5 things to know before choosing a gynecologist in the Czech Republic

From pelvic exams to prenatal care, choosing the right gynecologist is of vital importance to women's health. A doctor's location, range of services, and bedside manner are all key factors to consider when choosing a gynecologist. But a number of additional challenges may come up for foreigners seeking to establish a long-term relationship with a gynecologist while living in the Czech Republic.

We spoke to doc. MUDr. Jiří Hanáček, Ph.D. a veteran of the Institute for Mother and Child Care (ÚPMD) in Podolí, Prague where he is the Head of Operating Theatre and Deputy Chief Physician of the Gynecological Section and MUDr. Helena Součková Secondary Physician of the University Hospital Královské Vinohrady, both on the staff of MY CLINIC a private family clinic in Prague's Dejvice district.

They told us what to expect on your first trip to a Czech gynecologist and why MY CLINIC has a different approach to women's healthcare in the Czech Republic.

In recent years the shortage of physicians in the Czech Republic has become particularly pronounced. In addition to a shortage of pediatricians, psychiatrists, and other medical professionals, there has also been a shortage of gynecologists in Czechia. This has led to longer waiting times for appointments and difficulties in accessing care, particularly for women living in remote areas.

In the Czech Republic annually, approximately 800 cases of cervical cancer are newly diagnosed with some 300 women dying each year from the disease. "In 99 percent of cases, persistent long-term human papillomavirus (HPV) infection is the cause," says Dr. Součková.

While the standard Czech gynecological exam includes a cervical smear, in 2020 the Czech government approved legislation that provided free HPV testing for cervical cancer in women at the ages of 35 and 45.

Since then the country has seen a gradual decline in the disease, says Dr. Součková who still stresses the importance of regular preventative screenings even for older women and the effectiveness of vaccination from an early age. Since 2012, vaccination against HPV has been covered by public health insurance for girls from the age of 13, and is now also offered to boys.

In the Czech Republic, the approach to medicine is entirely doctor-led, meaning the doctor knows best. The session can also feel rushed, lasting just 10 to 15 minutes. One thing that appeals to both MY CLINIC patients (and the doctors who see them) is that sessions are long enough to address all the patient's questions and concerns, says Dr. Hanáček.

"The major difference between doctors in the U.S. and UK and here in the Czech Republic is that in those countries, they explain options and let patients decide what they want to do. Here the doctor knows best and tells you what to do often without explaining," he says.

Perhaps one of the most jarring experiences for foreigners giving birth in the Czech Republic is spending time developing a relationship with a gynecologist across months of prenatal care, only to be sent to a hospital to see a new obstetrician in the lead-up to labor and delivery.

While in countries such as the U.S. and the UK, your OB/GYN is the same person and may even deliver your baby, in the Czech Republic this is not the case.

One of the most popular services among foreigners who are patients at MY CLINIC is the opportunity to choose your gynecologist as your obstetrician, says Dr. Hanáček who offers his patients birth management and registration at Podolí while also providing prenatal care at MY CLINIC. And that care doesn't end with childbirth.

"Not only the birth itself but also the sixth trimester period represents a significant stress burden for the mother," says Dr. Hanáček, adding that the Czech Republic lacks post-partum care.

"With so much attention focused on the baby and its healthy development, mothers must have adequate care as well, from post-natal lactation consultation to psychological or psychiatric support," he says.

Gynecological and obstetric care alone is not always enough to successfully address a woman's health problems. Infertility, pelvic pain, fibroids, and endometriosis are frequent issues that can arise in a patient's lifetime.

In general, in the Czech Republic, professional examinations such as diagnostics and ultrasounds are typically only carried out by specialists after a referral from a doctor. Patients must then make a new appointment at a diagnostic center or visit a large hospital facility which can be daunting particularly for foreigners who face a language barrier.

MY CLINIC is changing the narrative surrounding the ecosystem of patient care in the Czech Republic by working with doctors who belong to a network of specialists and have connections to hospital facilities, similar to the way it works in the West. This allows for the provision of comprehensive care outside the scope of just gynecology or obstetrics.