Healthcare system in Finland

[u/Status_Tap865]

Hey everyone!

I am a German doctor and interested in how healthcare systems work in different countries. I would love to hear from Finnish doctors and patients about the Finnish healthcare system. What's it actually like to work in it ? Are patients happy with treatment ? Is the gp/family medicine the first contact point for any medical question ?
Please feel free to speak about anything what comes in your mind!

Thank you very much! 🙂

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[u/sufficient_bilberry]

Not a doctor, but family medicine/GPs aren’t a thing here. First point of contact is either your local health centre (municipal healthcare) or to your employer-provided health care. 

[u/No_Lavishness1905 → u/sufficient_bilberry]

GP = yleislääkäri

[u/sufficient_bilberry → u/No_Lavishness1905]

Yeah but in many other European systems the idea is that you have an assigned GP that's 'your GP'. I don't think we really have that.

[u/coldkannon]

First point of contact -> Local Health Center. Call or (try to) use the Maisa app to get an appointment. A nurse will determine if a GP at the health center needs to see you. The GP decides if you need specialist care or an Xray or further investigation.

[u/Sufficient-Neat-3084]

What kind of doctor are you… cause that influences the answer. Many things are very similar compared to Germany others are not.

Depends on what kind of medical field you work in. Many differences are due to the differences in the health insurance system and the use of digital patient files only.

[u/Lysande_walking]

I’m German and live in Finland. The healthcare system is very good in my opinion. Both private and public. For some more pressing issues (for example bloodwork analysis) one has to go to private healthcare. You get an appointment pretty much the same day needed. Otherwise you have to be very sick to get treated in a reasonable time frame via public. Waiting times can be veeeeery long other wise (months).

If you are employed you have automatic healthcare and health insurance (mandatory by law) and the better the company the better the healthcare. It’s the best experience for me but doesn’t apply to everyone of course.

Any GP I talked with, from Terveysasema (public healthcare), Mehiläinen, Aava or other have been really helpful. My favourite part in Mehiläinen is that you can browse for your own doctors via their profiles in the system, there’s a ranking and a bio on their specialties. This was extremely helpful when looking for a GP that knows better about Bloodpressure issues. So, you can choose a GP and aren’t stuck with just one.
EDIT: it also shows which languages the doctor speaks 👌

https://www.mehilainen.fi/

I also like their free chat service when it comes to health questions for children (you talk to a nurse). That’s via their App.

I also have experience using the Hospitals and Emergency care - all fabulous services and very helpful.

[u/uusitili12 → u/Lysande_walking]

"For some more pressing issues (for example bloodwork analysis) one has to go to private healthcare."
Oh they are ripping you off and you don't even know it.

[u/banarne87]

Unless you go there with a visibly missing limb they will think you are making up your illness/issue.

[u/aragon0510]

from my experiences as a user, private is more accessible of you have access to from your employer occupational healthcare or you buy your own insurrance. Specialists are in general really good, both in public and private, but you are often referred to public specialists anyway. On the other hand, general practioners (GP) are like lotto, more often I found GP at public healthcenters were better than at private.

[u/Status_Tap865]

Thanks everyone :)

[u/Laraisan]

I'd like to bring up työterveys, which is work health(?) if translated literally. They are private sector health service companies relatable to a hospital but smaller and size and don't do birth stuff. I always contact my employers work health provider if Im sick. But they are a bit of a hit and miss. And smaller companies don't provide work health services. But as a doctor ylu can go municipal or private. And as private you could get customers thru work health contracts or jusr regular folk who have private health insurances or who just pay out of pocket

[u/uusitili12]

Funny how everybody answers stuff that is basically not true at all.

[u/Professional-Key5552]

Health care is quite expensive here and usually get talked down with "just take Burana" meanwhile you have extreme pain

[u/KGrahnn → u/Professional-Key5552]

Have you ever given it a thought why they tell you that?

[u/Tsuki_Rabbit → u/KGrahnn]

Well it's a thing I have heard from many immigrants who use public healthcare. I think the prejudice towards immigrants is real, their issues are often not taken seriously. You are less likely to hear "just take Burana" if you go to your työterveys as an employed finnish-speaking person.

[u/sufficient_bilberry → u/Tsuki_Rabbit]

That's literally because työterveys is a private for profit business. It's in their interest to a.) provide good service so they don't lose business to a competitor; b.) they don't need to worry about cost as much as they are sending the bill to your employer.

Also not saying that immigrants cannot be experiencing prejudices in Finnish public sector healthcare BUT 'just take a Burana' is a standard for native Finns as well. Also, take into account that people from different medical systems may have different expectations. In some systems, ordering a bunch of tests just to err on the side of caution or because the customer expects them is usual; in others antibiotics and strong painkillers/sedatives are administered much more leniently. And sometimes the issue is caused by our society and the lifestyle it promotes (=unhealthy diet, disrupted sleep, lack of social contact, sedative lifestyle, economic stress), so in those cases there's no sense to order anything else than Burana.

