Nacional journalist with Miladin Djordjevic Miladin Djordjevic, a 54-year old medical specialist and Deputy Director of Cardio, Thoracic and Vascular Surgery of the Klagenfurt Provincial Hospital, has found himself in the spotlight in Croatia after certain media announced that he was most likely to succeed Ognjen Simic, the cardiovascular surgeon who was arrested for taking a bribe. Djordjevic is a top specialist who has lived and worked in Austria for the past 15 years. The fact that he has lead 140 of the most demanding heart operations suggests that bringing him to the Rijeka Clinical Hospital would mean bringing a specialist able to train a whole new generation of cardiovascular surgeons.

Djordjevic conducted his first heart defect operation as a 17-year old under his future boss and mentor Vinko Franciskovic, and this was one of the main reasons why he decided to study medicine. Djordjevic began his medical career in 1977 after graduating from Medical School in Rijeka and beginning his surgical internship at the Susak Hospital in Rijeka. After 10 years of working in Rijeka and after passing his specialist's exam in general surgery, in 1986 he accepted an invitation from Dr. Ninoslav Radovanovic Djordjevic to come to Sremska Kamenica for a specialization in cardiovascular surgery. In addition to this, from 1978 to 1980, Djordjevic was also in specialization on invasive cardiovascular diagnostics in Ljubljana under Dr. Ivo Obrez. After completing his cardiovascular surgical training, Djordjevic wanted to return to Rijek and run the cardiovascular surgery ward. Despite the fact that then director of Rijeka Clinic Hospital Zarko Tomljanovic wanted him, he never returned to Rijeka. As he himself says, his appointment was to be decided by the higher political instances. When he learned that the position was also being offered to Ognjen Simic, he decided to give up on Rijeka and go to work in Austria instead.

“In May 1992, when I finished my specialization and was ready to return to Rijeka, I learned that there were several people from the top political ranks against my appointment as the head of the cardiovascular surgical ward. This made me give up on returning to Rijeka. That same year, well known Austrian cardiovascular surgeon and head of the European Academy of Science and Art in Salzburg, Dr. Felix Unger, awarded me a scholarship and after 6 months, a job at the cardiovascular surgery clinic in Salzburg,” said Djordjevic. He worked in Salzburg for over 8 years. In 2000, he spent two weeks in Klagenfurt, which left a good impression on him, and where they wanted him to join their team. Then head of the ward, Dr. Wolfgang Wandschneider, offered him a specialist’s position and in 2001, Djordjevic transferred to the Landeskrankenhaus Hospital in Klagenfurt. When Wandschneider became head of the ward in 2003, Djordjevic became his next in line. “Though I had excellent working conditions in Salzburg, Klagenfurt was a great step forward in my medical career. In this hospital, between 400 and 500 heart operations, 300 lunch and 600 to 700 vascular operations are conducted each year. To compare, in Rijeka and the entire Istria region, only 250 to 300 operations are conducted each year,” said Djordjevic.

Though he is very pleased with his work in Klagenfurt and holds the status of one of the best experts in the region, Djordjevic says that it is a great honour to be mentioned as a possible successor for Simic in Rijeka, but that it is still too early to discuss. One motive for a possible return to Rijeka is his family, who he sees only twice a month and who he misses more and more as the years pass. Djordjevic’s wife, Jelena Roganovic, is a well known oncologist at Kantrida Children’s Hospital and professor at the Faculty of Medicine in Rijeka, and many consider her to be a top specialist in her field.

“Both my wife and I are doctors and we have organized our life so that we do what we love, and help in the education and upbringing of our children. Oftentimes, it’s difficult to be far from my family and friends in Rijeka, though I am very satisfied in Klagenfurt and Austria is my second home. This year, my son Luka will enrol in medical school in Italy and my 13-year old daughter Ana will be going to Italian school in Rijeka,” says Djordjevic.

Though he admitted having been in contact with current director of Rijeka Clinical Hospital Herman Haller, Djordjevic said that they spoke privately. He is well aware of the chaotic situation in Rijeka and commented that this is the state in the whole of Croatia’s health care system. “There is no need to generalize and to automatically accuse all doctors, to make them all equal. I am aware that this case will seriously threaten the credibility of the Croatian health care system, but I’m sure than 90% of doctors are conscientiously doing their job, helping patients and putting their work first,” said Djordjevic.

