Began – Pattern – Threat – Action – Example – Overload / COVID-19 – Parallel Track – European Level – Current State – Next Step – Closing Thought

The following chapters trace the development of observations and responses that gradually moved from individual experience toward the institutional level.

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Where It All Began

For more than twenty-five years, I have lived and worked in Austria. During this time, maintaining close contact with people from my region of origin has always been important to me — and again and again I encountered the same situation: the onset of illness.

Particularly sensitive were situations in which a health issue arose within the family in the country of origin. In such sudden circumstances, in the middle of everyday working life, people often did not know whom to contact or what to do next. Navigating between different healthcare and insurance systems slowed down necessary actions.

At the same time, family members, physicians in different countries, employers, and institutions were involved — but without clear coordination. Instead of solutions, delays, missteps, additional burdens, and unnecessary costs emerged.

Over time, it became clear that these were not isolated cases, but a recurring pattern affecting different people in different circumstances.

What Recurred – The Pattern

Information was often incomplete, contradictory, or arrived too late. Instead of a clear pathway, parallel attempts to solve the same problem emerged.

The consequences included unnecessary examinations, repeated travel, and complex administrative procedures. Time was lost, costs increased, energy and resilience were strained — while the underlying issue, illness or old age, faded into the background.

All of this occurred while people were simultaneously trying to maintain their professional responsibilities and family obligations. A regular outcome was mounting pressure.

This pattern appeared regardless of age, profession, or the specific health condition involved.

What Is the Real Threat

These individual situations do not exist in isolation.
They reflect long-standing trends shaping the world of work and healthcare: labour shortages, rising sickness absence, and increasingly pronounced presenteeism.

The resulting losses do not affect only workers, and their families, but also employers, insurers, and ultimately society as a whole. They are particularly evident in the area of mental health, where pressures have been steadily increasing for years.

What I Actually Did

I received inquiries and requests not because of a formal medical title, but because of my familiarity with healthcare systems in different countries.

My role was very concrete. I explained which options were realistic and where it actually made sense to turn for help. In many cases, it was sufficient to clarify entitlements, administrative steps, or the names of therapies in order to avoid incorrect decisions.

This kind of support often prevented unnecessary travel, additional medical examinations, and repeated administrative processes. People gained a clearer understanding of their situation and were able to make independent decisions — without escalating tensions within the family or at the workplace.

Initially, these were individual situations handled informally and without structure. Over time, however, the number of such inquiries steadily increased.

 A Concrete Example

One example that clearly illustrates unnecessary expenditure of time, money, and energy involves a Croatian man who, after retiring, returned from Germany to live in Slavonia.

Month after month, he traveled to Germany to collect his medication, believing this was the only way to obtain the therapy he required.

No one had informed him that the same medication was available in Croatia under a different name.

The problem was not the medical treatment itself, but the lack of basic orientation. Clarifying entitlements and the availability of the therapy was sufficient to break the pattern of monthly travel and the associated burdens.

This case is not an exception, but an illustration of problems I regularly encounter in practice.

The Point of Overload – COVID-19 as a Catalyst

During the COVID-19 pandemic, the volume of such situations increased dramatically. Inquiries became more frequent, more complex, and increasingly time-consuming. What I had previously addressed sporadically now occurred in parallel and unpredictably.

At the same time, I was personally confronted with the terminal illness of my elderly father — accompanied by numerous open questions within the family, but also by concrete, selfless support from colleagues in my country of origin.

Simultaneously, borders were closed, regulations changed constantly, and access to healthcare services became unpredictable. Information was not available in one central place and was not clearly communicated between systems.

The informal form of support was no longer sufficient. The time required for orientation, explanation, and coordination became excessive, and the responsibility carried by these situations grew heavier.

During this period, it became clear that this was a structural problem that could not be addressed ad hoc, individually, or without a clear framework.

The Parallel Professional Track

Alongside these experiences, I have been professionally engaged since 2016 with the impact of health on work, employee satisfaction, and the effects of illness on productivity and absenteeism.

Within this framework, I conducted a study in several countries that revealed significant potential for improvement and cost savings — particularly through a better understanding of the relationships between employees, employers, and involved institutions.

In addition, I organized three international conferences involving experts from different disciplines. The response confirmed the relevance and timeliness of the topics addressed.

Over time, a network of contacts and an intensive exchange of experiences developed. The discussions gradually opened questions that extended beyond individual professions and national borders.

The European Level and Institutional Recognition

Work on these topics gradually gained a broader European context. The developed programs and initiatives were presented at relevant professional forums.

The professional community recognized the alignment between my operational and strategic approaches and current discussions on the development and reform of rural medicine. On this basis, I was invited to participate in a plenary discussion at a conference of the European Association of Rural Medicine.

At the same time, my participation in the European Forum for Primary Care and a conference on occupational medicine in Germany opened new partnerships and forms of collaboration. These experiences further confirmed that the issues described cannot be viewed in isolation, but require an intersectoral and international approach.

The Current State

Based on this body of work, we have structured knowledge, experience, and numerous contacts into clear, applicable formats.

Today, we operate a communication infrastructure shaped through programs and initiatives aimed at employers, healthcare professionals, and political decision-makers.

The goal is to provide clearer orientation in complex situations arising from illness within families and in the workplace.

Our work takes place through concrete projects and pilot activities, accompanied by continuous testing of practical applicability. Particular attention is given to communication processes, transdisciplinary coordination among involved stakeholders, and an understanding of real needs on the ground.

This approach is designed to remain open to adaptation, learning, and further development in response to changing conditions and requirements.

Next step: evidence

Through a research study, we aim to verify whether predictions based on previous experience and available data are achievable – namely, a reduction of up to 50% in sickness absence due to family-related reasons.

The research will be guided and monitored through three initiatives targeting employers, healthcare professionals, and policymakers.

A key element is the active involvement of rural physicians as partners and participants. Together with them, we develop and test new communication and organizational models of care for their patients and systematically measure the outcomes achieved.

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Closing Thoughts

• When information is available in a timely manner, responsibilities are clearly defined, and communication is aligned, unnecessary losses can be reduced.
• Time, financial resources, and energy are released and used more effectively — by families, employers, healthcare professionals, and political decision-makers.
• The central issue is not the availability of resources, but the coordination of communication in their use.

Marijan Gjukić