Burn Baby Burn

So I have noticed that many building in Copenhagen share a similar past: fire. I feel like on almost every tour I have been on, I hear or read about an all destructive fire.

"....and then in 1728 Copenhagen burned down in the largest fire yet..."
"...in 1808 fire destroyed the original castle, which was then restored by..."
"...the Royal family moved to this castle while the Christiansborg Palace was rebuilt after the fire..."

Get this: the Koldinghus Castle fire was re-enacted in 2008 to mark the 200th anniversary. Really? I think the Danes know enough about what fires look like. They do not need to be reminded.

Danes, meet fire extinguisher. Fire extinguisher, meet Danes. Finally.

Cultured

So this is the final post for our short study tour, and I think it might be useful to show you a map of where we went. Please note that we covered all of these distances in a few short hours or less, back and forth. Denmark is small.

Copenhagen to Vejle to Rødding to Ribe to Odense to Kolding to Jelling to Copenhagen

We spent the first night in Ribe, the oldest town in Denmark. And when I say oldest I also mean the quietest. It was tiny and quaint but nada was going on.
In Odense, we went to he H.C. Anderson Museum. He wrote The Princess and the Pea, The Ugly Duckling, and The Little Mermaid.

Humble abode where H.C. was born

Ok to be honest one of the best parts of this day was this:

We also toured the Koldinghus, yet another castle. It was built in he middle of the 13th century, burned down in 1808, and was then rebuilt. Typical.

Random: there was Beatles exhibit

Then we went bowling, but I will spare myself the embarrassment and not post pictures of the knee hight socks and bowling show ensemble I was rocking, or the fact that my score was half of my friends. I blame Somersby cider. 


Our final stop was in Jelling, which is pretty important historically. It is where the first King of Denmark, Gorm the Old, is buried. The Jelling Stones, the main attraction of the small town, were carved in the 10th century and mark the start of Christianity in Denmark.

FUN FACT: Bluetooth, the program thing that allows you to talk on your cell phone hands free was invented by a Dane and is named after Harold Bluetooth, the son of Gorm the Old and the one who commissioned the Jelling Stones. 

This symbol is the H and B (for Harold Bluetooth) in the Old Viking alphabet. 

Another FUN FACT: Vikings really did like to go around and kill people, then take their land. It was fun. After they became Christians, they did not want to give up this past time, so many became Crusaders. 


And then we were back. Back to "real" life in Copenhagen. 

Getting my Geek On

So I left off with a post about Danish healthcare...now let's apply that knowledge!


Stop 1: Our first stop was at Region Syddanmark, located in Vejle, Denmark. As mentioned, the region is responsible for hospital care and finance allotment, and therefore visiting this center was a great learning experience. Here is a description of the region:

"Syddanmark's main objective is health care. The region also has overall responsibility for regional development, and to solve tasks that the new municipalities cannot resolve properly. The organization handles preparation of development plans with the vision for the region's development in nature and the environment, business, tourism, employment, education and culture and the development of peripheral and rural areas."

A self-described bureaucrat gave us a lengthy presentation on Danish healthcare and its financing. I thought it was interesting he kept referring to himself as a bureaucrat, that is not something I often hear back in the States. The region has 41 employees, and it is key to remember that they are politicians, elected by the people of Denmark. I took a ton of notes but I will not bore you with these, because even I was somewhat bored during this presentation. Lots of numbers and facts and figures, not enough hands-on. However they did give us candy at 10am in the morning, so there's a plus. A few points interesting and worth noting:

• Council discusses which hospitals with stay open or receive more funds and which will close or receive fewer funds. 
• Denmark is on a "quality over distance" kick. They are trying to condense hospital resources so that fewer hospitals are open, but these hospitals every kind of specialist available for all 24 hours in the day, every day. 
• Currently, there is a shortage of general practitioners. Medical schools have been accepting too few students, and now they are reversing their ways so that by 2020, there will be plenty of GP's.