He immediately added that he has never taken money for treatment and operations and that he would never even accept money as thanks for his work. While he worked in Rijeka in the 1980s, there were several attempts to bribe him, but he believes that this is criminal and that patient care and health are more important than any financial gain. Djordjevic says that no one is ‘vaccinated’ against taking bribes, and that it varies from person to person just how much they are willing to risk their reputation and career for a few thousand euro. There was also a case in Austria where doctors was reported for taking money and all the doctors were so humiliated that they were unable to ever find work in Austria again, or in any other recognized European clinics.

“There are black sheep in every herd. I’ll mention one case in Austria. A doctor who performed more than 2000 operations in his career and saved thousands of lives was convicted of taking a bribe. Only a few people in that case stated that they felt required to give money and because of those 12 people who testifies against him, he lost his job, reputation and entire career that he spent 30 years building. Is there any point to risk everything you’ve worked for your whole life for an insignificant sum of money,” asked Djordjevic?

Djordjevic is certain that following Simic’s arrest, new people will step forward and confirm that Simic demanded money from them for operations, as well as other citizens speaking out about other doctors taking bribes. The main problem in Rijeka and all other Croatian hospitals, according to Djordjevic, is the long waiting list. He says that the waiting list for a heart operation is several months, and this is the main reason why people offer bribes – in order to get their loved ones medical help sooner. He is convinced that if waiting lists were cut and patients knew they could get an operation in two to three weeks, there would be no need to give bribes, though then doctors couldn’t additionally charge for their services.

“The wait list in Austria is 3 to 4 weeks. I have heard that patients are forced to wait 6 months to a year in Croatia, which is unacceptable, given that these are patients requiring urgent care and treatment. Perhaps this case will clear up the situation in Rijeka and the authorities will realize that they can approach patients in a different way and reorganize the health care system,” Djordjevic says. He added that the main problem in Croatia is the small number of new cardiovascular surgeons capable of independently leading complicated operations. Experienced doctors are doing too little to educate younger colleagues and therefore, he claims that this is the reason why there are only 300 and not 700 operations a year, a number that would be optimum for the region.

“We have interns and even students assisting us, in order to get them acquainted with the basics of heart surgery at the very beginning. Specialists begin to operate under our supervision and over time, their knowledge is expanded and with that, the share of the operation they can do independently. Over 2-3 years, we train several doctors in Klagenfurt who are then ready to operate on their own,” said Djordjevic. He stressed that there are a number of experts in Croatia who could work anywhere in the world, but that medicine is not as attractive as it used to be and interest in studying medicine is dropping.

“Young people today are realizing that they can earn good or better money with much less stress and are deciding to study medicine, as it takes up a lot of time and energy not only during studies, but also later, especially during the specialization phase. This is a very stressful job and that’s why we doctors have to protect our profession and we mustn’t permit anyone to put a blemish on it,” said Djordjevic.

Though in the beginning of our conversation, he denied the possibility of returning to Rijeka, we asked him again what conditions would have to be offered to return to Rijeka Clinical Hospital and whether the financial reasons were the only ones preventing his return. “Money isn’t everything. I do this job because I love what I do, because there is no greater reward than when I help my patients and I’m sure I did a good thing. I would love to return to Rijeka, but it would have to be an appropriate offer. Money really isn’t the priority. Considering that I wasn’t planning to return to Croatia, we’ve organized our entire family live in a way that we cannot allow less earnings that what I have here in Klagenfurt. One of the conditions would be to allow me to work freely and with colleagues I trust, who I could train to one day conduct the most complex heart operations independently. Here I am the assistant head of the ward, and only head of the ward in Rijeka would interest me – I wouldn’t accept anything less than that. It may seem to some that I am not humble and that my requests are unrealistic, but I have been building my career for 30 years and I know what it takes to do this job right. Money isn’t most important, but I have my standards and I will not go beneath them,” said Djordjevic.

Even if he doesn’t return to Rijeka, he says he is open to all forms of cooperation, as he knows that he can help and use his knowledge to positively get things rolling in Rijeka. His wish is to help the city in which he attained his name and reputation. However, it will be up to the health care officials to make him an offer that will satisfy both him and the hospital and which would mostly benefit the patients.

.>email to:Ante Mihic