Finding your way around the healthcare system
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Feel free to dial 1177 twenty-four hours a day, both for healthcare advice and for information about the clinics to contact about your particular needs.

Generally speaking, the best idea is to call your local health centre for problems that are neither urgent nor life-threatening. If necessary, the centre will refer you to a specialist.

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It’s not always so easy to tell how sick you might be. When you dial 1177, an experienced nurse will assess your condition. (S)he will offer advice and let you know which clinics are most suitable for you. You will have a shorter waiting time and receive better care if you obtain the right information from the very start.

Outpatient and inpatient care

There are some important differences between outpatient and inpatient care. After an outpatient appointment to assess your problem, you can go back home. Inpatient care, on the other hand, requires hospitalization.

Home healthcare is also available as needed. The municipality is usually in charge of those services.

Your local health centre - the first stop

Your local health centre - the first stop

Your local health centre is always prepared to see you if you are ill or experiencing a problem. The centre may also be called a general practitioner or family doctor clinic. If you are suffering from some kind of health problem and need care, a health centre is generally the place to begin. They will treat you immediately and refer you to a specialist clinic if they can’t provide all the services you require.

You don’t have to go to your own local health centre but can choose another one in the county or region where you are registered as living, or even somewhere else. Those rules apply to all health centres run by a region or county council as well as private ones with which the authorities have agreements.

You can also decide to enroll at a specific health centre.

Health centres handle a large percentage of outpatient care, including monitoring newborn infants and treatment of short-term illnesses such as tonsillitis and a sore throat, along with diabetes and other chronic conditions. They also provide excellent support if you want to make lifestyle changes like stopping smoking, losing weight, etc. Rehabilitation after an injury or illness is another service that health centres frequently offer. If the doctor determines that you need more specialized care or rehabilitation, s(he) will refer you to another outpatient or specialist clinic.

You can call a health centre any time during the week to schedule an appointment. Many centres also set aside certain hours of the week to drop in without an appointment. All of the centres provide healthcare advice on the phone and can arrange an appointment at home under certain circumstances.

A number of them offer emergency services in the evening, at weekends and occasionally at night. Usually they insist that you call and make an appointment. In some parts of the country, all emergency services are provided at hospitals.

Responsibilities of a general practitioner

Most doctors affiliated with health centres are general practitioners (also referred to as family doctors). A general practitioner is also a specialist in general medicine.

A general practitioner will assess your problem, determine its cause and treat both short-term and long-term illnesses that are not serious chronic diseases. (S)he will also refer you to any hospital or other specialists that you might need.  If you are suffering from mild or moderate depression, general practitioners are able to offer treatment. The idea is that you will be able to see the same doctor for any problem so that the two of you can develop a relationship of mutual trust.

General practitioners also provide preventive care, particularly when it comes to support for making lifestyle changes. They can help you stop smoking, lose weight, drink alcohol on a more healthy basis, etc.

Both health centres and hospitals may have residents or interns - doctors who are still in training. Internships last for two years after completion of the basic curriculum in medicine. Each intern is supervised by a general practitioner.

Residents are undergoing training to become specialists. Those affiliated with health centres are normally in training to become general practitioners, but they may have another specialist area. A residency lasts for approximately five years.

Other professionals at health centres

The staff of a health centre may include district nurses, assistant nurses, physical therapists, midwives and medical secretaries in addition to doctors. Some centres offer the services of occupational therapists, psychologists, counsellors and dietitians.

Pediatric and prenatal care are often available. A number of centres house laboratories that employ various analysts and assistants.  The cashier’s desk or front counter is often staffed by a receptionist or medical secretary who also performs an assortment of administrative tasks.

District nurses

District nurses have advanced training in their field. Their practical responsibilities include administering vaccinations, distributing medications and dressing wounds. They facilitate meetings of smoking cessation groups and engage in other efforts to prevent health problems from developing. Another frequent task of district nurses is to treat and administer tests at the homes of patients who cannot make it to the health centre.

They often run clinics of their own for people with diabetes, asthma and certain other chronic diseases. They perform certain kinds of treatment and are authorized to prescribe certain kinds of medications.

Assistant nurses

Assistant nurses cooperate closely with doctors and district nurses. They take blood samples, perform ECGs, dress wounds, etc. Many health centres also send them out to see patients at home. Sometimes they work at the front counter.

Physical therapists

Physical therapists normally threat people with muscular difficulties. These patients may have problems in their back or neck, or they may need rehabilitation after an injury, stroke, seizure or other illness. The treatment may include advice about relaxation and other exercises that can be performed at home. Physical therapists are authorized to prescribe exercise programs to prevent disease or relieve symptoms.

You can see a physical therapist without obtaining a referral from a doctor.

Naprapaths and chiropractors

Naprapaths and chiropractors also treat muscular pain. They work primarily with their hands and arms. While some health centres employ chiropractors, it is becoming increasingly common for naprapaths and chiropractors in private practice to have agreements with the various county councils.

Occupational therapists

Occupational therapists help people with disabilities try out various medical devices. They can make it easier to identify practical aids for performing activities in their daily life, such as making a home wheelchair accessible.

Counsellors

Counsellors provide social and psychological support. Sessions with people who are experiencing crises are one effective approach. Counsellors also offer financial and employment advice when you are ill. They have a degree in social work plus advanced training.

Psychologists

A few health centres have psychologists on their staff. In addition to psychological counselling, some of them are able to provide psychotherapy.

Their normal task at a health centre is to offer short-term support in dealing with a difficult situation you are going through. They may also administer psychological testing for use in rehabilitation assessment and similar investigations.

