‘Some say “Czechoslovakia”, some say “Czech Republic”. We Czechs are not as well known as Germans or English so to simply say you’re from Europe saves you a lot of explanation.’
Barbara shrugs her shoulders, smiling at me. The answers I receive to the question ‘Do you feel European?’ are idealistic at times, occasionally a bit politically correct. Barbara’s answer seems to fall in the category ‘pragmatic’. Her practical view of Europe began to take shape at an early age. ‘My father worked in East Berlin in the eighties, so I spent my school years there. It was a nice time, actually. It was nice to be abroad and to learn German.’
It was an interesting time as well, I guess? The Iron Curtain was still firmly in place at that time.
‘Actually, my father worked for the embassy, which meant we could freely travel to West Berlin. It was special. Many of my classmates had relatives in West Berlin but when they came to visit, they weren’t allowed to bring any newspapers or music – no “bad influences”’ Barbara explains, air-quoting the words. ‘So I would always take the wish lists of my classmates when going to West-Berlin, bringing back Western records.’
Can you remember which ones?
‘It’s a long time ago, but probably Deep Purple, Led Zeppelin. Maybe some AC/DC.’ Barbara grins.
There’s a bit of rock chick hidden somewhere beneath the refined doctor’s exterior.
After she finished high school, Barbara went back to Czechoslovakia to study medicine. When she was pregnant with her first child, she decided her hard work and many night shifts at the hospital’s maternity ward were not for her anymore. She opened her own paediatric office, one of the first private practices in Prague at that time. Today, she juggles medical work with co-ownership of Canadian Medical Centre, a private practice housing over a hundred specialists.
You opened your practice after the velvet revolution because it wouldn’t have permitted before then?
‘Correct. Before, it wasn’t possible to open a private office in Prague. It wasn’t constructive either, working as a general practitioner. Back then, it was a very administrative position with a lot of paperwork. General practitioners were basically there to send patients through to specialists, they didn’t do much themselves. That’s why back then, it was much more rewarding to work at the hospital.’
I have spoken to many doctors in Eastern Europe, and have learned that it used to be customary to pay doctors in cash, under the table. What was it like here?
‘We call it the grey economy. Unfortunately it’s still the case.’
Barbara smiles. ‘Yes. Most of the hospitals in Prague are state hospitals, led by the municipalities. In these hospitals, you will find doctors who are very good, but don’t have the time or motivation to give the patients that extra attention. So in order to get special attention, many patients pay the doctors extra, cash-in-hand. I don’t agree with this, it’s not a good system. Here at the practice we make the specialists sign contracts. This way the patient does have the option to demand extra service, but has to pay for it legally.’
It’s not a good situation to have to negotiate with the man or woman who’s making you better.
‘Right, but unfortunately during the communist days, salaries were quite low and all at the same level.’
Is that still the case?
‘Well, we’ve been living in a capitalist system for over twenty years, there are already differences in salaries. If you compare the hourly rate of a car mechanic with the wage of a doctor, the mechanic earns a lot more.’
Well, they’re car doctors, right?
Barbara smiles. ‘I know, I know. But you can imagine the doctors feel stupid. Doctors earn a lot more than before, especially if they work overtime. But when they get their cars fixed and see what is charged, they feel stupid.’
Barbara’s dark wooden desk is half covered with paperwork. On the other side there’s a small cast-iron statue of a horse, next to the file punch. The desk is placed diagonally so Barbara sits in the corner of the room, wedged in between the two windows overlooking Prague. As we talk, our voices echo against the high, ornate ceiling.
Do you cooperate with colleagues doctors throughout Europe?
‘We do, but only through our patients. If a Dutch patient comes in that has his or her own doctor in Holland, then I’m more than happy to cooperate with that doctor in Holland when something needs to be solved. Also, we have a specialist in the Great Ormond Street hospital in London. But it’s not like we have certain clinics or hospitals that we call our partners.’
Do you feel European?
‘Yes, I do’, Barbara smiles as she shifts her position. ‘I’m very keen on the idea of Europe even though there are some things that not everybody agrees with. Like making everything uniform, or the administration in Brussels which is quite big. But these aren’t life threatening things. In general, I like the idea.’
‘It has opened our world, and it has changed the world for our children. And at the end of the day it’s much better to be a part of Europe, than to be part of the Soviet Union’, Barbara chuckles. The dark frames of her glasses and somewhat flimsy shawl around her neck make her seem a bit prim and proper. But then a sparkle lights up her brown eyes, and just for a moment I catch a glimpse of that teenager smuggling LPs across the Iron Curtain.
You studied during Soviet times. Is the medical education better now?
‘I hope it’s better, because in the past there was a lot of political studying, we had to learn about Marx and Engels. We also had to study the Russian language. Not so much English and German; Russian was the main foreign language. I found it a bit old-fashioned. Very strict, no freedom for the students. No freedom to choose whatever, now you have a lot of freedom as a student. You can choose your subjects, choose to work alongside your studies. Before there was not much difference between the high school and the Uni. It was the same strict system. Now, the system is much better.’
Because by giving the students the opportunity to choose, they become better doctors? You teach them how to think, maybe.
‘Exactly. Before, it wasn’t possible to study abroad, only members of the communist party could do that. So if you weren’t a member, like me, you couldn’t even apply for a study abroad.’
How did the EU change your work? I guess there are more regulations?
Barbara takes a deep sigh. ‘Well… probably there are, but some regulations are very necessary.’
Can you give an example?
‘For example regulations on the quality in the clinics and the doctor’s office. The hospitals are obliged to be audited regularly and get certificates for the quality of their work. The outpatient clinics and private practices are not obliged to do this, which means they only rarely have a certificate. We went through the procedure of getting a certificate, and it cost us a lot of time and money. That’s why people didn’t get it, there’s no regulation forcing them. That’s why I think equal regulations in Europe are a good idea.’
Is there such thing as ‘European’ today? There’s an economic union, but what is it that binds us?
‘I think it’s the history and the culture which make us unique and which should also bring us together. Unfortunately we can’t be proud of every part of our history, but overall we have a legacy and culture to be proud of.’
(interview by Mark, written by Sophie Moerman)