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Old 01.09.2017, 22:11
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Does your insurance determines the experience of the doctor you get?

I'm moving to Switzerland soon, and I am trying to choose my family health insurance. I have read a lot of EF threads in the past days/weeks and somewhere I read that (I feel that it was in one of the "Things I wish I had known before moving here..." threads, but I cannot find it) your insurance determines the experience of your doctor that you get in the hospitals.

It was something like if you choose a more expensive option, you will get a doctor with 10+ years experience and not somebody who just finished his/her education when you are offered a specialist. The author stated that it it very important to put this into the equation. Now I read more about insurances, and I cannot find any proof of that.

Is it true? Unfortunately, I cannot find the relevant thread, but I am 100% sure it was on EF. Thank you!
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Old 01.09.2017, 22:51
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Re: Does your insurance determines the experience of the doctor you get?

this is probably about (semi)private vs non-private, which you can choose as supplementary health insurance.
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Old 01.09.2017, 22:59
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Re: Does your insurance determines the experience of the doctor you get?

Of course it is true that the cheaper your health insurance premium is the lower the standard of health care you can expect.

For example, if you require hospital treatment and have purchased only the very basic service, you'll end up being treated by some student who can't speak a word of any civilised language and has only just been able demonstrate that he knows the top from the bottom of an X-ray plate, and you'll be accommodated somewhere in a candle lit basement section where the patients must lie groaning with pain on blood soaked mattresses.

Those who aren't so cost conscious, and have subscribed to a higher level of service, may even be able to demand that the head surgeon deals with their treatment and have a relatively luxurious standard of accommodation.

The choice is yours.
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Old 02.09.2017, 00:17
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Re: Does your insurance determines the experience of the doctor you get?

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It was something like if you choose a more expensive option, you will get a doctor with 10+ years experience and not somebody who just finished his/her education when you are offered a specialist. The author stated that it it very important to put this into the equation. Now I read more about insurances, and I cannot find any proof of that.
I personally operate on the assumption that the majority of expats have only a vague idea of what they are talking about! Why? Because most of them are unable to read the documents they signed and rely on hear say rather than knowing what they actually signed up for.

If you are on basic insurance and need a specialist you will not end up with a junior doctor, you will get the on call specialist. Some additional policies do allow for selection of a specialist etc but if you read the small print you'll find it depends on the specialist being available when you go to hospital.
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Old 02.09.2017, 06:38
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Re: Does your insurance determines the experience of the doctor you get?

I have a very basic insurance but was operated on by a top nuerologist in an excellent hospital.
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Old 02.09.2017, 06:59
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Re: Does your insurance determines the experience of the doctor you get?

Where people like me.anon seem to get confused (and what he has posted is fear-mongering libellous twaddle - perhaps meant as a joke) is that if you pay more, you get greater freedom of choice of doctor. That is all. It does not mean that the doctors who treat you are in any way less dedicated, skilled or experience. If your condition merits the top specialist or the chief doc, then that's what you'll get.

If you pay more then your insurer permits you to apply to see the top specialist directly. Of course, he is not duty bound to see you. If not, then you need a referral. And if your doc things you need that, then that's what you'll get. Some insurers might argue whether it's necessary - and that's where the difference can lie. But it's the insurer that makes the difference; some are more awkward than others. I've been with Swica since I came here and have no complaints whatsoever.

If you pay more, then you'll be admitted into hospital as a private/semi-private patient. That usually means a room to yourself, rather than one shared with another 1-5 people (I've never seen a ward with more than 6 beds, and have spent sometime in one where I just had a roommate). It also may means the head doctor will pop by to see you. But head doctor is not the same as the best doctor for your treatment.

My experience is that there is no noticeable difference in the nursing care. Except in the public hospitals, your more likely to have a few English speaking nurses. On standard insurance, I've been treated by some highly trained and very experienced doctors.
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Old 02.09.2017, 08:16
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Re: Does your insurance determines the experience of the doctor you get?

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something like if you choose a more expensive option, you will get a doctor with 10+ years experience and not somebody who just finished his/her education when you are offered a specialist. The author stated that it it very important to put this into the equation. Now I read more about insurances, and I cannot find any proof of that.

