ZOIȚANU, Dr Raluca
Romania : VDGM rep on WONCA Europe executive
What is it like to be a young family doctor in Romania?
It is not easy to be a family doctor in Romania, young or not. There are many disparities in Romania and especially health disparities. As family doctors we have the opportunity to be there for almost all patients in need, especially in rural areas where no other specialist is available and the emergency services can’t always reach patients in time. Unfortunately, due to bad decisions taken by the Government regarding financing of healthcare services provided through the National Health Insurance System, and lack of involvement of local authorities in supporting healthcare professionals in the community, health disparities are still very much a reality in Romania.
We mostly work alone, with just one nurse, and both doctor and nurse act as office secretary as well, answering phone calls and doing paperwork. It is not easy and not rewarding so it is no surprise that many family doctors are leaving the country. But we are constantly working to fix things, to make them better for our patients and ourselves. What governments often don’t seem to understand when they, hypocritically, say “we always put patients first!” is that when doctors suffer, their patients will suffer as well. A doctor in burnout, a doctor who can’t meet his own needs, will not be a very efficient doctor for his patients.
As a medical student I volunteered in projects designed to help patients in need and increase health literacy and education while also improving practical skills of medical students. I continued to do so later as a Family Medicine trainee when I also decided to join the Family Doctors’ Association in Bucharest (AMFB), my hometown and place of work. AMFB is organized as an NGO with voluntary membership and it is the professional association of family doctors in Bucharest and the surrounding area, Ilfov county. It is a member of the national professional association, called the Romanian National Society of Family Doctors (SNMF), a proud WONCA member since 1994.
How did you get involved with the VDGM?
Early on I realized that as family doctors we need to be more than just doctors. We need to accept our roles as leaders in the community and advocates for family medicine and for our patients. In 2010, with a lot of enthusiasm I accepted the role to lead the trainees department of AMFB - this gave me the opportunity in 2011, to meet with WONCA leaders of the time including, WONCA Europe President, Tony Mathie, and WONCA President, Prof Richard Roberts.
It was an eye opening experience which quickly helped me decide to apply for the position of National Delegate to the Vasco da Gama Movement
Council and thus to become involved in family medicine projects on a European level. Back home that same year, following the mantra “think globally, act locally”, I created the Young Family Doctors’ Group as part of SNMF, a group which five years later has 400 members and a core group of regional coordinators of nine young family doctors. Last year I stepped down as the VdGM Council country delegate.
When I joined VdGM it was a time of change in leadership, with a completely new Executive Group starting its term. In my first year in Council, Harris Lygidakis was just starting his Executive role as Image Liaison, a position I took over from him the next year, when Harris was elected President of VdGM. Big shoes to fill, because Harris had done so much in the Image Group in just one year, but with a great team around me we managed to do it.
It was such an amazing time to work together for a few years in the Executive with Raquel Gomez Bravo, Martin Sattler, Sara Rigon and many other young, dedicated, enthusiastic family doctors from all over Europe.
VdGM grew during our mandate over the 1000 members mark, organized a World Preconference in Europe, then its first Forum. Now, many of the young family doctors who helped VdGM grow are active members of WONCA Europe and the Member Organizations, working as hard as they did for VdGM. I see them every year in the WONCA Europe Council as representatives of their National Colleges, Organizations and Academies but also in the Networks – EGPRN, EQuiP, EURACT, EURIPA, Europrev. What a journey! And at the VdGM preconference in Copenhagen I saw many new faces of young family doctors who I am sure will grow into future leaders.
What is your current involvement in WONCA?
Last year in October in Istanbul I joined the WONCA Europe Executive Board as representative of VdGM. It is an exciting duty for me personally and a great acknowledgement for the Vasco da Gama Movement, which, eleven years after its birth, was last year accepted as a Member of WONCA Europe with a seat on the Executive Board.
In 2013 I was appointed by WONCA Europe to be the regional representative on the WONCA Organizational Equity Committee (OEC). A fantastic experience and the opportunity to work together with many great WONCA leaders from all regions. The Committee is working towards ensuring WONCA is a transparent and equitable organization for its members.
It is a very exciting time to be an active part of WONCA and in particular WONCA Europe. The organization is growing now in the direction of working with other healthcare organizations to provide better healthcare to our patients and improved working conditions and education to family doctors. The link with WHO is becoming stronger every year due to the big efforts and commitment of WONCA and WONCA Europe leaders. My home country WONCA Member Organization, SNMF, which every year since 2013, has run immunization awareness campaigns together with the WHO Country Office in Romania during the WHO European Immunization Week.
Every form of collaboration helps towards the goal of developing our specialty. For a few years between 2013-2016, I coordinated the e-health working group of SNMF and leading the creation of a position paper on the development and implementation of the Electronic Health Record in Romania. The position paper was given to policy makers in Romania in an effort made by SNMF to support a better legal framework for EHRs.
Another collaboration worth mentioning is the Social Media Compass guide, a collaboration between VdGM and EQuiP, which was shared by WONCA President Michael Kidd with the United Nations High Level Panel on Health Technologies earlier this year. I am a strong believer in the fact that by being proactive and using every appropriate opportunity we can push family medicine forward and improve the care we provide to patients. WONCA is the perfect place to collaborate and share our experiences.
What are your interests as a family doctor and also outside work?
My family doctor work in the office, caring for patients, takes half of my work time. I’m currently a part time family doctor in Bucharest and part time “activist” for doctors and patients in family medicine organizations. Last month I volunteered, as delegate of SNMF, to assist the current Health minister of Romania in improving the legal framework and financing for healthcare in general and primary care in particular.
So I would say my interests are health services organization, e-health, family medicine training, quality improvement. I am also interested in the doctor-patient relationship and how privatization of health systems is influencing this relationship. Too many managers and CEOs and too few doctors! Who do patients need the most?
Outside work I try to find time to enjoy nature and be physically active outdoors, because all my work keeps me mostly indoors and sedentary. Lately I haven’t been very successful but I keep on trying! I enjoy reading, travelling, spending quality time with close friends and family, learning from experiences and life stories. Guess I picked the right medical specialty then, as we always get to know our patients’ life stories as their family doctors.