or municipalities. In addition, the Association is making statements on all subjects relative to the healthcare system in this country. We’re realizing conferences on significant topics of present interest to the healthcare system. We’re sought for opinions and standpoints by both general practitioners and faculty members. In the society, there’s a need of objective truth, and we’re filling that void.
In 2005, the BMA initiated a meeting upon the basis of close contacts with the respective associations in Macedonia, Albania, and Greece, and we created an organization that would express the common interests of the countries in our region – the Southeast European Medical Forum. This way, we can implement projects that would be useful to all countries, to organize forums useful for the integration and the sharing of experience between physicians. Step by step, the organization expands – Slovenia and Croatia joined, too. The first congress, in September 2010 at the Golden Sands resort was attended by more than 650 physicians from 14 countries. The medical associations of Ukraine, Serbia, and Bosnia and Herzegovina were affiliated officially during this first congress. Now we’re expecting Turkey’s and Romania’s membership. This is a large-scale organization that puts the emphasis onto the most significant social problems, which are debated at the congresses with input from physicians of world renown. These forums turn into a university of some sort. For the first congress, we earned high praise not only from the attendees but also from the European Continuing Education Commission.

Are changes in health care indispensable?
This is a wide theme with many aspects. Health care should be viewed as a whole organism instead of speaking of its separate components only. In order the healthcare system to be stable and functional, adequate regulation on all levels is necessary. If the policies implemented are incorrect, all the system is suffering. There’s misunderstanding by the institutions on this subject. Often physicians only are held accountable, which is intolerable. Problems should be examined in their entirety. The system is hurt and this is why mistakes are committed. Without a stable healthcare system, the society is put at risk as a whole. The governing bodies do need that truth be told. A social and political consensus is necessary. Above all else, objective debate is required, as is seeking solutions on the specific steps that would guarantee the accessibility of medical care, its quality, and its adequate funding. Those are the fundamental elements that guarantee the system. We could draw experience from European practices, too. We’ll have high-level discussions of these topics with representatives of the World Health Organization at the second congress of the Southeast European Medical Forum in Varna next September. We’re going to give an answer through public debate, to which we’ll invite representatives of the authorities, of all institutions.

Are global experience and medical achievements applied in Bulgaria?
Undoubtedly, this is an important element for the qualification of practitioners and for medical services of quality. Unfortunately, because of weak financing, only a small fraction of Bulgarian physicians has the possibility to attend worldwide forums. This is why, one of the objectives of our forum with participating world-scale physicians is to give more local practitioners the opportunity to hear first-hand what main problems are scientists discussing around the world.
We are at a good level in medicine but in the high-tech area we’re definitely lagging, except in isolated disciplines. Adequate resources are required to keep the qualification of physicians at a fair, no concession level. Regardless how much that would cost the state, it is to the benefit of the whole society. And this cannot be measured in money. The most important is guaranteeing welfare to our citizens. The lack of technologies at home leads to them seeking treatment possibilities abroad.

Is our country offering good conditions for the treatment of certain illnesses, for the so called medical tourism?
Bulgaria has all the geographic prerequisites – mountains, sea beaches, curative mineral springs, etc., but the capacity isn‘t used efficiently. In this respect, too, we’re lagging with the investments. Medical tourism could generate revenue for our country if the propitious conditions are fully used. This is a question of national healthcare policy.
Do we have world-scale healthcare achievements, medical achievements?
We do have some achievements but they are episodic. Again, inadequate financing and the lack of investment in science postpones great achievements. Bulgarian physicians are of high standing but we’re lagging in technological medicine. A large problem is the lack of fair working conditions, which leads to seeking job opportunities abroad.

Which diseases are the most prevalent here? Are there preventive measures about them?
Very unfortunately, we’re among the leaders in Europe in terms of cardiovascular diseases. The number of cancer patients is high. We’re observing a serious demographic collapse, due mostly to the lack of prophylaxis, of prevention of illnesses. The average life expectancy here is 10 years less than in the EU. This is why adequate investments in health care are necessary to increase life expectancy. Funds from certain programmes can be used. However, to get access to them, a transparent healthcare policy, including concerning medications, is required. Healthcare institutions must share responsibilities.