From Chief Physician to Private Medicine

When I worked as a Chief Physician (primářka) at the hospital, I held a strict professional principle: to give every patient in the outpatient clinic my full undivided attention, to delve deep into their medical history, and to offer truly individualized care. However, the reality of the hospital system is unyielding. In my role, I was constantly torn between dozens of responsibilities. During scheduled outpatient examinations, I frequently had to leave to attend to the emergency room, handle acute consultations across other departments, or manage urgent administrative tasks. My attention was permanently fragmented. I was forced to be in multiple places at once and solve several crises simultaneously. This layout is relatively common during night shifts, but I was living in this chaotic rhythm every single working day. The result? Immense stress for me and pure discomfort for the patient. It was then that I realized a fundamental truth: My patients, and frankly neither I, deserve such an approach.

I wanted to keep moving forward, grow professionally, and realize my own vision of modern medicine. A vision where healthcare is not an anonymous factory, and care is not delivered in the exact same manner as it was 30 years ago just because "that's how it's always been done." Instead, I envisioned a deeply individualized process where clinical innovations are integrated into practice without unnecessary delays. In the standard hospital setup, a patient encounters a revolving door of doctors during non-acute, scheduled outpatient check-ups. It is entirely common in hospitals that every single visit means talking to someone new—someone exhausted from a night shift, or someone who just started their duty, who doesn't know the patient at all and is hurriedly skimming through the medical files. The patient is then forced to repeatedly explain all their symptoms, feelings, and the entire medical history they have endured from the very beginning. When this occurs during routine, planned follow-ups, true continuity of care by a single physician is completely non-existent.My vision was exactly the opposite: to create a dedicated space where the patient perfectly knows their attending doctor, and the doctor intimately knows every detail of their health condition. Therefore, I decided to leave the hospital and build a private neuro-microclinic in Brno. A Year and a Half of Wasted Struggle with Bureaucracy. To offer this standard of care to patients within the traditional "health insurance" (na pojišťovnu) framework, I fought for a year and a half. For exactly eighteen months, I intensively negotiated with Czech health insurance companies to secure contracts, writing to various institutions, including the Ministry of Health. During this time, I experienced absolute systemic absurdity:

• Absolute Ignorance of Reality: The insurance companies repeatedly rejected my applications, claiming that "there are enough contracted neurologists in the region." This statement was issued at a time when patients in Brno and its wider surroundings routinely face waiting times of 3 to 6 months just for an initial neurological evaluation, and clinics are turning new patients away due to overcapacity.
• Dozens of Desperate Calls and External Pressure: Every day, my phone rang with calls from desperate patients who had unsuccessfully tried to get an appointment covered by insurance across the entire city, only to be rejected everywhere. As a physician whose only goal was to help, I also frequently had to face aggressive, resentful comments from helpless patients as well as from some colleagues. They looked down on me and proclaimed that, unlike me, they had "honestly bought" their clinics. However, I wasn't buying an established "business" with pre-allocated limits and ready-made insurance contracts. I was building a brand-new medical practice from scratch on a greenfield site. I wanted to legally and cleanly create new healthcare capacities for people who had nowhere else to go, but for the rigid insurance cartel, this was an unwelcome step.
• The Cancellation of a 20-Year Practice: My neuro-microclinic is located in the exact same office where another neurologist successfully practiced for over 20 years. When he retired, he closed the practice. The insurance companies preferred to let an established medical location serving thousands of patients vanish completely rather than sign a contract with a new physician who wanted to continue care on the very same spot.
• The Search for Medical Records: The pinnacle of this absurdity is that today—more than 2 years after the original doctor stopped practicing—his desperate former patients still walk into my clinic. They demand examinations and refuse to believe that I am legally not allowed to simply continue his insurance-based practice. They ask me where their long-term medical records are. If you are one of these patients, I highly recommend calling your health insurance provider directly—it is there that you must demand information regarding where your medical records ended up and who took over your care.

This bureaucratic bizarre did not leave me indifferent. I wrote a letter directly to the Minister of Health to personally draw attention to the critical shortage of neurologists and the insurance companies' unwillingness to resolve the situation. My futile battle with the system and the incomprehensible behavior of the insurers eventually became the subject of a major report by the national media outlet Aktuálně.cz, titled: "There are enough of you, doctors hear. They won't get a contract from insurance companies. Yet people wait for months."

