In Germany you must practice good surgeries, or you can not work.

Jose A. Vidal
Published in
5 min readJan 31, 2023


Martini Klinik has a post in this blog, written in 2018 where we dedicated some lines to revise how this private Clinic has been representing the best case managing in a fantastic way data in healthcare. .

Months later, I realized that I had a fellow there, Dr. Luis Busto Martin and we were in contact in order to share preventive medicine scenarios since January 2020.

At the end of 2021, this Doctor was recognized among the 50 most influential Doctors in Private Medicine in Spain, based on Top Doctors ranking.

I think it´s a good idea to start this year paying attention from a surgeons point of view, about different healthcare system in Europe, precisely someone who has been working and developing his professional career in several countries in the old continent.

The head tittle of this article, opens a fantastic interview to Dr. Busto Martin, published in La Voz de Galicia, with some questions, so interesting to revise:

Source: Martini Klinik.

What is the key difference in Martini?

“In Germany there is a mix system, everyone has an insurance, private or public, and the amount of these different payment models, are regulated by law. The patient can choose. Martini has two types: private option is where the patient enjoys an individual room, and double room in the case of patients from public option.”

And talking about the clinician attention?

“It’s exactly the same for both of them. If you want to choose doctor, there is charge. But they develop satisfaction surveys and between 97–99% of the patients would recommend this Clinic to their families.”


“It’s not only because they attend 2.500 surgeries and patients yearly, more than the double compared with the second one, Hopkins Clinic. The second reason is the quality about healthcare service. Patients want to be operated there. The key point is the super-specialization and the facultative educating program, there is fourteen surgeons and the auto-evaluation is a must, surveys are digital, looking for complications, functional results, etc.”

And in Spain?

“In Spain the quality of the healthcare system is fine and we are able to attend any kind of clinical case. Unfortunately not at the same level, because there is not the same investment. In Germany the minimum cost of healthcare insurance is 350€/ month, but you can find other options with costs higher than 1.200€/ month. In Spain, population pays less for this option of private healthcare insurance. In Germany, there is a charge for some new techniques, like Da Vinci Robot. There the payment depends on the disease and you can attend surgery according to the patient´s option. If you want robot, you pay the difference (charge). The system is a little bit corporate, you can choose Hospital, Doctor, which is more than enough to practice a good surgery and to earn money. It’s a healthy and competitive environment for Doctors. In Spain, you can not choose Doctor, there is less control and more mistaken investments. In Germany you must practice good surgeries, or you can not work.”

Based on this article, sometimes we have comment and revise this situation around the healthcare systems in Europe, talking about digital topics and connections between countries.

“In Germany, France and UK, healthcare systems are less connected between same Hospital and Regions than in Spain, but during these last years these Governments have been developing changes to create a digital environment and connecting Hospital and Healthcare Centres. In my personal experiences each Hospital had its own program and that was unique and exclusive for this Hospital and Healthcare City.”

About developing metrics and data in healthcare, it’s obvious that after having lived an ecosystem like in Martini Klinik, it makes you take into consideration that excellence can be possible, it’s a specialized Clinic, and this helps.

“Data evaluation in healthcare, in Martini used to be the way of developing auto- control and also to promote it, via scientific publications or social media, but this required a great personal effort because apart from paying attention to patients, we recollect data in an internal software developed in a specific way for Martini, and also in the common IT program for the Country, In France and UK, the control is not so strict and obviously data collection in health doesn’t exist apart from scientific objectives.”

It’s obvious that in those countries, IT systems are not enough, and it’s so complicated to practice an adécuate exercise in preventive medicine.

“I think normally European countries follow recommendations based on scientific societies, which use to be based in scientific evidence, therefore I don’t think there is much difference about this topic in these countries.

Just in controversial and critical points, where scientific evidence is not so clear (for instance, in PSA like a reference in prostatic cancer). In this case you can find difference in what kind of clinical steps to proceed. In England you only practice a PSA if you order it, the system doesn´t consider this in a systematic way until you are 50 years old.”

Talking about public and private relation, Dr. Busto Martin indicates: “In Germany and France, the patient can choose Hospital as long as it´s part of the healthcare system, it depends on being private or public, accepting patients with healthcare insurance. In the UK, I think it´s not the same, there were separate models.”

Finally, evaluating difference between countries about Access to innovation in surgery, Da Vinci Robot, for instance:

“ In all these countries, access to technological innovation depends on how big the Hospital is. From my experience, all these Hospitals have more tools and resources than in Spain. Healthcare professional has not in general, too much influence in this process.”

We need better IT systems at international, national, regional and local levels to change our mindset in medicine. Instead of treatment medicine, establish preventive medicine. Martini Klinik in Hamburgo, is a fantastic best practice in how to manage data in health.

ES version


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Jose A. Vidal