Stop 2: Next we headed to Rødding to tour a general practitioner practice. This particular practice consisted of four GP's who each own 1/4 of the practice. Dr. Anne Birgitte V. Andersen spoke to us, and then we toured the facility. I'm not sure if I have mentioned this word before, but my absolute favorite Danish word/concept is hygge, which loosely translates to cozy. This doctors office had hygge; it was not at all similar to the sterile offices in the States. There were no tiny examining rooms with harsh lights and white walls: each doctor (and nurse) has their own large office, which is complete with a desk, examining table, mini library, and other necessary equipment. It is intended to make the patient feel comfortable and involved in their own care, as the patient is able to sit alongside the doctors desk to review any tests or records. A few points interesting a worth noting:

• Each doctor sees about 20 patients per day for 10-30 minutes each, with one doctor being on house-call duty. 
• Acupuncture is big here. About 20% of GP's use this method, including one of the doctors at this facility.
• Danes do not go to the doctor expecting to be prescribed a medication for each and every ailment; in the US, most people want to walk out with a prescription.
• GP's handle most psychological problems. Only for "serious" are people sent to psychologists or psychiatrists, as both are hard to find specialists. 

This is the outside of the office

The waiting room, which like the rest of the facility had wood beams and floors

Interestingly, the paramedic unit is attached to the building, and we were lucky enough to meet the on duty paramedic. He was really friendly and passionate about his job.

Stop 3: Our third stop was in Odense, and was definitely interesting. It clearly demonstrated Danish open mindedness and American prudence. That is all I will say about that, but if you really want to know more you can ask me. 

Those are all three academic visits that we had, but we certainly did a lot more on our three day excursion. Hopefully you have enjoyed this little bit of learning, I need to go take a break from it and enjoy Tuesday night. Should I wear this out?

Healthcare 101

At the end of this week, my core class, Healthcare in Northern Europe, went on our short study tour across western Denmark. This trip combined academic visits with cultural excursions and was a really fun way to learn a lot about both healthcare in Denmark and its rich history. I am going to recap the trip, but I thought that a little Healthcare 101 might be necessary, and hopefully interesting. Plus, I have not been doing so much academic work lately and was missing it (kidding). 




Like the United States, the system is very complicated and especially hard to grasp from an outsiders perspective, but the objective of my class is to learn as much as we can. I'm really, really excited about this but I realize not everyone cares. Because I don't want your eyes to glaze over or put you to sleep, here is a brief summary.


Structure: Healthcare is decentralized and divided into the national, regional, and municipal. There are 5 regions and 98 municipalities within these 5 regions. 

• National: The Ministry of Health and Prevention coordinates and mandates healthcare laws.
• Regional: In charge of running hospitals, responsible for managing private sector care, and makes payments and contracts with General Practitioners.
• Municipal: Responsible for all public health care, home nursing, school health service, prevention and rehabilitation, and many social services. 

Care: General Practitioners (GP's) serve as gatekeepers to all other areas of healthcare. Each person in Denmark (including me!) is assigned a CPR card number (similar to a social security card) and a doctor to whom they see with any health concern. These GP's have a wide scope of practice: pediatrics, gynecology, and chronic disease management just to name a few. They care for a problem until their professional opinion states that a patient needs to see a specialist. This gatekeeper role is a key function in Danish healthcare, as they are extremely lacking in specialists and therefore need to manage (nice word for control) the number of patients seeing specialists. In order to get into a hospital, the patient needs to either have a emergency that cannot be controlled by a GP's phone advice or home visit, or be referred by a GP.


Payment: Money, money, money. As American's it seems that this is what we are most interested in. Well, in Denmark, healthcare is based around the principle of free and equal access for all. 85% of care is publicly funded. Healthcare accounts for 9.4% GDP in Denmark, as compared to bout 17% GDP in the United States. And most people in Denmark are satisfied with the healthcare they receive. Interesting...


Denmark went through a healthcare reform in 2007. The most important elements of this reform were that the number regions and municipalities was reduced and the waiting time to receive any treatment was capped at one month. This means that if the government cannot ensure that you receive a needed treatment (such as a hip replacement) within one month, they will pay for you to go to a private hospital. 


Whew. So there you have it: a very, very brief summary of the Danish Healthcare system. More to come on the study tour, but for now go eat a spoonful (or two, or three) of Nutella. It is World Nutella Day!