Launching Neuro(b)log: Why I Dedicate My Time to Patient Education

My vision of modern medicine does not end with closing the office door. I am convinced that successful treatment begins with clear, understandable information. Knowing how difficult it is for an average person to navigate the flood of Latin medical terms and contradictory advice on the internet, I founded this Neuro(b)log.I view patient education as a core pillar of my work. I want to translate complex neurological topics into simple, universal language accessible to everyone. A well-informed patient understands their body much better, manages any anxiety about upcoming tests more effectively (such as a lumbar puncture), and becomes an equal partner in the healing process. This blog is my personal contribution to public health education, which the overburdened state system simply no longer has the time to provide.

A Launchpad for Medicine Without Compromise

After eighteen months of knocking on closed doors, I realized that high-quality neurological care could not be built within the confines of the old system. I had to let that idea go. Today, I know it was the best thing that could have happened to me and my patients. Those closed doors became a launchpad for modern medicine. By operating my practice on a direct-payment basis, I have gained 100% independence from insurance limits and state clerks. I no longer run away mid-examination, and I do not handle emergency room inflows at the expense of your time.

• The Certainty of One Doctor: You always see me. I know your medical history, perceive the deeper connections of your condition, and we build upon previous steps without you ever having to repeat your difficulties from scratch.
• A Guaranteed 60 Minutes: You have ample time allocated in my calendar for a comprehensive initial examination. In absolute peace, and in a comfortable environment.
• European Speed: While you might wait months elsewhere, at our clinic you will secure an appointment within 14 days, and the exact time you book via our online system, Reservio, strictly applies.

High-Tech Diagnostics and Therapy Under One Roof

This independence has freed my hands to invest in advanced technologies that standard neurological clinics or hospital departments simply cannot offer. You do not need to walk around with referrals or beg for an appointment over the phone only to wait months. Under one roof, I combine high-end electrophysiology with targeted, high-tech therapies and medical cannabis:

• Precise Diagnostics: EEG, EMG, and comprehensive evoked potentials (VEP, BAEP, MEP) performed using state-of-the-art diagnostic systems directly on-site.
• Advanced Therapy: The synergistic power of deep 3-Tesla magnetotherapy (Salus Talent A) and highly effective biostimulating LLLT laser (PhysioGo 400C).
• Innovative Approaches: Approved and fully legal prescription of medical cannabis for the highly effective management of chronic pain, spasticity, and specific neurological conditions.

How Private Neurology Works Worldwide

My concept naturally aligns with the latest global trends in Western healthcare, known abroad as Boutique Neurology or Direct Specialty Care. While "state-run" clinics logically focus on fully developed, severe pathologies (strokes, severe trauma, ALS), Western private microclinics focus primarily on preventive neurology, brain optimization, and the comprehensive management of chronic conditions. These conditions might not be immediately life-threatening, but they brutally diminish the quality of life (migraines, tinnitus, chronic back and spinal pain).In these modern medical centers, specialists heavily utilize concepts of Neuroplasticity (the brain's ability to regenerate and rewrite its neural networks) and Neurological Inflammation Management through targeted lifestyle adjustments, sleep optimization, advanced supplementation, and high-tech neurotechnologies.

What Does It Actually Mean When I Work on a Direct-Payment Basis?

In my practice, I frequently encounter patients who are still surprised by the term self-payer (samoplátce) and ask why they should pay out-of-pocket when they have faithfully paid public health insurance their whole lives. I completely understand their confusion—for decades, our system has fostered the illusion that healthcare is entirely free. The reality, however, is that the health insurance premiums you pay go into a state fund, from which insurance companies only fund their contracted partners. And as you now know, the bureaucrats refused to let me into that system.When you pay directly at my clinic, you are not paying for a "stamp in your file" or a luxury waiting room. You are investing in my full, undivided attention, my expert experience as a former hospital Chief Physician, top-tier European technologies, and above all—you are buying time that no one in the standard system can give you. At my clinic, your financial investment guarantees that:

• My phone will not ring in the middle of your examination, and I will not leave to cover the ER.
• You do not need to beg a general practitioner for a referral and wait half a year while your symptoms worsen.
• You receive precise diagnostics and cutting-edge therapy in one place, in Brno, within 14 days.

Direct payment is not a luxury or a whim. It is the only way available today to guarantee a medical service of the highest European standard while preserving the deeply human, attentive approach for which you came to me in the first place.I left my position as Chief Physician and abandoned the exhausting battle with insurance companies to grow both professionally and humanly, and to practice medicine the way it was truly meant to be done. With my head and my heart. With full continuity of care, zero distractions, and absolute respect for your health and time.

MUDr. Petra Mištríková, MBA