Holistic Fast-Track Treatment - A Paradigm Shift For The Established Health System?
Apr 12, 2011
In the last decades, working as a doctor in big public University Hospitals, you have been more forced into the exercise of treating the health system in reducing the cost for treatments (“producing” as many patients to the lowest cost as possibly), than helping the individual patient back to an optional mental or physical health as possibly. This has partly happened because of the increased amount of patient by the longer lifespan with older people with special needs and increasing demands of being active in leisure or sport without pain, the need of being young as long as possibly together with the many scientific proven offers of new medical treatments for even rare and expensive diseases. These increased demands have collided against the limited budget. We have reached a point where the tax paid funded treatment, is gradual replaced by health insurance and privately funding. I am all aware, that this economic political point mainly goes for the Scandinavian countries, but the conflict in the increasing medical offer and demand is universal.
To increase the numbers of patients, we have changed a hospital into a factory, where we in the orthopaedic world have invented the smart term FAST TRACK treatment. The patients are operated Monday or Tuesday and returned to home latest Thursday or Friday the same week, reducing the stay on hospital and postoperative rehabilitation from 10 to 2 days. Some clinics shut down for the weekend and the poor patient is sitting alone with pain, swelling and anxiety alone in their apartments. We have observed how some patients in despair seek the needed help in public emergency rooms or doctors on call. The fast-track concept is cheap and cost effective but for some patients difficult to deal with. The concept has benefits in both the surgical and anaesthetic technique but disadvantages in the postoperative management and care of the patient.
Several weeks later, they will start for the needed training and very often they have a sick leave for 3 months, if not retired.
Holistic approach by medical health tourism.
Our concept is developed in the cold and rainy Denmark with the highest taxation in the world but with the happiest people? Our clinic is placed in the International House in Copenhagen, which is only 5 minutes drive from Kastrup airport, and 5 minutes walk to train and Metro going to downtown. Our hospital and rehabilitation centre is located in Alicante in Southern Spain, 3 hours flight away, but 10-15 degrees warmer.
In the Copenhagen Clinic we examine the patient for the medical indication for operation, and medical fitness for flight and operation abroad and even do the follow up, when the patient has returned.
We have specialist in hip- and knee replacement as we here use as an example, but we have senior doctors in urology, general surgery, eye surgery, gynaecology and plastic surgery. For patients who are admitted for same day surgery, the patient and spouse must find a hotel themselves, but we pay for the transportation and are helping in reducing the cost for the patient by negotiating special prices on hotels.
In our concept we take a flight from Copenhagen to Alicante and will be picked up by a bus to the famous and prestigious hospital USP San Jaime in Torrevieja. This hospital is 10 years old and placed close to the salty lakes, which are very healthy for the skin and airways. WHO have appointed the area to be the healthiest in the world.
Our team is composed of doctors and nurses from Scandinavian, educated and speaks the language of the patient, but English and some German as well. We have interpreter for the relation to the Hospital administration.
Basically the operative treatment will be the Fast Track, but three days after the operation, we will drive the patient to a Wellness and Recreation Centre with Spa, in-and outdoor swimming pools, fitness centre, relaxation rooms, and here we will complete the physiotherapy in 10 days. The spouse is included in the concept. This rehabilitation centre is owned by a Norwegian couple (www.akinoncenter.com) which is very keen on creating a relaxing atmosphere.
The above mentioned Fast Track will be garnished with 10 days rehabilitation you’re your spouse, full transportation and half board for two and individual and specific exercise for the patient. There is focus on mental health and healing for higher awareness, healthy food, Feng Chui in the facilities, spa and wellness with sound and aroma therapy. We have daily rounds to monitor the improvement.
Copenhagen – a definite better total outcome for the patient
After the patient has returned to Denmark, they are able to continue the daily exercise by the instruction they have got from our rehabilitation centre without further help from public rehabilitation centres. By the end of second month after operation, we make sure that the patients are doing well and give the last advice and help. The same doctor makes the preoperative assessment, operate the patient and do the follow up, with all the comfort in mutual language, cultural background, familiar food and intense rehabilitation in the warm, dry, sunny climate.
In average the price for the patient, in need of a hip or knee prosthesis in a private hospital in Copenhagen, will be about 12.000 Euros for 2-4 days hospital stay, but we do the whole concept with the spouse included in Spain all together for 2 weeks, at the same cost level.
The price is obvious reasonable, but the medical benefits are significant. Danish citizens suffers in big numbers of D-vitamin depletion, but with the sun in Spain with better D-vitamin formation, improve regulation of sleep and mood depression disorders , cancer prophylaxis, sclerosis prophylaxis, rheumatism relief, diabetes regulation, better rebuilding of bone with decreased risk of osteoporosis and fracture, improve immune stimulation with less infections. All this together with a rehabilitation programme after Fast Track treatment, gives a better total outcome. And the patient will be able to work or sports much faster than after the traditional treatment. Both the scientific evidence for doing a joint replacement for arthritis is on level B, which is the same scientific proof we have for saying that this holistic concept is significant better than the traditional fast-track treatment.
Can you imagine a better treatment and possibilities for patients with daily ailments as stress or burnout, cancer disease, dialysis or others in this concept? Special for patients from northern cold countries.
About the author:
Jørn Boel, MD, Senior Consultant Orthopaedic Surgeon, Hospital Medical Director, borne in Denmark 1953 and educated in the National University Hospital (Riget) in Copenhagen where he worked as associate professor. Consultant Orthopaedic Surgeon in Dhahran in Saudi Arabia and University Hospital Tawam in UAE, University Hospital in Helsingborg in Sweden, Nuffield Private Hospital in Lancaster.UK. Since 2005 owner of the Spanish Clinic: “Clinica Internasional Ortopedia” (www.laclinica.eu), which is based in the Scandinavian Shopping Centre in Torrevieja in Spain and in International House in Copenhagen in Denmark together with the Swedish group “Ostelenkirurgin” which treat patients in the private hospital in Simrishamn (www.osterlenkirurgin.dk), as a part-owner. Written articles and lecturing about health, sport and quality control by computer monitoring.