Future of Balneology in EU prof. dr hab. Irena Ponikowska dr Przemyslaw Adamczyk Clinic of Balneology and Metabolic Diseases Collegium Medicum of the Nicolaus Copernicus University Ciechocinek, Poland

Past, present, future...  People were concerned about balneology for more than 200 years. It developed in many countries, especially in our part of Europe (but not only of course)  It was a mainstream of medicine  Past was marvelous....

Past, present, future... Present is difficult…  Balneology is not a mainstream of medicine any more, but it should be included in health care system  Not enough public „health insurance money” are introduced into the system of health resort treatment  Because of a market demand, many private „spa centers” are built, where mostly recreation and truism are present. There is NO ANY control upon them, and they can treat people in improper way  There are fewer places where education of balneology can take place  There are no common standards in balneoogy  Very few good research are carried out  Not enough good journals are printed

Past, present, future...  Many not proved methods are introduced into health market and soon wave of them will cover classical balneological procedures  There will be no possibility to tell which of them is working, and which doesn’t, so all of them together will be classified as „weird”, with for ex. iridology, oxygen therapy, artificial salt caves, hydrocolonotherapy or others  Patients and public opinion will start thinking, that all those „weird” methods are standard  Some researches study new „weird” methods, and receiving some financial support from producent, will prove them working even when they don’t (incredible but it already happens in Poland!)

Past, present, future...  I’m really worried abut future...  I think, all of us have almost common problems as we in Poland  Therefore we should solve them together What shall we do? How to save balneology?

What should we do?  What I think we all need is one, strong medical organization which will stand for us. To be it strong we have to set strong rules  We need one umbrella organization, which will unite all doctors working in the field of balneology from our countries  It can be organized as a committee under ISMH, or other organization, but can also be set as a new organization and this is something to discuss about  All national associations of balneology should participate in it

How to organize it?  Whatever we will agree on we have to organize it well to work well  Lets look at balneology as any branch of medicine  As any branch of medicine there are three main branches, on which everything stands on. There are:

StandardsEducation „UMBRELLAORGANIZATION” Research

How to organize it?  We need to set 3 main commissions: Commission of Education, Commission of Standards and Accreditation, Commission of Research  Above them there should be board of the Umbrella Organization (European Board of Balneology(?) which approves all decisions of commissions.  Board should be chosen at the European Congress of Balneology

Commission of Standards and Accreditation  Sets standards of treatment using balneological procedures.  Issues guidelines for all European Associations  Decides, if new method will be included in one of 4 main groups: standard (classical) methods of treatment standard (classical) methods of treatment new, proved method new, proved method methods under research methods under research not proven methods not proven methods

Commission of Research  It supervises research carried out in countries, and checks whether results are reliable!  In future it could publish European Journal of Balneology  Proposes to the Commission of Standards and Accreditation new methods of treatment

Commission of Education  Approves new standards into education. It supervises education of balneology, and in future creates one European exam in balneology  Exam should be one and the same in all Europe, given annually. It should be based upon the guidelines set by Commission of Standards and Accreditation  Commission accredits (approves) Centers of Education, and gives them it’s approve for education, and examination.  It gives title which states, that person is well educated in balneology

How to organize it?  All commission should cooperate- for example- when new method is proposed, Commission of Research should investigate it, whether it works or not, than method is proposed to Commission of Standards and Accreditation which sets standards of treatment  All standards and guidelines are approved by European Congress of Balneology and proposed to Commission of Education which issues it as guidelines and teaches about it

Is this something really new?  Few European associations are already working on those bases proposed today  It seems, that for example European Association of Urology which as one of first proposed this paneuropean standards into life, works very well and develops very promising  Few another associations are preparing themselves into the same way of working  What do we waiting for? Shouldn’t we do something about it?

We are capable…  There are so many great balneologists around us today, good researches, educationists, etc  With help of everybody we can manage to do it

Thank You for your attention