Healthcare systems are organized differently in different countries. In this article you can learn how to use various medical services in Poland.
NFZ and health insurance
The National Healthcare Fund (Narodowy fundusz Zdrowia, NFZ) is a governmental institution that finances medical services. Not every Polish resident is entitled to healthcare – the insurance is dependent on one’s employment. If a person has a job within a work agreement (umowa o pracę) or an order-based contract (umowa o zlecenie), their employer should pay their insurance fees. If a person is registered as unemployed in the Labour Office (Urząd Pracy), then the Labour Office pays their insurance fees. The fees are received by the NFZ and the person becomes eligible for NFZ-based medical services.
A person who is unemployed and not registered as such in the Labour Office, who wishes to use medical services, can either be listed in NFZ insurance of their relative, buy private insurance or buy the voluntary NFZ insurance.
Primary healthcare services (Podstawowa opieka zdrowotna, POZ)
Primary healthcare services include:
- general practice doctors and pediatricians – these are the doctors whom you could visit in case of any health problems. They can give a referral for a specialists’ consultation and for primary medical tests. They can make treatment plans for basic healthcare problems and prescribe non-specialized medication.
- nurses – primary care nurses can give shots, take samples for laboratory analyses, conduct prophylactic tests and provide nursing and rehabilitation services, especially for people with mobility related disabilities.
- midwives – they provide care throughout pregnancy, educate on planning pregnancy, birth and parenthood, provide post gynecological surgery nursing care and take samples for cytological tests.
- school nurses – they are responsible for school healthcare education, prophylactic actions, and providing pre medical first aid.
Primary healthcare services also include:
- night and holiday healthcare departments – providing first aid, consultations, signing prescriptions, doing shots and providing nursery services during weekends and official holidays and at night (6pm to 8am) from Monday to Friday.
- medical transport – transporting patients on the basis of a general practice doctor’s referral from the place of residency to a healthcare facility.
- certain diagnostic and screening procedures – the full list of them can be found at the NFZ website (https://www.nfz.gov.pl/dla-pacjenta/informacje-o-swiadczeniach/podstawowa-opieka-zdrowotna/).
How to access general practice doctor?
In order to make an appointment with a general practice doctor or a pediatrician you need to call or visit the clinic (przychodnia), at which you have filled out the declaration (deklaracja). The declaration is, in short, a specific document you fill out to express that you plan on using healthcare services at a certain clinic. You can fill out the declaration in person at the clinic you choose or online via Patient’s Internet Account (Internetowe Konto Pacjenta, IKP). The second option requires a trusted profile (profil zaufany).
If setting an appointment in person or by phone is inaccessible/uncomfortable, then you’d need to find a clinic which offers making appointments by email or via booking form. Some clinics offer to book appointments via an online calendar (you can find out about them at the specific clinic), however the calendars can have restrictions, e.g. only allowing you to make one appointment every three months. A consultation for which an appointment was made at the clinic/by phone would usually happen the same day or the next day. This process can vary depending on the clinic.
In order to use nurse’s or transport services, or to make lab tests, you would need a referral from a general practice doctor. So when you want to check your blood iron level or get injections from a nurse, for example, you first need to make an appointment with the general practice doctor.
Using medical services at night and holiday departments does not require appointments. If you need a medical service at night or during weekend/holiday, you can find the nearest or a specific night and holiday department (via maps application or NFZ website), come over there and act according to the staff’s instructions.
Immediate risk to life or health
Emergency phone number
The European emergency number is 112. This is the number you can call when you need an ambulance, paramedics’ aid, or in case of any other emergency. First thing you need to state upon calling is your location, as precisely as possible. This way, in case the connection breaks off, the receptionist will know where to send the ambulance. After you’ve stated the location address, you should explain what the situation is – the symptoms, their intensity, what had led to them. The emergency number receptionist will ask you various questions and then decide whether it’s necessary to send aid. If they decide that the emergency crew is not required, they will most likely instruct you to go to the nearest or a specific hospital emergency department.
Hospital emergency department (Szpitalny oddział ratunkowy, SOR)
Hospital emergency departments are those places where one goes when they need an immediate medical intervention that can’t be provided at a night and holiday department or the latter is closed. The SOR staff can make resuscitations and emergency surgeries. They can put a cast, diagnose an injury, run laboratory tests in critical situations, etc.
When you come to a SOR, you need to take a place in the line (usually by taking a ticket from a specific machine) and wait till they ask you in at the reception desk. The reception worker then conducts an initial interview and assigns you a color. Red color means that the situation is urgent and requires immediate intervention. Other color is green, which stands for a stable case. You then need to wait for a doctor to ask you to come in. Waiting time can be very long, up to 12 hours or more, especially if the situation is labelled as stable.
Specialized medical services
The category of specialized medical services includes those more complex tests and consultations with doctors with specialization other than general practice care (e.g. psychiatrist, endocrinologist, dentist). Specialized medical services are provided based on referrals. So in case when you, for example, need to see an ophthalmologist (eye specialist), you first have to make an appointment with the general practice doctor, ask them for a referral; then use the referral to make an appointment with the specialist. You can make an appointment with specialist in the clinic where you have signed the declaration or in any clinic of your choice. A referral can have an annotation “urgent” or “stable”. The waiting period for a specialist consultation is generally long and it could be several months even for the “urgent” referrals. For example, allergologist consultations are usually booked around six months ahead in Warsaw, and the wait for an MRI could take a year. It’s worth it to check which clinic can provide the service quicker – one of the platforms where you can do it is one of the NFZ.
Gynecological and psychiatric consultations are two exceptions from the referral system – referrals are not required to make an appointment with these specialists. You can make them at the clinic’s reception, same way as in case of general practice doctor.
Most medications in Poland are prescription based. The prescription system applies to antibiotics, contraceptives and day after pills as well. Any doctor could write a prescription for these medications. Specialized meds, such as psychotropes or steroid medication, can usually only be prescribed by the specialists. However, a general practice doctor could give follow up prescriptions for such meds if a specialist issues a document permitting acquiring prescriptions from other doctors. So if you regularly take meds prescribed by a specialist, it’s important to ask them about such a document – it could come in extremely handy when you can’t book a visit with them for whatever reason.
Things to remember
Remember that if a doctor disrespects you, rejects your demands for information about your health state or treatment plan, or just generally treats you in a way that makes you feel uncomfortable, you have a right to change the doctor. If you feel that a medical professional violates your patient or human rights, it can be worth it to file a report to the hospital administration – it can help prevent similar situations from occurring again in the future, whether it’d be with you, or with the doctor’s other patients.
Considering the long waiting time for medical services, preventing diseases appears to be especially important. So if it’s only possible, it’s important to conduct regular health checks, e.g. blood morphology or cytology. It’s also worth it to save up money for hypothetical private healthcare services, if you can, so that in case of NFZ’s inefficiency when you require urgent aid, you can get it in a private clinic.
Get it done with us!
Making a doctor’s appointment isn’t always as easy as explained in this article. Do you have questions about the Polish healthcare system? Do you need aid with requesting medical services? Contact CPC!
In the time of coronavirus, our Help Center for Foreigners will help you remotely! Send an e-mail to: [email protected] and briefly describe your problem. If you want us to contact you quickly, you can also send us your phone number – it will make communication easier and shorten the waiting time for our response.
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