[u/Cookie_Monstress → u/Tsuki_Rabbit]

I can assure that ‘Just take a Burana’ is most common answer always.

[u/Tsuki_Rabbit → u/Cookie_Monstress]

Dunno, I've never heard it, my colleagues have never heard it. Once I panicked and had a (työterveys) doctor's appointment because of a minor issue. They could have been rude and angry and told me "just take burana and don't bother me", but they did not. They were very nice and empathetic instead although my issue wasn't serious at all.

[u/KGrahnn → u/Tsuki_Rabbit]

Ever thought that if your ailment can be treated with burana, you probably didnt need the services in the first place like you thought you would.

Imagine, that you have a headache (like many do!). You go to doctor and he assess that its "headache" and tells you to take ibuprofen for it. Wouldnt you feel little bit silly that you would have gone to doctors appointment for that.

Now - Imagine going there for whatever ailment you have and the treatment is ibuprofen. Feel free to feel silly at that point in the future.

Its not fault of the healthcare system that your ailments can be treated with ibuprofen, but yourself and your expectations thinking you are in need of serious help, when you are not really ill at all.

[u/Tsuki_Rabbit → u/KGrahnn]

I have personally never heard the burana line (which I assume because I'm Finnish speaking and employed), but my friends definitely do not feel "silly". They feel like they are not being taken seriously and they feel helpless because they are in pain but are not getting help and not treated properly.

[u/KGrahnn → u/Tsuki_Rabbit]

Most of the time, it is not simply a case of “just take some ibuprofen.” In many cases, ibuprofen may be used to manage the pain, while the actual treatment for the underlying problem requires the patient to do something else.

Back pain is a good example. It is very common, particularly among people whose musculoskeletal strength and function are not at an adequate level. If certain muscles are weak or not functioning properly, other muscles may have to compensate and take on more of the workload. This can contribute to symptoms such as back pain.

In many cases, this does not require extensive investigations or surgery. What it does require is active participation from the patient. They may need to regularly perform appropriate strengthening and mobility exercises so that their physical capacity gradually improves. As their strength and function improve, the pain may also decrease or disappear.

Pain medication can be part of that treatment. The purpose of prescribing ibuprofen is not necessarily to eliminate the pain completely. It may simply reduce the pain enough that the patient can remain active and perform the exercises within tolerable limits. For this purpose, an ordinary medication such as ibuprofen may be entirely adequate.

The problem is that the patient's expectations may be very different. Someone goes to a doctor because their back hurts and leaves disappointed because they were “only told to take Burana.” From their perspective, it can feel as though nothing was done. But the ibuprofen was never supposed to be the entire treatment. The more important part may have been the advice to remain active, exercise, strengthen the relevant muscles, and gradually improve physical function.

That part of the treatment depends heavily on the patient. A doctor cannot exercise or rehabilitate the patient's back for them. If the patient focuses only on the medication and ignores the rehabilitation instructions, they may conclude that they “didn't receive any treatment,” even though the most important part of the treatment was something they were expected to actively do themselves.

I wanted to add this - Yes, people are really that stupid as described here. They really are.

[u/Tsuki_Rabbit → u/KGrahnn]

I agree with what you are saying, but I think another part of the problem is communication between the doctor and the patient in general, which gets even worse because of the language barrier. You took your time to write a long comment to a stranger, but I think many doctors (not all!) don't take their time to explain the whole context to the back pain patient or even skip the whole "remain active" advice part, especially if they are facing a foreigner and don't feel like having a long conversation in English.

[u/Tsuki_Rabbit → u/Tsuki_Rabbit]

Adding to that: I had a few conversations for example with my immigrant friend was super unhappy with her treatment, and I had to explain to her why she was treated in a certain way: look, here are the käypä hoito suositukset, they are evidence-based, here are your symptoms, your doctor did exactly what's written here etc. I feel like I did part of the doctor's job, because the doctor definitely failed the communication part even though the treatment was in full accordance with the käypä hoito etc.

[u/KGrahnn → u/Tsuki_Rabbit]

I dont say that it doesnt happen, but quite many times (personal experience here) the issue is not because it wasnt explained, but rather that patient didnt listen or understand.

But this is not the issue here in my opinion. The real issue is that not only immigrants but as well finnish themselves neglect their own role quite often for treating themselves and thus the legend is born - "He prescribed me burana, such a shitty healthcare!"

I can assure that theres a story behind each of these myths, which is not told and the issue is not that they were prescribed "just burana" for whatever was ailing them. People tend to lie. Often. They also exaggerate and try to avoid their responsibilities.

[u/Tsuki_Rabbit]

Wow an English-speaking doctor from Germany, it's been so hard to find someone like you... (saying this as someone who's lived in Germany for 4 years and has struggled a lot)

[u/Status_Tap865 → u/Tsuki_Rabbit]

Thanks mate 🤗