I work all night, I work all day to pay the bills I have to pay. Ain’t it sad? And still there never seems to be a single penny left for me. That’s too bad. Money, money, money, always sunny, in the rich man’s world…
For many of us, the text is familiar. ABBA's unforgettable song about the dream and lure of money has forever left an imprint on music history. And without a doubt, money plays a central role in our lives. Access to money gives freedom and security. It is also linked to status and indeed even happiness. In the just right amount though.
As psychiatrists, our patients face issues concerning money quite often. Several of our patients find it difficult to make ends meet financially. Some patients overspend in manic phases – while others subjectively experience dismal poverty in other sick phases. It is often difficult to help people achieve good mental health so long as the social and monetary issues remain unresolved. It is well known that people with a lower socio-economic status have poorer mental health and shorter life expectancy.
The financial perspective also pervades the organizations in which we work. Rarely is there a budget surplus in healthcare. On the contrary, a constant adaptation to financial cuts in expenditure is a part of everyday life. Even though psychiatric morbidity accounts for a large part of the burden of disease in society, psychiatric care is allocated an ever-decreasing share of the total healthcare budget.
To what degree is the level of allocated funds for psychiatric care related to qualitative outcomes? Are resources for care adequately prioritized? To what extent are private healthcare providers an asset? To an increasing extent, money is being spent on locum positions, which in some places has led to an exodus of medical professionals from the public healthcare sector. How can colleagues be motivated to continue in the public system?
As doctors, we are all driven by different motivations. Money is a motivator for many who choose to work in the private system. But some have altruistic motivations and choose to work in charities.
Gone are the days when pharmaceutical companies financed most of doctors' continuing medical education. Among our Nordic and Baltic countries, different models are used both regarding requirements for recertification and for financing this continuing education. In some countries, clear and extensive funds are set aside. In others, there are neither funds nor requirements for continuing education at all. In other words, the differences are striking.
The questions and issues are many. As usual, a large number of colleagues participate as writers to shed light on these perspectives. It is a joy to meet the positivity and enthusiasm of the contributors when asked to write for the magazine! As always, you can read a summary of the latest articles from the Nordic Journal of Psychiatry as well as about historical and cultural aspects. And it may also be a good idea to save the date for next year's Nordic Psychiatry Conference in April 2024 to take place in Riga!
As always, I welcome your feedback about our magazine and suggestions for future content. Maybe you would like to contribute something yourself? □