Doctors from Greece flood Cyprus healthcare

With better salaries and health service, Greek medics are at home here although concerns have been raised by locals feeling squeezed out

Demetrios Bestitzanos is a doctor, specifically an internist. A few years ago, around the time he turned 50, he decided to relocate from Athens – where he’d been studying and working for 30 years – to Agrinio in western Greece, where he and his wife are both from.

He returned on a wave of nostalgia, “like Odysseus going back to Ithaca,” as he puts it. What he found, professionally speaking, shocked and disheartened him.

Greece was battling Covid, with internists right on the front lines. The system in Athens was already dysfunctional, after years of austerity and crisis, but the situation in the provinces was “tragic”. By the time he found himself doing 24-hour shifts as the only doctor on duty, shuttling between increasingly desperate patients, he knew it was unsustainable.

“I wanted to stay,” he tells the Cyprus Mail. “I only left out of necessity.” Like many other Greek doctors, he began to look beyond Greece – and finally settled on two options: a position in Saudi Arabia, or a job as internist at the Mediterranean Hospital of Cyprus in Limassol.

The Saudi job paid €10,000 a month. The one in Cyprus was less lucrative, but not by much: the gross salary – before taxes and social security, and of course not counting living expenses – was close to €9,000.

And in Greece?

“In Greece I was topping out at €2,500, with overtime.”

Bestitzanos’ story is increasingly typical. Greece is facing an exodus of experienced doctors – and their destination is quite often Cyprus.

According to Efi Kammitsi, the director of the Health Insurance Organisation (HIO), there are currently 3,400 doctors registered with health service Gesy, of whom 860 (25.3 per cent) are Greeks. That proportion is going up: provisional figures show a 19 per cent year-on-year increase for each of the past two years.

That’s just Gesy. The Cyprus Medical Association (Cyma) includes all doctors licensed to practise in Cyprus – and the numbers are startling. Five years ago, Cyma’s membership was around 3,700; now it’s 5,200.

It’s unclear how many of those came from Greece – and in any case the 5,200 also includes aspiring doctors just out of medical school, another recent surge inflating the total as more schools appear on the island.

Still, a 40 per cent rise in five years is remarkable – and much of it is due to the arrival of foreign doctors, almost all of whom (given that doctors have to be fluent in Greek) come from the motherland.

Gesy works on a so-called ‘global’ budget, to safeguard its “financial viability,” as Kammitsi puts it. “We pay all doctors in the same way, through the global budget. When they [as a whole] perform more transactions than provided for, their unit price goes down… So the question is how the pie gets shared out between them.” 

Clearly, a big influx of new doctors could translate to a smaller slice of pie for existing doctors. No-one’s exactly sounding the alarm yet, but the upward trend is a worry – especially since the Greek health system is unlikely to recover any time soon.  

There’s also a question of “demographic change” according to Cyma secretary Michalis Anastasiades – in the sense that “a significant number of young colleagues will be affected professionally”, i.e. elbowed out by the influx of experienced foreign doctors. 

“This is obviously a phenomenon that we’re following closely, and it’s causing some well-founded concerns,” Anastasiades told the Cyprus Mail, speaking of the increase in numbers.

“Because – we’re already seeing it, but it’s likely to hit even harder in some specialties – there’s going to be a saturation, in terms of professional development.

“This has nothing to do,” he added, “with colleagues’ ethnicity – and we certainly have absolutely no problem with the fact that they come from Greece. On the contrary.”  

This seems to be the general refrain, the result of two rather contradictory impulses. On the one hand, doctors are alarmed by a trend which – if it continues – could adversely impact their financial and professional situation.

On the other, they’re reluctant to criticise or condemn doctors from Greece – not because of political correctness, but also genuine goodwill.

“So many of us studied for free at their universities,” Nicosia GP Ioannis Kronis told the Cyprus Mail. “And now we’re going to tell them they can’t come here?”

53-year-old Nektarios Rizakis, also an internist at the Ygia Polyclinic Private Hospital in Limassol, says he’s encountered no resistance or prejudice from Cypriot colleagues. “I think it’s more the opposite – like, ‘At last! Welcome!’.”

Rizakis worked in his native Larisa for many years but actually came here from France, where he’d spent six years after fleeing the Greek health system. It’s an interesting twist, since doctors’ salaries in France are presumably on a par with Cyprus – but it’s not just the money that leads Greek doctors to our island.

“For me personally, Cyprus is Greece,” he says. “Now, if someone doesn’t want to consider it as being Greece – well, that’s their right. Or their problem, probably.”

Rizakis has no plans to leave, appreciating the culture and especially the religion, which – being devout – caused him problems in secular France.

“Do you know what it means,” he muses, “to spend the whole day at the hospital, speaking maybe 10 sentences and 100 words all day, then go out to a coffee shop for a cold coffee [i.e. frappé]? Do you know what it means to see a church on the street, and be able to cross yourself without being abused for it?”  

Bestitzanos seconds his fellow Greek’s enthusiasm – though he’s not so sure about staying indefinitely, mostly because his wife and four kids stayed behind in Greece. He also owns his home in Agrinio, whereas of course he rents here: a two-bedroom flat near the hospital – that’s to say, in the centre of Limassol – costs over €1,300 a month in rent and common expenses.

There are costs involved in relocating, which may also be the main reason why the flood of doctors from Greece hasn’t been matched by a flood of nurses. Precise numbers are hard to come by, but the influx of healthcare workers is more of a trickle – probably because, though wages are higher here than in Greece, it takes a doctor’s salary to absorb the additional expenses.

In the end, says Dr Bestitzanos, his take-home pay is between two and three times (closer to three) what he’d make in Agrinio, while the hospital is much better organised. Dr Rizakis agrees, describing the health system here as being “one and a half notches above that in Greece” – albeit also a notch below the system in France or Germany.

The only problem is perhaps homesickness – but at least Bestitzanos can easily find fellow countrymen with whom to reminisce.

The internal medicine department at the Mediterranean Hospital of Cyprus is staffed by five doctors. At the moment, all five are from Greece.