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„The Physician Should Have Blond Hair And Blue Eyes“
Minors regional and cultural
studies: the medical staff in
Hamburg; © UKE
MEDICA.de spoke to Leonore Boscher, managing director of the International Office at the University Medical Center Hamburg-Eppendorf (UKE), about multicultural nursing staff, Russian buckwheat groats and added revenues.
MEDICA.de: Ms Boscher, the patients in your ward pay the clinic thousands of Euros. That gives them an exquisite status. How do you prepare the nursing staff?
Leonore Boscher: In fact our patients pay - in the Arabic countries it is often the governments who bear the costs - starting from 5,000 Euros up to 300,000 Euros for the services of the clinic. Our employees are trained in good manners by a self-employed lady who has worked for many years in a luxury hotel. However, not only the staff of the international ward but all our hospital employees practice with her because customer focus is generally very important to us.
MEDICA.de: How do you prevent the international patients from getting a culture shock in Hamburg-Eppendorf?
Boscher: Our team is multicultural and speaks many languages, for instance English, Russian and Arabic. The patients are picked up at the airport, we have 800 televisions and of cource an islamic prayer room. In the lounge, Al-Dschasira is shown on the flatscreen, drinks and fruits are offered. The patients get a personal caretaker and can decide about their menu themselves. The range of choice includes typical foodstuffs such as Russian buckwheat groats or kosher meals. Furthermore we are more flexible than other wards: the Russian and Arabic patients do not get up before nine or ten o'clock. Thus, on this ward late breakfast is no problem.
MEDICA.de: Nevertheless, problems or misunderstandings occur certainly every now and then.
Boscher: No, actually everything runs smoothly.
MEDICA.de: Completely trouble-free in such a mixed ward seems impossible though. Everybody who has been living in other countries knows that.
Boscher: Well, especially the Arabic patients are accustomed to more luxury than we do offer them. In their home countries they often have two or three nurses at their command, and they expect suites of 50 square metres. Of course that is impossible in Germany. Usually, they do accept this quickly though. Also, the disclosing of the diagnosis is often difficult. Arabic and Russian families do not want the patient to get informed if he suffers from a serious illness. They wish to protect him. That means with the consent of the patient we first talk to the family. The relatives prepare the patient gently. We are in the tricky situation then that we have to give the patient drugs with heavy side effects or even have to operate him without telling him clearly what he has. Instead of „You have cancer“ he is told „You have an ulcer that grows quickly and has to get out". That is a balancing act between German law and foreign culture.
MEDICA.de: Do you need kind of an intercultural mediator on your ward?
Boscher: No, the medical staff is responsible for that, too. Our employees have to be well versed in the different codes of behaviour and take part in special trainings. In these, they learn about cultural and religious, but also political and economical differences. For example the separation between men and women has to be observed strictly: female staff may not shake hands with an Arabic man. After knocking at the door the staff has to wait, so that the Arabic women have time to wear their headscarves. And there are politicial disputes: Azerbaijan and Armenia are countries that have a tense political relation. An Armenian patient can therefore never be matched with an Azerbaijanian translator, even though they both talk the same language. On purpose many of our nursing staff have an immigration background so that they know the culture of their patients already. The exact oppsite holds true for our physicians. They best should have, talking exaggerated, blonde hair and blue eyes. The physician necessarily has to be German as the patients associate the medical quality with that. Otherwise they get the feeling that they just as well could have stayed at home.
MEDICA.de: That sounds nearly as if the service was more important than the medical quality.
Boscher: No! We are a hospital, no five star hotel. Many come here because they are severely ill. Then the luxury element looses importance anyway. Others who come only for check-up or due to less serious diseases indeed wish for more than medical quality only. For those, we sometimes organise a complete programme including shopping and sightsseeing. Service in this case is equally important as medical quality.
MEDICA.de: Social health insurance patients lie in a loud shared room while the nurses wait on the Arabic patients hand and food. How does that fit together?
Boscher: It fits together because the revenues finally inure also to the benefit of the social health insurance patients. We are not a hedge fund that enriches private persons. Hospitals today face the problem that they have high expenses but only limited income because the tax payer does not want to pay ever higher insurance premiums. With the additional revenues, we can employ urgently needed personell, and the raised number of staff can in return take better care for all patients.
MEDICA.de: Does your service go to such lengths that the foreign patients get an earlier date for surgery than the social health insurance patients?
Boscher: No, God heavens. For us, a stomach carcinoma is a stomach carcinoma, no matter whether sheik or homeless person. The medical quality is the same for everyone. Only the service is different. The international patients pay out of their own pocket for the costly treatments and operations, and for their money they expect smooth procedures and a stay as pleasant as possible.
The interview was conducted by Anke Barth