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Health in Luxembourg“If you earn as well a living in the practice as in the hospital…”
ETTELBRUCK – New medical director of the Center hospitalier du Nord, Jean-Marc Cloos looks back on the difficulties of recent months and discusses the challenges to come.
A maternity hospital closed for several months for lack of paediatricians, six cardiologists who resign… The Northern Hospital Center (CHdN) went through a zone of turbulence in 2022. For its new medical director, Jean-Marc Cloos, calm has returned. “Maternity works and meets needs”, he assures, thanks to the collaboration with the CHL via telemedicine.
On the cardiology side, a specialist has been appointed coordinator and two others are “being recruited”. The resigners agreed to stay until the end of March. For the future, they have committed to ensuring that their practice is available to support the hospital, via quick appointments, or the possibility of being called.
Guards not valued enough
“Enough to ensure the continuity of care both at the hospital and outpatient level”, notes Dr. Cloos, according to which a hospital the size of the CHdN needs at least three doctors per specialty. “A group of specialists who leave has already happened to other hospitals”, tempers Dr. Cloos, who however calls for reflection on a question: “How do we keep medical professions in the hospital who do not ‘don’t need the hospital to exercise?’
He thus observes a “paradigm shift” with doctors seeking a better balance between professional and private life. Major problem: the guards, who would not be valued enough for the specialists on site. “Guards from a certain age become very restrictive. In Luxembourg, they should stop at 55, but so far it is around 60 in all hospitals. Young people should be found to do it, but with adequate remuneration, ”said Dr Cloos.
“It’s a problem when hospital life bursts into private life. If you earn your living in the practice as well as in the hospital, doctors make their choice. If the hospital wants to remain attractive, it must respond to these changes. Offer crèches, be compatible with family life…”.
Shortage of specialists
If the “diversity of work”, the multidisciplinarity, or the premises remain attractive at the hospital, the medical director judges the “administrative burden which weighs on the doctors more and more important. A job that is not valued enough”. For example, he points to the remuneration of a coordinating doctor (130 euros / hour) lower than the 144 euros recently set for psychotherapy or the 245 euros during the Covid crisis. “On average doctors are well paid, admits Dr. Cloos, but it varies greatly.”
Geriatrics, psychiatry, gastroenterology: shortages of specialists are numerous. “All hospitals are looking for it,” insists Dr. Cloos, who stresses the importance of the University offering a master’s degree in medicine in Luxembourg as soon as possible. To date, only a bachelor’s degree is possible. Another challenge is to train doctors in all specialties where there is a shortage. “The United must get involved”, assures the medical director of the CHdN, who underlines that around a third of Luxembourg doctors who train elsewhere do not return.
For Jean-Marc Cloos, the great challenge of the Hôpital du Nord is to continue to build a basic public health network capable of treating the population of the North. Its future will therefore also depend on the philosophy of doctors. And the CHdN has its strengths, according to its medical director, who describes a hospital “with a human and family dimension appreciated by patients. It is their hospital, the hospital of the people of the North”.
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