BULGARIA | Emergency | Cultural issues

Different roles and responsibilities of staff working in emergency medical care

Bulgaria is one of the few countries in Europe where a doctor is always part of city-based emergency teams, although it is becoming increasingly difficult to provide this level of service. In smaller towns and villages, emergency teams are more likely to include a physician assistant (Feldsher) instead of a doctor. In addition to the doctor/physician assistant, the emergency team includes a nurse and a driver. A number of ambulance drivers have some paramedic training.

In Bulgaria, nurses are exclusively female with only very few exceptions. This is reflected in the name of the profession in Bulgarian: The literal translation into English would be “medical sister”. The few male exceptions are called “medical brothers”, but no such profession exists in the National Register of Professions.

Cultural or religious issues

Doctors are required to inform patients about any proposed medical procedur and the patient’s consent is needed before treatment can commence. In cases where the patient refuses a medical procedure which has been recommended by the doctor, they (or their representative, e.g. a relative) are required to sign a paper confirming their decision. In extreme emergencies, the doctor may decide to carry out a medical procedure without first informing the patient or his/her representative.

Form of address

In Bulgaria, doctors may address patients either formally, i.e. "Mr/Mrs" + family name, or informally, i.e. first name only. Nurses are more likely to call patients by their first name. This is particularly the case after the first visit and it is also more likely with younger patients (children, teenagers) or elderly patients (who may also be addressed as “grandma”/ “grandpa”), as well as with patients who are less educated or who have less status.

For more information on general medical cultural standards, click here.