They offer you 3,000 hands for the job; there are none I want yet: doctors are no longer disappointed even by an impressive salary.

Jurgita Sejonienė, a member of the Lithuanian Medical Movement, told Delfi rytas how to deal with this situation and what is the mood of the doctors who have weathered various waves of coronavirus.

– Doctors have endured a pandemic for almost a year and a half, not a single wave of coronavirus. In what states of mind is the medical community living today?

– In the COVID-19 pandemic in particular, it has certainly been a great challenge for the health system and, of course, for everyone who works, especially those who have worked directly with COVID-19 patients, because it really is a I work very hard. Difficult patients, they need a lot of care and of course all those extra things like special clothing didn’t really add medical satisfaction to their job.

Fatigue is really felt and it should be noted that a significant number of doctors leave some medical institutions, even dozens, precisely because of fatigue.

Secondly, there is the problem that indeed, especially in the periphery, a large proportion of workers are older. They, too, are determined to solve the problems in their lives and just quit their jobs.

The problems that existed before, before the COVID-19 pandemic, namely medical fatigue, doctor shortages, unsatisfactory working conditions, appear to be exacerbated by the pandemic.

– Business today looks at the lessons learned from the pandemic: share good and bad examples. And the health system? Did we learn something good or did we just highlight the problems?

– And yes, and so on. In fact, the problems I already mentioned have arisen: both the lack of doctors and the availability of medical care in general, which is unsatisfactory and uneven across the country. On the other hand, it also taught good lessons: it showed that the support hospitals that organized the work in the regions were well placed to deal with this.

It will probably be a step towards restructuring the structure of services, not institutions, in a country that we have been talking about for years, but it seems that now we have good examples, and the time has come.

– Are there changes in the health system that have been affected by this pandemic today?

– There are changes even in the legal framework. The Seimas passed a law that will make it easier for medical institutions to organize their work so that they can connect with each other and have multiple stakeholders. This, of course, will facilitate the organization of services: more complex services should be taken over by larger treatment facilities, which obviously have more opportunities and more experience.

On the other hand, it could help to solve the problem of the shortage of doctors, especially specialists, when they are not even willing to go to work in the districts, not even for 3,000 euros. Such a model of organization of services, rotation of specialists, visits, telemedicine consultations could really help to solve the provision of services to the residents of the districts.

Going back to remote counseling, doctors from various fields (oncologists, cardiologists) are sounding the alarms that people are not dying from coronavirus, but from neglected chronic diseases. What is the current situation?

– In fact, COVID-19 disrupted the normal and smooth transition. Telemedicine services, teleconsultation are really good when applied when needed. There really is no need to abuse them, and a significant number of patients actually need contact services.

I think that some of those services should remain, when appropriate, when it is possible to help the patient over the phone, to write the same prescription. However, during the first wave, planned medical services were scaled down and due to that great confusion, reports that some hospitals were indeed overcrowded with COVID-19 patients, so they simply could not physically provide services to patients with other diseases and patients. They themselves feared that hospital health facilities are the place where COVID-19 can be infected, it has been stopped.

On the one hand, the availability of services was limited and, on the other hand, the patients themselves were afraid of going to medical institutions.

Oncologists, cardiologists, and other professionals are now warning that services are currently unrestricted. Second, we now have a new patient registration system: it took a while, not everything went well, not all institutions joined the system in the same way, efficiently and quickly, but the situation is better now. Both professionals and I urge patients to stop immediately if they have any complaints, chronic illnesses, if they have new symptoms and to seek medical attention.

– With regard to the coronavirus, today we live quite calmly. But everyone is looking forward to the varieties in Europe and looking forward to autumn. Are doctors psychologically and physically ready for another wave?

– Clever. That’s the job. If there are more of those patients again, the doctors will just go and work. The situation is also alleviated by the fact that subsidies are paid to those working with COVID-19. But, of course, doctors do not expect or want to have another wave of this type.

The varieties are really spreading and we cannot be consoled that everything is fine in Lithuania at the moment, because the situation may suddenly change. However, these strains do not cause more serious forms of the disease.

Second, the example from the UK itself shows that the incidence is higher in younger people, who are generally stronger, have fewer comorbidities and therefore seem to get sick more easily. They get sicker than older people who are at higher risk of getting sick or dying.

The situation, although quite calm, still requires vigilance.

– Educators already say that when working conditions worsen, some people are already thinking about leaving work. What do the doctors say?

– Unfortunately, not only do they talk, they do it too. Some institutions, as I said, have lost dozens of employees precisely because of more difficult working conditions or because of their retirement age, because it is too difficult for them to work.

That problem was in Lithuania even before the COVID-19 pandemic: the uneven distribution of healthcare professionals, the fact that the system employs more women and more elderly people, especially the lack of nurses. It has been many years trying to solve that problem.

I don’t know why people lose their jobs during a pandemic. I understand that in health care in general, as in education, the work is hard: and the patients are hard, work hours, stressful, psychologically and physically exhausting.

Many people choose to study healthcare, medicine and nursing, but why they do not want to work in Lithuania, work in the regions, even though the living conditions and salaries are really motivating, is a mystery. I believe that the task of the Ministry of Health, the Government and the Health Affairs Committee of the Seimas is to convince these people that it is possible to live and work anywhere in Lithuania.

I understand young people and their ambitions: Larger healthcare institutions have greater opportunities for professional development, especially for highly qualified individuals. However, it should be understood that people are everywhere and not only suffer from diseases that require highly qualified treatment or special diagnostic equipment, or the like. There are different people, they have different diseases and it is necessary to provide that medical care in the most uniform way possible in all countries.

– But if doctors are not attracted to smaller cities for higher salaries or supplements, what could be the raisin that would seduce them?

– First, we must make use of the residents’ competencies model, which is already in its infancy and is gaining momentum. A resident who has acquired certain skills certainly does not have to pass a residency in some third-level institution, a hospital. You can also make sure you have your skills and work fully in a second-tier health care institution.

It is really necessary to expand the number of residence bases. I think it would also be an incentive for young people, if they succeed there, if they fit into a team, if they form social ties and then stay there.

Second, as I already mentioned, the same model that was organized during the COVID-19 pandemic – the provision of medical care – and after COVID-19, if a regional, regional and support hospital were organized, it would turn it back into easier to ensure medical rotation.

There is no need for a healthcare professional to drive and live somewhere seven days a week. Enough to come at that time. Some professional services are in such a need that you should work there full time, and there are none. The days when it is needed, when there is a need, it would be much easier to organize.