Healthcare in Portugal – the views of two doctors

To better explain what a foreigner seeking healthcare in Portugal can expect, the Resident spoke with two doctors practising in the Algarve.

Healthcare systems differ from country to country, which makes it difficult for a foreigner to understand how it works in Portugal, where there is a public and a private system.

Although it is up to each patient to decide which hospital or clinic to go to, it is important to consider some aspects. The system is not transversal, and information is not shared; patients must take responsibility for holding on to their test results and, if possible, their entire medical history. This way, it helps the process and allows doctors to be aware of all details relating to the patient’s health.

Lisbon-born Dr Paulo Sousa moved to the Algarve in 2008 to take up the position of Clinical Director at the HPA Private Hospital Group. He is also the president of the group’s Medical Council, which means he is responsible for coordinating the whole team.

From a young age, he knew he wanted to be a surgeon, help others and save lives. He went on to become a specialist in General Surgery, Proctology and Surgical Oncology.

When he finished his specialty in the capital, he worked in a National Health Service (SNS) hospital for around four years, but the “unattractive working conditions” led him to take a new direction and embark on what, up to this day, has been “a great challenge”.

He came to the Algarve to develop “an exciting and appealing project” that was still in its early stages, at a time when private healthcare provision was growing in the country. He already had some experience in the insurance industry and an understanding of clinical management and services, due to having worked for more than 10 years for an insurance company.

Dr Paulo Sousa

Dr Paulo Sousa

Dr Paulo Sousa

Experience in teamwork, costs and conflict management have certainly helped him to develop his position in the hospital, but there are other pressing challenges he has to deal with, such as attracting doctors to work in the Algarve, away from the metropolitan areas where the majority of them spent their academic years. “My hardest job as a Clinical Director is to find ways to attract health workers to the Algarve,” he recognises.

He recalled that initially there were only 70 doctors performing a total of 1,000 surgeries per year, numbers that have now increased to 870 and 20,000, respectively, which brings him face to face with another challenge: “To create the working conditions that professionals need to ensure everything runs smoothly, with patient safety always at the forefront.”

Quality, safety and closeness in the doctor-patient relationship are the benefits of private healthcare, says Dr Paulo Sousa, who reveals that, every three years, HPA Group’s policy and facilities are monitored by the largest hospital surveyor, the Joint Commission International, a US-based accrediting body for healthcare facilities, as well as Portugal’s health regulatory authority.

What sets HPA apart from the others, reveals Dr Paulo Sousa, is how patient information is handled, which makes healthcare provision much easier. “We are the only group that has a single and transversal network, always ensuring confidentiality and good practice, thanks to intrusion protection systems,” states the doctor, admitting that the system used at HPA should be an example to follow in Portugal, advocating an integrated health system as already exists in other countries.

He believes that the best way to avoid duplicate services and costs to both public and private systems would be to integrate both through health data sharing, thus avoiding two completely separate systems running in parallel.

Dr Paulo Sousa

Dr Paulo Sousa

Dr Paulo Sousa

The same vision is shared by Dra Joanna Karamon, General Practitioner and Clinical Director at the Luzdoc International Medical Services Network, with clinics in Praia da Luz (Luzdoc) and Lagos (Medilagos).

Born in Poland but raised in Durban, South Africa, she moved to the Algarve in 2000, having only visited the country once before. Since 2001, she has been working in the clinic where she is now responsible for Medical Management.

She is living proof that taking risks and moving to another country should not be overthought but, instead, it should be a “heart and soul” decision. That’s what she learned from her parents when they moved to a country where they didn’t speak the language, know the culture or have family members, but yet they still believed it was the best decision.

“That same spirit of resilience and being able to cope with anything life throws at you was also very much part of the South African culture and that has been my motto too,” she shared with us.

As soon as she arrived in Portugal, she fell in love with the country, culture, weather, food and people, highlighting that “the feeling of open space here is much more palpable than in other European countries and that made the transition easier”.

Portugal “has everything”, she says, suggesting that “if you want the sun and the sea, you should live in the south; on the other hand, if you prefer slightly cooler temperatures, you should live up north”.

Even though the physical adaptation felt effortless to her, due to the ease of life, the outdoor lifestyle and security, a downside was bureaucracy, which she still finds complex to deal with as Portuguese services are “slow and not always organised”; however, she believes “that is changing”.

Becoming a General Practitioner was motivated by the fact that she grew up surrounded by medical objects, as Joanna’s mother was a paediatrician. Her good school grades and keen interest in science planted the seeds for success in the medical career.

Although her position as Clinical Director is fairly recent, she says she feels confident and focused on making sure that “quality healthcare is assured, and patients are happy”. Her perspective is that “management is based on having a lot of common sense, practicality and a plan”, reinforced by “a practical approach to a solid scheme”.

She works full-time as a GP, seeing a heavy patient load a day, which makes finding the time to juggle everything her biggest challenge. Nowadays, her biggest affirmation is having the opportunity to treat the children of the children she saw and treated when she first started working at Luzdoc, which gives her “a great sense of fulfilment”.

Much like Dr Paulo Sousa, Dra Joanna also defends a transversal approach to public and private healthcare, “using a platform with all patient records directly uploaded to their file, with all doctors having access to it”.

While people assume European countries all have the same health system, she refers to the importance of explaining to patients that each one is different and, in Portugal, private and public “don’t mix”, there is no information sharing as happens in the United Kingdom, for instance, where she worked while she waited for all the formalities that enabled her to officially practise here to be completed.

As a final note, both doctors recommend that those who opt for private healthcare, and don’t have access to the European Health Card, take out health insurance which is “essential” and helps with the costs, something most foreigners living in Portugal already do.


Portugal Resident