Is it true?
No.
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Old 02.09.2017, 11:32
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Re: Does your insurance determines the experience of the doctor you get?

Thank you everyone for the answer! (I cannot thank them otherwise because I have not had 10 posts so far.)
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Old 02.09.2017, 13:22
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Re: Does your insurance determines the experience of the doctor you get?

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If you pay more, then you'll be admitted into hospital as a private/semi-private patient.
Again it depends if the rooms are available... I knew a chap about 10 years ago who had been paying private insurance for years, when he was admitted to the local hospital he discovered they did not offer private rooms at all! And in my local hospital priority is given to terminal patients regardless of insurance type, so it can happen that there are no rooms either.
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Old 02.09.2017, 13:34
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Re: Does your insurance determines the experience of the doctor you get?

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Again it depends if the rooms are available..and in my local hospital priority is given to terminal patients regardless of insurance type.
Is it like being offered, "Rooms to die for".... ?

It is a bit of a lottery really. If you choose a Professor Doctor Doctor (Germans and Austrians like to address people with all their titles) he might be the studious type, but with less practical experience, and the young doctor is happier to use the latest techniques he has just learnt at the university.

The safest approach is to ask your GP doctor to recommend someone.
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Old 02.09.2017, 13:48
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Re: Does your insurance determines the experience of the doctor you get?

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Again it depends if the rooms are available... I knew a chap about 10 years ago who had been paying private insurance for years, when he was admitted to the local hospital he discovered they did not offer private rooms at all! And in my local hospital priority is given to terminal patients regardless of insurance type, so it can happen that there are no rooms either.
Works both ways, my wife had a private room for the first two days since the shared rooms at the birth clinic were full already.

Personal note: I prefer shared rooms, a private room is just so damn boring eventually and even if I could stroll around I haven't seen hospitals here that are big enough with included stores/small malls, restaurants and everything to actually enjoy such for longer time.
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Old 02.09.2017, 14:26
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Re: Does your insurance determines the experience of the doctor you get?

My partner had pneumonia and was admitted to hospital. She shared the room with a woman suffering Alzheimer's disease.

Every time my partner coughed in the night, her neighbour switched on her bed light and said "Are you alright dear?" and then promptly forgot about it... this went on for a week....
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Old 02.09.2017, 14:34
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Re: Does your insurance determines the experience of the doctor you get?

You get what you pay for in terms of accommodation, but the actual medical care is pretty standard across the board.

I recently accompanied a friend to an appointment at the Bethanien Privatklinik and it's like a 5* hotel. https://www.klinikbethanien.ch/de/ I waited for her on the outside terrace and had a glass of wine whilst to listening to the resident pianist. Whilst the place is stunning, it was very weird seeing patients wheeling their drips out onto the terrace so that they could have coffee and cake. All quite surreal.
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Old 02.09.2017, 16:27
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Re: Does your insurance determines the experience of the doctor you get?

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It is a bit of a lottery really. If you choose a Professor Doctor Doctor (Germans and Austrians like to address people with all their titles) he might be the studious type, but with less practical experience, and the young doctor is happier to use the latest techniques he has just learnt at the university.
That is interesting what you are saying. I read somewhere an article about that younger doctors (with a few years of experience, so not completely beginners) are statistically better than older ones. I cannot find the article now, but I tried to look for research and I found this (Physician age and outcomes in elderly patients in hospital in the US: observational study):

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Conclusions Within the same hospital, patients treated by older physicians had higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients.
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Old 02.09.2017, 16:37
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Re: Does your insurance determines the experience of the doctor you get?

Don't forget the rusty knives...
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Old 02.09.2017, 23:14
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Re: Does your insurance determines the experience of the doctor you get?

I found the message that I referred to in the first post. It was in a completely different thread.
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Old 02.09.2017, 23:24
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Re: Does your insurance determines the experience of the doctor you get?

OP, I had/have private insurance in Germany and have basic insurance in Switzerland. If I ever have another operation due, I´d do it in Switzerland!
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Old 03.09.2017, 07:59
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Re: Does your insurance determines the experience of the doctor you get?

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I had/have private insurance in Germany
Well which is it? Have or had? If you are resident in Switzerland, why do you have insurance in Germany?
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Old 03.09.2017, 10:54
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Re: Does your insurance determines the experience of the doctor you get?