Like counsellors, they are trained to facilitate group sessions on stress management and other lifestyle issues.

Dietitians

A dietitian is an expert in eating properly. They offer advice to people who want to gain or lose weight or change their diet in the face of diabetes, allergies and other chronic conditions.

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Pediatric and prenatal care

Pediatric and prenatal care

Prenatal clinics

A health centre or related facility frequently includes a prenatal clinic staffed by midwives. If you have questions about contraception or sexually transmitted diseases, or if you are pregnant, these clinics are equipped to assist you. Most of them arrange parent support groups and workshops for couples who are expecting.

Midwives take biopsies to detect cell changes in the cervix. Prenatal clinics are free of charge and you can go to the one of your choice.

Midwives are specially trained nurses. They have often worked previously in maternity and delivery wards. Some of the clinics employ assistant nurses to take biopsies and handle certain testing procedures.

A gynecologist or general practitioner is typically there once or twice a week.

Pediatric clinics

A pediatric clinic is often associated with a health centre. These clinics are staffed with district nurses, doctors and nurses who specialize in children. Assistant nurses with pediatric training may also work there.

The clinics perform checkups of healthy children until they turn six, at which point the school health services take over. Pediatric clinics also administer vaccination programs and provide advice on breastfeeding, diet, sleep, etc. If your child is sick, go to a health centre or the emergency pediatric services regardless of her or his age. Pediatric clinics do not normally require an appointment. However, you can usually make an appointment if you so wish.

Both pediatric and prenatal services provide access to psychologists.

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Private care

Private care

The various healthcare providers include regions and county councils, as well as businesses with which they have agreements. Both health centres and prenatal clinics may be privately run. Patient fees are the same whether you go to a regional or county clinic or a private one covered by an agreement with the authorities.

Some private caregivers do not have any kind of agreement. If you see these, you must pay the entire fee out of your own pocket. Cosmetic surgery clinics and some doctor’s offices fall into this category. Many psychology clinics are privately run and do not have an agreement with a region or county council.

If you are unsure about a particular clinic, you would be wise to ask in advance how much the appointment is going to cost you.

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Specialist care

Specialist care

Doctors at specialist clinics are trained in fields other than general medicine. Some of them do not require referrals and a number of neighborhood hospitals, particularly in the metropolitan regions, provide emergency services during the week. Otherwise you will need to obtain a referral from your general practitioner.

Specialist clinics offer outpatient services in a particular area, such as ophthalmology or dermatology. Some of them focus on kidney disease or other specific conditions.

You are welcome to go to the outpatient specialist clinic of your choice anywhere in Sweden, but sometimes you will have to obtain a referral first.

Different types of specialists

Specialists are doctors who have completed their residencies. They may have been trained in one of many different fields. In addition to general medicine, the most common fields are internal medicine, surgery, orthopedics and psychiatry.

Internists are experts on cardiovascular disease, gastrointestinal problems, lung conditions, etc. Generally speaking, they treat disorders that do not require surgery but respond to medication or lifestyle changes.

Surgeons treat diseases of the internal organs (gallstones, kidney stones, appendicitis, hernias, etc.) by operating on them.

Orthopedic surgeons specialize in the musculoskeletal system - fractures, joint disorders or herniated discs.

Psychiatrists treat severe depression, personality disorders, substance abuse and other mental problems. They all start off by obtaining a degree in medicine.

Special needs

Some regions and counties provide addiction and substance abuse care, child and adolescent psychiatric services, and other special needs. Care professionals who have received specialist training perform the treatment. You can either obtain a referral from the health centre or contact these clinics directly.

Many youth, reproductive health and relationship clinics do not require a referral either. Most people who go to youth clinics are 13-25 years old.

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Emergency services

Emergency services

Emergency rooms are open around the clock at special hospitals. If you have a severe illness, acute injury or other condition that must be addressed immediately, you should go to an emergency room. Chest pain, fractures, severe bleeding and sudden deterioration of an existing illness are included in these conditions. Your general practitioner at the health centre will issue a referral to an emergency room if you need immediate care at a hospital.

Various healthcare professionals at emergency rooms

Emergency rooms have doctors, nurses, assistant nurses and counsellors on hand.

Counsellors focus on support for family members following injury or death. They also work with rape and abuse victims.

The doctor you see at an emergency room may be a specialist but is typically a resident or intern. The doctor reports to a specialist, who can assist as needed. If you go to an emergency room at a university hospital, you may see a medical student. They are there to gain experience but are not personally responsible for your care.

The primary task of a doctor in an emergency room is to assess your condition and determine whether immediate outpatient treatment is available or whether you need to be hospitalized. Another option is to keep you in for observation for a few hours or overnight in order to monitor your condition.

You may need additional outpatient care, usually at a health centre or specialist clinic. In such cases, the doctor in the emergency room will issue a referral or advise you to contact your local health centre.

Local and neighborhood hospitals

Local and neighbourhood hospitals are small facilities that do not always have a 24-hour emergency room. Their staff includes various kinds of specialists. Most of the care they provide is on an outpatient basis. These hospitals have a number of wards that will admit you if you do not need the sophisticated services offered by emergency hospitals.

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Publicerad:
2015-10-19
Redaktör:

Editor: Ingemar Karlsson Gadea och Helena Vogel, 1177 Vårdguiden

Granskare:

Reviewer: Johan Berglund, specialist i allmänmedicin, Kompetenscentrum landstinget Blekinge, Karlskrona