Erring doctors deprived of right to work in Finland

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During the past three years in Finland, 21 doctors from territory of former Soviet Union have been deprived of right to practice as physicians or subjected to restrictions. Of these, lion's share have passed their medical exams in Estonia.

«We have information regarding doctors who have passed medical examination in Estonia, Russia or elsewhere in former Soviet Union and whom Valvira has stripped rights to work in Finland as physicians or has restricted it,» Postimees was told by Heidi Laurila, a jurist at the Finnish health care supervisor Valvira. During the past three years, 21 doctors have had to give up their practice due to that.

«Among these, doctors from Estonia are more than a half,» said Ms Laurila, choosing her words carefully. A moment later, she specified that the doctors carrying a University of Tartu diploma are 14.

The jurist said the reasons for the above were many. «A doctor may be deprived the licence when for health reasons he is no longer able to work as a physician and poses a hazard to patients i.e. he has a neurological or a psychiatric disease and his work capacity is reduced, he is addicted to alcohol or medicines,» she cited, stressing that for health reasons the licence is only withdrawn when the sickness is affecting work and the individual does not realise it does.

«A doctor uses methods of treatment which are not acceptable, has problems with diagnosis like fails to properly examine a patient or errs with prescribing medicines,» continued Ms Laurila to bring examples of professional slips possibly leading to deprivation of licence. Of professional mistakes committed, erroneous prescription of medicines is the most widespread.

«For instance, they might casually prescribe painkillers, antibiotics or even psychiatric medicines which can be misused,» said the jurist. She underlined this was not the problem of Estonia doctors only but something that is generally spread among physicians in Finland. Valvira qualifications of a doctor as such information regarding them is filed. «Anybody may notify us,» said Ms Laurila.

While talking about the Estonian doctors, the Valvira representative underlined these were single occasions. «It definitely cannot be claimed that we have problems with Estonian doctors,» she stressed repeatedly. There are about 25,000 doctors in Finland and during the three past years about 170 have had their licence withdrawn or restricted.

Health Board deputy director-general Üllar Kaljumäe said they have received information regarding four doctors from Estonia whose rights to work in Finland have been restricted. The discrepancy in data he explained by the information not having reached us yet. He said such doctors may continue working in Estonia as current law does not automatically extent to other EU states.

He added that no member state may publicly spread information regarding said restrictions nor  notify employers in the member state. «But Health Board does have the right to more carefully monitor these doctors in Estonia,» said Mr Kaljumäe.

The Health Board does not know why the Estonian doctors run into problems in Finland as pursuant to EU agreement they are only notified of the names and the content of the restrictions.

Also, Mr Kaljumäe said the case with Valvira are carefully investigated which may take years and lead to a conclusive decision. «Definitely not all cases of restrictions wind up negatively for the doctors and their licence may be restored,» he said.

While in many countries the law provides options for restricting doctors on basis of potentially insufficient physical or mental health and not professional inadequacy only,  the «Estonian legal space in health care is based on standards and infringements, not principles. There are lots of situations which cannot be treated purely as standards or infringements,» said the official.

In Estonia, Health Board may only suspend a doctor’s registration in case of failure to observe a precept, and only for a year max. Deletion from register in Estonia is only on basis of court judgement after investigation, for up to three years.  

According to Mr Kaljumäe, Health Board has temporarily suspended registration of doctors thrice, and the courts have at three occasions forbidden individuals to practice as doctors.

As confirmed by both Health Board and Valvira, they cannot disclose names of the doctors who run into problems while working in Finland.