Working as a doctor in Finland
Working as a medical doctor involves not only working with patients and the associated documentation but also providing medical expertise in various roles. This page offers insight into these tasks.
The different roles of a medical doctor
Diagnosis and treatment
A medical doctor or physician is responsible for determining the diagnosis and deciding on the appropriate care and treatment. This is done in close co-operation and with the consent of the patient.
According to the Patient Act, the patient has the right to good quality health and medical care. However, the patient does not have the right to receive whatever treatment they want, but the treatment provided must be based on medically acceptable criteria.
In practical situations, the attending physician decides what kind of treatment the patient’s health condition requires and what kind of treatment the patient is therefore entitled to. This right is given to the doctor in Section 22 of the Professional Personnel Act.
Consent means that the patient has given consent to treatment or research. The patient has the same right to refuse examinations and treatments proposed by the medical doctor, as well as the right to actively participate in the treatment event.
In order for the patient to be able to make informed choices, the medical doctor has an obligation to give the patient an explanation of his state of health, the meaning of the treatment, the different treatment options and their effects, i.e. the benefits and harms. The patient has the right to make negative – even destructive – decisions for his health, but it is the medical doctor’s duty to explain what their meaning might be. If possible, the patient must then be treated in another medically acceptable way.
The explanation given to the patient, the treatment solutions made and the implementation of the treatment must be recorded in the patient records. If a patient refuses examination or treatment, the refusal must be recorded in the patient’s records.
There are specific procedures to follow if the patient is a minor or has a memory disorder, a mental health disorder, an intellectual disability or other condition limiting their ability to make informed decisions and provide consent.
Confidentiality
The purpose of the duty of confidentiality is to maintain confidentiality between medical doctor and patient, which is important for treatment. Without permission, a medical doctor may not reveal to third parties what they have learned about the person they are treating and their illness in the course of practicing their profession.
The doctor-patient relationship is always based on trust. Confidentiality guarantees the patient’s privacy when communicating possibly sensitive health information to their medical doctor.
According to Section 17 of the Act on Health Care Professionals (559/1994), “a health care professional may not reveal private or family secrets to an outsider without permission, about which information has been obtained based on his position or duties. The obligation of confidentiality remains after practicing the profession.”
The confidentiality of patient data and the obligation to remain silent also cover the processing of social and care customer data in the so-called health act. in Sections 4-6 of the Client Data Act (703/2023).
Medical doctor as witness or expert
A medical doctor’s job description also includes writing certificates and statements and appearing in court either as a witness or as an expert. However, this should be done only when necessary.
Section 23 of the Act on Healthcare Professionals (550/1994) grants licensed physicians and dentists the right to issue medicolegal certificates and statements and other certificates intended to be presented to a court of justice or other public authority.
According to the provision, a physician’s or a dentist’s opinion which is certified “on my honour and conscience” can be used as sworn testimony in court or official proceedings.
Volunteer work
In their free time, medical doctors can act as volunteer doctors in hobby activities, sports, cultural and other events without compensation. The volunteer doctor must also remember the responsibilities and obligations related to their profession.
There is generally no compensation for volunteer work. The recommendation of the Finnish Medical Association is that the medical doctor is paid compensation for the work and an employment contract is drawn up. The employer is then responsible for employer obligations and also for taking out patient insurance.
If a medical doctor provides medical services as part of his entrepreneurial activity, the activity is regulated by the law on social and healthcare supervision and its obligations, including registration. The Finnish Medical Association’s group patient insurance is valid for private entrepreneurs (self-employed). If the services are provide through a company, the company needs to take out patient insurance.