Submitted by Amanda Kucharzyk on the 2019 winter session program in Athens, Greece sponsored by the Department of Medical Laboratory Sciences…
At Attikon General Hospital in Athens, there is 110 percent bed coverage, meaning that all beds are occupied and there is overflow out into the hallways as well. For what they have to endure, Greek doctors are overworked and underpaid, but I was endlessly impressed by their dedication and passion. During my last week of shadowing, I took some time to reflect on some of the procedures.
With the universal healthcare system in place, patient treatment plans and strategies seem to be much different in Greece than they are in the United States. For example, there was one pneumonia patient who had been in the hospital for two months. This length of time might seem expensive to an American, but the cost was alleviated for her through Greece’s universal healthcare system. With this plan, the hospital is able to provide care even to the poorest patients. After all, it is often the poor population that requires healthcare most desperately. Lower-class Americans tend to be discouraged by expensive hospital bills, and sometimes do not receive care at all.
Another clinical strategy that stood out to me at the Greek hospitals was the sheer number of Cesarean sections that were performed. According to the World Health Organization, Cesarean sections made up 56.8 percent of all Greek births in 2017. In the United States, they are performed for 32 percent of births. A Cesarean section is medically necessary only 15 percent of the time. Performing unnecessary Cesarean sections is dangerous since it puts the mother at risk for placental accreta and death. These risks are most likely not presented to pregnant Greek women since many are quick to opt for a non-natural birth. The Greek system favors elective Cesarean sections because this procedure can be scheduled, which is almost a necessity in a busy hospital like Attikon. Additionally, the government profits more from elective Cesareans than natural birth or emergency Cesareans. It is a bit disheartening that the government cares more about money than the health of new mothers and their children. I only saw one birth at Attikon, and it was as traumatic for me as it was beautiful. The Cesarean section seemed so much more invasive in real life than I had imagined, and the incredibly long scar on the mother’s abdomen after the procedure was proof of this. Not only that, it was surprising to me that the father was not allowed to be in the room with his wife to witness the birth of their child.
As I shadowed in more departments, I soon realized that the treatment plan is not always up to the patient. In Greek culture, it is common practice to disclose information about a cancer prognosis to the patient’s family, who will then decide on the treatment. This process is backed by law. On one hand, if patients do not know of their terminal diagnosis, they can maintain a positive outlook and not become bogged down with stress. On the other hand, not disclosing the truth can strip the patient of his or her autonomy and choice. I see both sides, but I think that I would personally become frustrated if I did not know anything about my treatment or diagnosis.
In order to synthesize some of this information concerning Greek treatment plans, I researched the life expectancy averages for both Greece and the United States. The 2017 life expectancy for Greeks was 80.70 years. In the United States for the same year, it was slightly lower at 80.00 years. Obviously, life expectancy is contingent on many factors, but in general, healthier people live longer. The fact that the United States’ life expectancy is lower than many European countries could potentially suggest something about the flaws of the current American healthcare system.