I think that mid career doctors are the best. Those with a good bit of experience, and keeping up with new techniques. I've said this in another thread, but a good measure is to ask how frequently the docs do these procedures.

When I first met the gyn who did my breast cancer surgery, I asked her how many similar surgeries had she done. Clearly no one has asked her this before and she was shocked. But it's a standard query in the US. So we worked out that it was at least one a week, she took no offense and she did a great job. The other question to ask a doctor is "would you prescribe this for a member of your own family with a similar diagnosis?"

So far in Switzerland, I've been lucky. And having basic insurance hasn't been an inssue. So far. Am going to have my knees replaced next year finally. Not looking forward to that though.
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Old 03.09.2017, 11:53
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Re: Does your insurance determines the experience of the doctor you get?

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I found the message that I referred to in the first post. It was in a completely different thread.
That was my post, from seven years ago.

I am of mixed mind about the issue now, given my experiences in the intervening years.

I live in an area with a shortage of medical care options, especially for specialist care. The local hospitals are... let's just say local and leave it at that.

I have had difficulties accessing quality care here, or accessing care in a timely fashion. Perhaps because there is more demand than supply, but there are indeed physicians who limit their practices to private patients.

Is this common throughout Switzerland? Who can say - as you have read, many EF posters have not had problems accessing care. I have indeed, and know several others who have as well. YMMV. I would venture to guess that in an urban area, where there are more doctors, one might not run into this.

What I have learned in the intervening years is that there are ways around the problem. As with every system, you have to learn how to navigate it.

I've written about this before but... when I needed surgery my GP suggested that it would be better to have the op done by someone other than the local doctors, and so was kind enough to arrange for the surgery to be done by a surgeon she trusted. Normally an external surgeon would not take basic patients but because of my GP's intervention he agreed to do mine.

So if you find you are unable to see the doctor recommended in your case, get your GP involved, often 'professional courtesy' opens doors. You might need to pay an extra fee, or you might get lucky.

I chose to upgrade the room to a single on the general ward, the cost was minimal, CHF 200 per night. One could even upgrade to the fancy private floor for something like 400 per night, but that seemed overkill to me. All I wanted was not to have to worry about disturbing roommates, as I had been told that the first night would be tough.

Upgrading the room depends on availability.

The downside to having only basic came when I was trying to find a second opinion before that operation. I could not get in to see any area specialist in a timely fashion. A private patient would have been seen more quickly, I was looking at wait times of 6 months plus. Because the surgeon who had agreed to do the op had limited time available and as he was doing this as a favor I couldn't push too much, so took the risk of not getting a second opinion.

Had I not had the time issue I probably could have found someone, somewhere, for a second opinion. Heck, my insurer offers a second opinion service, but again, that would have taken months to arrange.

Post surgery care was entirely in the hands of the nurses, I never saw a doctor in the hospital during my entire stay. So in this case, the question of inexperienced newbie or Chefarzt was moot - I wouldn't have seen a doctor no matter what my insurance level allowed.

Perhaps for another type of hospitalization it would make a difference; certainly if diagnosis was in question I'd want to see the more experienced doctors at our local hospital - and if I had to I would gladly pay to upgrade in that case.

If I am unable to see a specialist and the need is urgent, I go back home to see someone. With diagnosis in hand, things then tend to fall into place here in Switzerland more easily.

I've seen the difference between private and basic most starkly in rehab care; friends have very different post-op stories to tell based on insurance levels.

From a financial standpoint, given my health care needs I am probably better off with only my basic insurance, and then paying to upgrade as needed. Much would depend on the cost of your supplemental premiums. If private insurance is only a small increase I'd probably go for it. If you are paying close to a thousand per month, as some EFers report, I'd likely go with basic and pay for upgrades from the savings. Again, YMMV.

And of course much would depend on how hospitals operate in your area. The whole issue might be moot in your area.

As above, I was for years frustrated in my inability to access quality care in Switzerland, and indeed some of that was due to only having basic insurance. But once I learned how to better navigate the ins and outs of the system, I've mostly found ways around the issue. Key was finally finding a good GP. (That took many years.)

All the best with your decision.
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