Medici fara frontiere

According to an article from the Romanian newspaper Evenimentul Zilei translated in the wonderful Czech resource Transitions Online:

Between 10 and 20 percent of Romanian doctors under 35 years of age are leaving their home country every year, according to an estimate by the Romanian Doctors College (CMR), the country’s main professional medical society. They head chiefly to the United States, but in the past several years increasing numbers have chosen France and Germany, countries that are opening their hospitals to foreign workers due to the lack of local specialists....

Paul Doru Mugur, 34, a native of Romania's second-largest city, Constanta, has been working as a doctor in New York since 1996. He heads the oncology and hematology department in a public hospital. In 1991, during his fourth year of university, he left Romania for France on a Tempus scholarship awarded by the European Community. He finished his studies in Paris.

“I've had the opportunity to get to know three medical systems very well: the Romanian one--a tribal system characterized by influence, bribes, and the mentality that the doctor is a small god; the French one--a bureaucratic system characterized by a rigid administration where the doctor is a clerk; and the American one--a business-based system where our patient is our client and the doctor is a businessman,” Mugur said.

In 1983-84, when a single pack of Kent cigarettes could magically change a bureaucratic nu to a da, doctors required a whole carton--or a bottle of imported whiskey, or a kilo of imported coffee, or the like. The only people who actually smoked the Kents received in bribes were said to be doctors or security officials. Everyone else just used them to bribe someone else up the line. Once, an older man who had struck up a conversation with me during a long train ride offered me a cigarette from his open pack of Kents. I didn't have to ask who he worked for.

Fortunately, those days are long gone. Bribes are now in convertible currency rather than in bartered goods.

In Romania, as a beginner, you’re not allowed to touch the patient because then the patient doesn’t know which doctor he should give the envelope with the cash to.