Prof. Gencho Nachev, Executive Director of St. Ekatherina University Hospital: Physicians who extort patients should go to prison

- Prof. Nachev, the Bulgarian Medical Association proposed amendments to the Criminal Code, stipulating 15 years of imprisonment for severe physical injuries inflicted to doctors. Do you support this idea?
- Yes, I do and I believe this should have been done long ago. However, I would like to draw attention to something else, too. Regretfully, attempts have been made recently to demonise the work of doctors. They are depicted as corrupt and people remain with an impression that profits are the only driving force for physicians. This is not true. People who study medicine love their profession and are willing to work overtime for the sake of their patients. Money is not their foremost objective. The fact that there are cases of doctors racketeering patients for BGN 100 in cash once again shows that our system is detrimental to both patients and doctors. I believe there should be clear regulations on which doctors could be chosen by the patients. In this way, there will be no ceiling on the money payable for choosing a medical team. Forms and ways to punish racketeering will also be found. Currently, artificial norms are being created which are afterwards violated by paying money “under the table”. It is absurd to think that we have dealt away with corruption in this way.

- How should the choice of a medical team be regulated, according to you?
- First, the management boards of individual hospitals should decide which physicians could be selected and patients to know from the price lists of the respective hospitals how much they will have to pay for their choice. For example, patients should not be forced to pay if there are only two doctors at a certain medical establishment and the choice to be made between them. I believe that in like stipulating 15 years of imprisonment for attackers of physicians, doctors racketeering patients should also be sent to jail and this must be stipulated in the Criminal Code.

- How many years in prison should be the punishment for doctors who racketeer patients?
- It may start from three years probation for a first-time offense, three years in jail for a repeated offense, and reaching up to 10 years for a third offense.

- A few days ago, it became clear that there had been only three donors of organs in 2011. Where do you see the reason for this?
- The reasons are complex. First, there was tension between local coordinators and the Executive Agency for Transplantation. One of the major problems is that potential donors are not submitted in time, while where this was done they were either not suitable or could not be coordinated well enough.

- Who should organize the process you are talking about?
- This is a prerogative of the Executive Agency for Transplantation. The experience of national consultants, of the most prominent surgeons and of intensivists in the respective medical area should be used. If there is evidence of a potential donor, regulations should be adopted about who should be informed about the case, should the patient be transported to the Transplantation Coordination Centre, etc.

- The money earmarked for transplantation for 2012 has been increased, but will it be sufficient?
- Of course, it is not. The money for healthcare is not sufficient anywhere in the world. Currently, the money earmarked for a heart transplantation is BGN 60,000. This money would suffice only in case everything goes on very smoothly and the patient can go home on the 20th day after the surgery. However, this is rarely the case.

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