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Interview with Robert Saftic MD, director of Axis Special Hospital

Endoscopic spinal surgery procedures significantly decrease cost of treatment and enable quicker return to work.

Biggest expert for minimally-invasive spinal surgery procedures in Croatia and south-eastern Europe, Robert Saftic MD spinal neurosurgeon, achieved his education in most prominent clinics of the world.


He is a member and speaker on most world congresses of minimally-invasive spinal surgery. Also, he is a director of Axis Special Hospital in Zagreb, Croatia. Besides that he is a neurosurgeon and also a manager although he thinks this job is not for medical professionals.

Axis Special Hospital was created with mergers of two polyclinics. Why were they merged and what was achieved by this mergers?

– Axis Special Hospital is a result of the efforts of Mladen Miskulin MD as an orthopedic surgeon, and myself as the neurosurgeon to offer the patients treatment of the whole musculoskeletal system in one place, in center of Zagreb, Croatia.

What are the main specifics of Axis Special Hospital? Which services do you offer and how many patients do you treat?

–  We provide multidisciplinary treatment of the musculoskeletal system, with a focus on minimally-invasive transforaminal endoscopic spinal surgery procedures, in which we are unique. We have about 300 surgical procedures a year and that is the base of our income.

What is the capacity of the hospital, how many employees do you have and what was the income in 2014?

– Hospital has around thousand square meters, thirteen beds, fifteen  employees (of which five are medical doctors). In 2014 we made eight million Kuna in revenue (approximately 1.1 million EUR).

proba1What is the difference between traditional and endoscopic spine surgery, in the context of load of the health system incl. sick leave?

– Patient journey from diagnostics, surgery, hospital stay and sick leave with traditional spinal surgery procedures takes about eight months.In case of minimally-invasive endoscopic spinal surgery procedures, return to administrative works is within 2-3 weeks, and physical work within 6 weeks. With endoscopic spinal surgery, skin incision is only 6 millimeters long and surgery is performed in local anesthesia. Surgery takes around 45 minutes, and patient can literally stand up from the operating table on its own. After two hour observation, patient is ready to be released. When taking into account all the parameters, costs with traditional spinal surgery procedures are much more expensive!

Are the capacities of the hospital, with about 300 operations a year, filled?

– This numbers represents a third of our capacity, but for development of health business you need to have serious partner. In the situation as it is everywhere in the world, this would be Croatian Health Insurance Fund or private insurance companies. We need to highlight that our services are at the level of world’s bests, and costs are at the level of 50% you would pay in EU countries like Germany, United Kingdom and France… and not to mention Switzerland that is even more expensive.

Where did you learn this advanced surgical technique?

– I always point out people who taught me what I am doing today, and that are Rogert Hartl MD from New York, Anthony Yeung MD from Phoenix and Sang-Ho Lee MD from Wooridul Spine Hospital in South Korea.


How many surgeons in Croatia do what you do?

– Unfortunately, only I perform endoscopic spinal surgery under local anesthesia in Croatia and the region. In one University (public) hospital in Zagreb surgeons are trying something, but for now I don’t see a success.

 Where are your patients coming from?

– About 70% of our patients are from Croatia, and rest of them are from all over the world. More and more patients from Slovenia are coming to as because Slovenian health insurance fund reimburse about 80% of the cost of treatment in our hospital. So far, we have treated patients from 17 different countries, mostly from United Kingdom, Norway, Iraq, Egypt, USA, Canada…

How much do you invest in marketing?

– Marketing of this sensitive job I would say is very morally questionable. Traditional form of advertising is not our practice. Most of the time we apply Internet advertising techniques to provide the patients with information about what we do, without any other accents like actions, discounts, etc.

Are you preparing any new projects?

– Currently Croatia is preparing a major project in the medical tourism, in which we participate. However, development in the sector of small medical institutions such as ours depends on the development of health insurance and their active participation in the system.

What are your future plans?

– Establish Axis Special Hospital as a center of excellence for minimally-invasive treatment of musculoskeletal system in Croatia and region. We are on a good way.

This article was originally published on a “Lider” website on 07.05.2015. on Croatian language.