If a foreigner staying in Poland becomes ill, can they count on professional medical assistance and where should they seek it?

Gone are the times when foreigners employed in Poland had to travel back to their home country if they became ill or had to undergo a surgery. Today there is a growing movement in the other direction: Polish doctors not only see more and more foreign patients who stay in Poland but the number of foreigners who are planning a special visit to Poland to undergo surgery, receive treatment at a sanatorium or from a dentist has been on the rise.

In Poland, one can receive effective treatment for disease, have a transplant (Polish doctors do kidney, liver, pancreas and heart transplants), undergo even the most complicated diagnostic tests, receive dental treatment and order a dental prosthetics, remove wrinkles and benefit from sanatorium therapies. Health and beauty spa centers with luxury equipment are waiting for those tired and burnt out by work.

■ Who pays?
Poland has a public healthcare system, financed mainly from health insurance contributions collected by the National Health Fund (NFZ) and from the national budget. There are numerous hospitals, outpatient clinics, diagnostic labs and nursing homes operating on the basis of contracts with the NFZ. They provide free services to the insured. Also other EU nationals who stay in Poland temporarily have the right to use these services. They have the right to free medical care if they are insured in their own country and can present appropriate documents confirming their insurance coverage.

A sick person can consult a general practitioner or a specialist in an outpatient clinic, receive hospital treatment and dental treatment, use ambulance and medical transport services. Patients need a referral if they want to receive hospital treatment or see a specialist, except for gynecologists, dermatologists, venereologists, oncologists, ophthalmologists, psychiatrists and dental surgeons.

In the event of a sudden illness or accident, the patient can call for an ambulance or go directly to a hospital emergency room.

However, the public health service is contending with the shortage of funds—apart from health service establishments with ultramodern equipment, Poland has poorly equipped clinics filled with poor retirees waiting in long lines to see a doctor. As a result, patients who have money and do not want to wait for treatment increasingly choose subscription medical services or private healthcare services, despite the fact that by doing so the patients cannot use the contribution they obligatory pay for health insurance because private health funds are still non-existent in Poland.

Following in the footsteps of large multinational corporations, between 10 and 20 medical companies which offer medical services for a regular monthly fee appeared on the Polish market in the last decade. These include: Medicover, Damian Medical Center, Enel-Med Medical Center, Medycyna Rodzinna and Falck Medycyna Sp. z o.o.

As a rule, reputable medical companies have their own websites. Damian Medical Center (www.damian.pl) has its own modern hospital, outpatient clinics and experienced physicians who speak English and German. Apart from specialists in internal medicine, consultations and treatment are also provided by surgeons, orthopedists, ENT specialists, dermatologists, ophthalmologists, allergists and many other specialists.

“At Damian Medical Center, we have a specialized unit, the Individual Medical Care, to deal with patients who have medical insurance coverage from Western companies like BUPA, PPP Cigna and others. These are mainly foreigners who work or stay in Poland. We provide them both with emergency and planned treatment. This is a special, high-quality service intended exclusively for these insurers,” said Manager Paweł Opatczyk.

Enel-Med Medical Center (www.enel.pl) has its own hospital and specialist clinics. Patients can receive private healthcare services by paying for each consultation or on the basis of a monthly subscription fee. Enel-Med offers access to physicians of all specialties and comprehensive treatment including diagnostic services, consultations, hospital treatment and rehabilitation. The patient can order a home visit by a pediatrician or internist. As is the case with public hospitals, Enel-Med has ENT, orthopedics and internal medicine standby duty.

A whole network of private healthcare establishments, a network which has been consistently expanding, had developed thanks to the subscription system.

Private medical services paid for exclusively by patients are also developing. Physicians see patients in their own clinics, where a consultation is more expensive (usually around zl.100 or more), or in private and cooperative clinics offering services of several or more physicians of the same specialty or of different specialties. Prices here are slightly lower.

■ Medical tourism
The number of foreign patients who choose Poland as a place of planned surgeries and medical examinations is on the rise. Poland’s advantages include treatment costs lower than in other EU countries in the case of many diseases and a shorter waiting-time for some specialist procedures.

“We offer medical tourism services to people who permanently live abroad and visit Poland only to undergo a surgery or diagnostic tests. Our services are attractive for them because their quality is up to European standards—we have ISO certification and accreditation with the Quality Monitoring Center—while prices are three to seven times lower than in their home countries,” said Opatczyk. According to him, interest in individual types of treatment depends on which country the patient comes from. For example, orthopedic procedures (hip joint surgery, arthroscopy) and plastic surgery are the most popular with patients from Great Britain.

There is a number of hospitals specially prepared to admit foreigners. Hospital rooms are small and modestly furnished, but this does not discourage those foreigners who pay for treatment in Poland on their own and want to minimize costs.

■ Innovative methods
Medical centers which use innovative methods are developing in Poland. Heart transplants are performed in Cracow and Zabrze. Deaf patients receive implants which restore their hearing at the International Center of Hearing and Speech of the Institute of Physiology and Pathology of Hearing in Kajetany near Warsaw.

