Hello again! I am sad to say that the Comparative Healthcare in Graz program has finally wrapped up. It has been an exciting and action-packed four weeks. In my last post, I had spent two weeks in Graz, Austria along with a weekend in Salzburg, Austria and Zagreb, Croatia. Since then, I spent another week in Graz, a weekend in Vienna, and a week in Maribor, Slovenia, with excursions to the Slovenian capital of Ljubljana and the Karst region. Our trip has been focused around visits to healthcare sites: we have seen three hospitals (two in Austria, one in Slovenia), two retirement facilities (one in Austria, one in Slovenia), two gardens for medicinal herbs (one in Austria, one in Slovenia), a sensory research lab, a pharmacy, a free clinic, a housing community for homeless men, a disability center, an ambulance center, a mountain rescue demonstration, and a virtual reality CPR demonstration. It hasn’t been all school though; we’ve visited parks, museums, palaces, castles, and many other cultural locations.

I learned a lot through this program, even having already had a connection to Austria through family throughout my life. This program was, at the most basic level, an introduction to Austrian and Slovenian culture. The people of both countries are laid-back and take life at a slow pace. Shops are often closed on the weekends, there are many national holidays used for recreation, and you can wait at a restaurant for hours before deciding to order food or pay. Austrians and Slovenes are also very physically active; at every park or outdoor area I went to, I saw people walking, hiking, biking, and running, regardless of their age. The transportation infrastructure of these counties also encourages physical activity, with every city containing bike lanes and pedestrian zones. Austrians and Slovenians also have a collectivist view of the role of government and society. Even very old buildings reflect these attitudes: the cities of Salzburg and Maribor both contained elaborate castles whose roles were not only as residences for nobility, but as places for the general population to take shelter during invasions. Finally, people take more interest in natural foods and products, and foods in these countries are fresher and healthier, with fewer additives.

With some of these things established, it is easy to see how Austrian and Slovenian healthcare have developed. Both countries have universal, national healthcare programs for their citizens. Drug costs are kept low by national and European law. Both countries also have programs to care for more vulnerable people. For senior citizens, there are state-run assisted living and nursing facilities which are paid for largely by the government or by national pension insurance. These locations offer care and enrichment that would be very costly in America: the Albert Schweitzer Institute for geriatric care in Graz offers technological innovations such as VR headsets and animatronic animals, training for family caretakers, and round-the-clock access to physicians, while the nursing home in Poljčane in Slovenia offers in-house physical therapy, community gardens, and pigs and rabbits for the residents to raise. For other groups, the Austrian government supports private, non-profit organizations in providing care, such as the Marianambulanz free clinic and Vinzi-Dorf homeless village run by the Catholic Church or the Mozaik disability center run by the Styrian Federation for People with Disabilities. With such a strong belief in natural living, herbs also play a much larger role in Austrian and Slovenian medicine, and are even developed into medications at apothecaries. The citizens of Austria and Slovenia seem to be mostly satisfied with their medical care, more so than most Americans are. There may be something to be said for these elements of these nation’s healthcare systems.

Many of the healthcare offerings of Austria and Slovenia have developed out of a collectivist obligation to ensure that everyone receives basic healthcare, even at the expense of individual money-making. However, America embraces individualism, and healthcare in America is an innovative and profit-rich industry, not one solely devoted to providing care. Austria and Slovenia’s healthcare systems are also suffering from strain, with a shortage of primary care providers and an aging population. Both these countries are much smaller and less diverse than America, and it would be naïve to think that implementing a universal system overnight would be effective. I think the best strategy to improve American healthcare based on European models is to first strengthen our existing system so that we can better accommodate care for all Americans. America has a primary care shortage as well, particularly in rural areas, so more resources should go into strengthening primary care and building a system that, if it switches to universal healthcare, will not experience strain. As things stand right now, we can also direct more money to public and private organizations that provide care to vulnerable people, similar to the programs we saw in Austria. Creating model, pilot programs should serve to educate Americans on the importance of a collectivist healthcare model, as anyone can find themselves old, disabled, or in need of special care, and everyone could therefore stand to benefit in some way at some point. Knowledge of herbs could also be included in pharmacology education, as herbal medicines offer affordable and safe remedies containing many of the same organic compounds as prescription drugs.

Most of the differences I observed in European and American healthcare are not at the patient/provider level but at the structural level. Still, physicians are the leaders and changemakers of medicine, and are the people politicians look to when developing new systems. Once I am a physician myself and established in my practice, I hope to use my influence to advocate for the changes I described to whomever will listen to me: politicians, hospital administrators, or the general population. I also hope not to lose my connection to Austrian and Slovenian healthcare and remain in close conversation with how healthcare continues to develop in Europe.

I also think that this program has helped me develop personally. I feel a much closer cultural connection to Austria and enjoy the relaxed pace of life in Europe. My travels have taught me that while it is important for me to work hard and focus on my goals, there is no need to rush and it is also important to see the world and try new things. I developed a new group of friends on this trip, and we all pushed each other to be adventurous with our limited time in Europe. As a student of German, I’ve also practiced my speaking skills, and as a student of History and Philosophy of Science, I now better understand the context of how medicine has developed as a science, social service, and industry. This program was a perfect fit for me, and I am incredibly grateful for being able to attend.

Luckily for me, my time in Europe is not quite up. I am writing this final post from a friend’s place in Bolzano, Italy, and will go on to visit Zurich, Liechtenstein, Innsbruck, and Munich in these next three weeks with my family. I am still learning more, seeing new places, and trying new things and can’t wait to see what the rest of my time in Europe will hold!

Yours in travels,

Karl Rennick-Zuefle

Graz, Austria

Maribor, Slovenia