EXCLUSIVE Dramatic appeal of a radiologist from Vinogradska: ‘This is a serious threat to patients!’

“We are addressing you with a strong sense of professional responsibility and deep concern about the new staffing and organizational circumstances at the Department of Diagnostic and Interventional Radiology of the Sisters of Mercy KBC, which in a very short time could have serious consequences for the continuity of the provision of health services, the availability of diagnostic and therapeutic procedures and, ultimately, the safety and health of our patients.

We consider it our professional and moral obligation to timely warn the Hospital Management, competent institutions, professional organizations and patient representatives of the seriousness of the situation. Our goal is to enable timely measures to be taken to prevent the consequences that we consider likely, and which are not the result of a lack of expertise, commitment or responsibility of healthcare workers, but rather a decision about which we repeatedly and unsuccessfully warned – they stated in the appeal, which we received from several sources.

Circumstances of the appointment of the Head of the Institute and previous warnings

– We believe that you are at least partially familiar with the circumstances of the election of the head of the Institute for Diagnostic and Interventional Radiology, including the cancellation of the previous competition, in which the competent election committee selected another doctor, and the implementation of a repeated competition, after which, by decision of the director, prof. Ph.D. sc. Diana Zadravec.

The circumstances of the cancellation of the first competition, as well as the reasons for making such a decision, in our opinion, have not been satisfactorily clarified.

Radiologists of the Tumor Clinic, interventional radiologists of the Vinogradska location and radiologists of the Traumatology Clinic repeatedly, individually and jointly, warned the Management of KBC Sisters of Mercy about the possible consequences of the re-appointment of prof. Ph.D. Zadravec.

We expressed our views in direct conversations with representatives of the Administration, but also in official writing, including an open letter addressed to the competent authorities of the Hospital and the Ministry of Health. Unfortunately, unfortunately with repeated warnings, we did not receive adequate guarantees for the protection of the professional integrity of employees or convincing solutions that would ensure the stable functioning of the Institute. Our concern is not based on personal disagreements or on non-acceptance of legitimate management powers, but rather; on concrete previous experiences, documented events and seriously damaged trust. Previous periods during which prof. Ph.D. Zadravec held the position of acting director or head of the Institute was marked by pronounced interpersonal and organizational conflicts, damaged working relationships and employee departures. The seriousness of the circumstances at that time is indicated by the official internal acts and court proceedings, including the legally binding second-instance verdict of the administrative court in Pula, the content and legal significance of which we consider important for understanding the current situation. Considering the above experiences, we believe that the Administration had to particularly carefully assess the possible consequences of re-appointing the same person, especially in the circumstances of the clearly expressed opposition of a significant part of doctors and other health professionals – they wrote in the appeal.

Re-appointment of Prof. Ph.D. sc. Zadravec led, he said, to the final loss of confidence of part of the employees in the possibility of continuing to work in a professional, safe and dignified working environment.

– Due to previous experiences and the absence of effective guarantees from the Management that employees will be protected from possible unfavorable treatment due to publicly and officially expressed professional views, part of the doctors made an extremely difficult decision to terminate the employment relationship.

‘Cancellations have been officially submitted’

At the time of sending this letter, the dismissals are already over. officially submitted and approved, and the notice periods have begun.

We especially emphasize that it is not a matter of hasty decisions or an attempt to pressure in order to achieve personal interests. Riječ is about decisions made after repeated attempts to find an acceptable solution, with full awareness of the consequences that the departure of experienced experts may have for the healthcare system. We expect particularly worrying consequences in the field of interventional radiology, including urgent, life-threatening endovascular procedures. For years, interventional radiologists of our institution have been participating in the care of patients with acute vascular and thromboembolic conditions, including procedures that prevent death, permanent neurological deficit, severe disability and other serious consequences of acute diseases – they stated in the appeal.

Such care cannot, they say, be replaced by a simple administrative redistribution of employees. It requires highly specialized knowledge, many years of experience, appropriate work organization and the availability of an educated team.

– Već are two interventional radiologists on notice period, because of which there is an immediate danger that within approximately three weeks part of the interventional procedures available so far will no longer be possible to provide in the existing scope. We especially warn about the possible consequences for patients who need urgent endovascular treatment, where any delay or additional transport may be decisive for the final outcome of the treatment. We consider it imperative that the Administration and competent authorities determine without delay how to ensure the continuity of these services, who will provide them, and what organizational measures will be taken to prevent endangerment of patients.

We are equally seriously concerned about the future of radiological diagnostics in the Tumor Clinic, especially for patients with breast and rectal cancer. Over the years, we have developed and established highly specialized diagnostic algorithms and a monitoring system for oncology patients, which in certain segments exceeds the usual organizational standards of the public health system.

Our work is not limited exclusively to performing diagnostic tests. We continuously monitor patients’ needs, update lists of expected check-ups, provide additional appointments and adjust work processes in order to provide patients with timely and continuous diagnostics. We make a special effort so that our oncology patients, despite due to the large volume of work and the complexity of diagnostic procedures, they would not be forced to seek the necessary examinations outside the public health system. Employees and, in the part related to the availability of health care, the interested public are informed in a timely manner about the measures taken and the planned solutions.

We especially emphasize that with this letter, we inform the competent authorities in a timely manner of the risks that we have recognized and to which we are aware. repeatedly warned. We believe that after such warnings, possible disruptions in the provision of health care should not be presented as sudden or unforeseeable circumstances.

“Further action is now in the hands of the Hospital Management”

We want to avoid a situation in which the seriousness of the problem will be recognized only after the patients feel its consequences – they state in the appeal.

In conclusion, I would like to point out that this letter is not being written lightly.

– Behind us are years of professional work, numerous demanding diagnostic and therapeutic procedures, built professional teams and, above all, thousands of patients to whom we tried to provide the best possible health care. Leaving the system that we have helped to create and improve for years is an extremely difficult professional and personal decision for us. Nevertheless, we believe that professional dignity, mutual trust and the possibility of working in a safe and stable work environment are fundamental prerequisites for quality patient treatment.

Our biggest concern is not the consequences this situation will have for us personally, but the consequences it could have for patients who depend on the availability and continuity of health care. We still believe that there is a possibility of a reasonable, responsible and timely solution. For this reason, we invite you to actively get involved in finding it and, with your authority and action, help preserve professional teams, the availability of health services and everything that we have built together over the past years.

Further action is now in the hands of the Hospital Management. If he wants to maintain professional teams and continuity of health care, it is imperative that he convenes a meeting with representatives of the organizational units without delay. After our past experiences, we no longer trust promises and verbal guarantees.

We demand that the Administration, in consultation with the heads of services, within three days of receiving this letter, reach a consensus on the optimal solution for the urgent restructuring of the department, protection of patient safety and preservation of continuity of health care. Within the same deadline, the agreed solution must be delivered to us in writing, with clearly defined measures, implementation deadlines and responsible persons, with a written guarantee from the Management that the agreed measures will be implemented within the specified deadlines.

The decision and the written guarantee must be available to the public. It is the Management’s responsibility to enable dialogue and take the necessary steps in this short remaining time – it is stated in the appeal signed by the doctors of the Department of Diagnostic and Interventional Radiology of the KBC Sisters of Mercy, Department of Oncological Radiology.