Telemedical services are becoming increasingly popular worldwide. Services launched in April 2004 by the Cardiology Institute in Anin (a district of Warsaw) are a novelty in Europe. The system that operates here enables remote cardiological and cardiosurgical consultations. Thanks to these services, foreigners staying in Poland can receive advice from their doctor in Western Europe or the United States. The foreign doctor who has access to this system can assess medical examinations performed for the patient in Poland. For patients from abroad telemedical consultations with Polish doctors are cheaper than those provided by Western hospitals.

There is a term for contracting services in countries where labor costs are lower but qualifications of the medical personnel equally high—this is called Business Process Offshoring (BPO).

Teleradiology, which means sending medical images from one point to another, is based on BPO and has been known abroad for years. Enel-Med Medical Center has used this method for over a year.

Enel-Med’s Teleradiology Center offers online teleradiology services. The Center uses a medical image transmission system in the DICOM 3.0 standard. Specialists working for Enel-Med provide medical image descriptions around the clock. The teletransmission system also enables neurologists, neurosurgeons and orthopedists to evaluate results of examinations and qualify the patient for surgery. Hospitals which use a medical image transmission system can lower their costs—they do not need to employ radiologists and can pay only for image descriptions.

■ Open wide
Polish dentists’ offices, most of them private, are equipped with modern equipment. Dentists use both cheaper traditional and most modern materials to fill cavities. There is strong competition among dentists—in recent years the increase in the number of dentist’s offices was faster than growth in the nation’s affluence. As a result, patients from abroad are welcome enthusiastically. Organized groups of patients come to Poland from Scandinavian countries. Dental tourism is also practiced by Germans.

In Poland, one can also receive psychotherapy. The British, Americans, Germans and in rare instances Italians, the Dutch and French come to Laboratorium Psychoedukacji (Psychoeducation Laboratory), a well-known therapeutic center in Warsaw. “They usually seek individual therapies, consultations concerning their children or consultations for couples. This particularly concerns relationships in which one person is from Poland and the other from abroad,” said Anna Kopacz of Psychoeducation Laboratory. The psychotherapists speak English, French and Russian.

■ Beauty trips
A visit to Poland can also provide an excellent opportunity to remove flaws in one’s appearance. There are large hospitals in Poland reputable for their achievements in plastic surgery, for example Warsaw’s Orłowskiego Hospital. However, an overwhelming majority of plastic and cosmetic surgeries are performed in Poland outside hospitals—in private offices or small surgical clinics. One of the centers dealing with esthetic medicine is the Health and Beauty Clinic Villa Park Hotel in Ciechocinek. Facial correction procedures are performed in Iwonicz-Zdrój, a health resort located in the Beskid Niski Mountains, 16 kilometers from the town of Krosno. The local doctors remove scars, spots and wrinkles.

Most of Polish spa towns are located in the most picturesque parts of Poland, have excellent climatic conditions and rich resources of therapeutic substances with confirmed medicinal properties.

There are 1,100 health resorts across Europe. Poland has 44 spas. Spa hospitals and sanatoriums offer a total of 45,000 beds. Treatment facilities in Polish spas are of good quality and up to Western standards. Accommodation standards are slightly lower but many facilities are being quickly modernized. There is already a large number of spas offering high-standard hotel services, for example Nałęczów, Kołobrzeg and Krynica-Zdrój.

■ Healthy alternatives
Spa tourism, associated with spa treatment, has been developing in Western Europe and demand for preventive therapies for healthy rather than sick people is on the rise. There is also growing demand for wellness services. Relaxation coupled with health and beauty therapies is the objective of one’s stay in such centers.

Polish sanatoriums and private companies, for example the well-known cosmetics producer Irena Eris, have already spotted the new trends. Located 150 km from Warsaw, the Nałęczów spa specializes in cardiac rehabilitation. But apart from a spa hospital and sanatoriums, there is also SPA Nałęczów operating in the town. The luxury facility offers health and beauty, and cosmetic programs.

The four-star Health and Beauty Clinic Villa Park Hotel in Ciechocinek, the largest health resort in lowland Poland, located at a distance of 200 km from Warsaw, offers a thalassotherapy program—baths in Dead Sea brines and wraps of Dead Sea mud. Patients can use treatments in a massage capsule or benefit from lymphatic drainage. Also offered is a body contouring program.

Health and beauty therapies in luxury spa centers are also available from Iwonicz SA spa in Iwonicz-Zdrój, Mieczysław Hulewicz’s company Eden operating in Sarbinowo and Polanica-Zdrój, and Delfin Hotel in Augustów.

■ A Polish specialty
Polish caregivers for the elderly and disabled as well as physiotherapists have a good reputation and are increasingly needed by aging Western European societies. Polish physicians and nurses can easily find employment in Western Europe and in Scandinavian countries. Sanatoriums on the Baltic coast and in western Poland have more and more patients from EU countries. All this confirms the opinion presented a few years ago by the consulting firm McKinsey & Company that health services may become one of Poland’s specialties in the region. “Polish medical services providers should focus on orthodontics, prosthodontics, rehabilitation, analyses of laboratory test results, organizing holidays combined with medical services, and opening nursing homes for the elderly,” McKinsey & Company experts advised. Poles have acted on their advice and have been looking for opportunities also in other spheres of medical services.
Wanda Jelonkiewicz

The website of the National Health Fund (www.nfz.gov.pl) offers basic information about healthcare in Poland in Polish, English, German and Spanish.