Ciao Bucharesti, Hello Sinai!

This morning's activity was another lecture series at the University of Economic Studies Bucharest. Our first speaker was an academician who shared the place that Romania's healthcare system has in the EU. There are many low rankings when it comes to the epidemiological area such as diabetes, TB, syphilis. Among some other challenges that Romania faces, it is the emigration of clinicians to other countries in the EU for more lucrative career opportunities. She shared the results of other Health Assesments which brought to light more issues that the country needs to work on. The picture on the right shows me giving her a token of appreciation on behalf of the OLLU students. She received a Cross Pen from OLLU, a corporate finance book, and a small monetary gift.

The second speaker was quite interesting, Dr. Turculet is the Director of the Medical staff at the hospital that we visited yesterday. In Romania the hospitals used to be run by physicians only. However with upward spiraling healthcare costs, administrators have had to get involved in hospital management. Doctors who are administrators must revoke their right to practice to stay in hospital administration. This is kind of strange, and not the case in the US. You can certainly pick up on the tension that exists between administrators and physicians due to this law. I can understand the separation in a sense, however it is an extreme solution. There must be positive synergies between these groups instead of animosity. The method of reimbursement in Romania is fee for service, and there is no incentive to pursue efficiency and quality for patient care. The doctor was a bit put off when asked about quality improvement initiatives, and the possibility of TQM or lean operations implementation in the future. Interestingly enough, he felt that hospital based medicine would work for Romania in the mean time. There was no concern for length of stay, increasing patient turnover or revenue cycle maximization. I think this reflects the basic level that their healthcare system is at right now.

After this lecture, we had lunch and headed off to a meeting at the US Embassy. The US officials wamrly received us and shared some great information regarding the economic situation in Romania. The growth has been so fast that there may be a bubble in certain industries such as housing and the workforce. Romania has experienced a "brain drain" of sorts and will face a shortage of clinicians, professionals and skilled labor in the near future. Wages are increasing to alleviate that, however inflation can result if this is not handled correctly. Doctors and nurses in Romania have experienced their desired salary increases, but administrators haven't. This just goes to show the disconnect that exists in this area, however the Minister of Health and other officials are not giving up on this battle. The information was extremely valuable because we could get more accurate and neutral interpretation on certian key indicators.

I'll cut this short, because I know this is long. We took a 2 hour bus ride to Sinai, a small city in the Carpathian mountains, and a beautiful place! The hotel we're staying in is about 150 yrs old and was desinged by Gustave Eiffel, who also was the architect for the Eiffel Tower! Hope you enjoy the pictures!