New perspectives and open exchange

Urs Brügger discusses his Sciana journey so far and his working group's focus on end-of-life care

Urs Brügger is an independent healthcare consultant. He is also a member of various boards of directors in this field. Previously, he headed a health economics institute at the Zurich University of Applied Sciences for 15 years and then the Department of Health Professions at the Berne University of Applied Sciences for more than five years. Urs has qualifications and references in leadership, organisational development, health economics and health policy. He is a member of Sciana's sixth cohort.

This interview has been edited for brevity and clarity.

Sciana Network: What attracted you to apply for Sciana: The Health Leaders Network?

Urs Brügger: There are two main reasons. One is the content of the programme. I am a health economist, and I have always been interested in both the system level and the organisational level of healthcare. Health systems are very complex and difficult to change. So, leadership is a key function.

I used to be more on the academic side; however, in the last few years, I have become more interested in the practical side. I consult in healthcare for authorities and organisations, and I've become a board member on various boards in Switzerland.

This includes a cantonal hospital group, a specialist clinic for the treatment of alcohol and drug addiction, a foundation that operates housing for persons with disabilities, and a specialist clinic for the treatment of epilepsy. Since last year, I have also been on the board of Careum, one of the three foundations that support and fund Sciana: The Health Leaders Network.

Through this work, I have learned a lot about healthcare from a practical organisational perspective, and I strive to ensure that I can contribute to the development of these organisations with my knowledge and experience. The overall challenge theme of Cohort 6 is a good fit with these activities.  

The second reason I applied to join the Sciana Network is that I've always found it interesting to learn from people with different backgrounds and perspectives, and people from other countries working in a different healthcare system.

The Sciana Network gives you the opportunity to meet a special selection of dedicated leaders in their countries and fields. This is inspiring and helps you to be more creative in your own work when new solutions are needed.

SN: You mentioned that you've been appointed to Careum's board. How did that transpire?

UB: One day, I got a call from the chairman of the board of Careum, and I was invited to apply for a board position. I think it is a good fit on both sides. Careum is a foundation, and its main purpose is to run schools for the training of nurses and other health professionals.

For more than five years, I was the head of the Department of Health Professions at the Berne University of Applied Sciences, where we trained nurses, physiotherapists, midwives, and dieticians. So, I am familiar with this 'business', and I think my former background as a health economist was also a valuable perspective for Careum. 

For me, this new task fits well into my portfolio of activities.

SN: The Sciana Network's mission is to create a network of international health leaders equipped for future challenges in health and wellbeing. As a consultant, what are some of the challenges that emerge in the conversations you're having with different people at the moment?

UB: Well, at the moment, everyone is saying, 'These are more challenging times in healthcare than ever before.' Healthcare is currently characterised by major challenges, such as a shortage of health professionals and cost pressures, as well as other major changes - both technological and social.

It is, therefore, very difficult to maintain the quality of health care and the level of access for all, as was previously the case in Switzerland. I hear these discussions in the board meetings or from the healthcare leaders I work with in my consulting projects.

SN: Another aspect of the Sciana Network is that it focuses on health systems in Germany, Switzerland, and the UK. How much are you already familiar with the healthcare systems in Germany and the UK? Is there anything you're looking to learn about them further?

UB: One of the courses I taught at the university was a comparison of healthcare systems. So, I think I have a basic understanding of the construction and the characteristics of these different systems. The Swiss system is somewhat similar to the German system, which we call a Bismarck-type system, and the UK has the Beveridge-type system.

I went on several study trips to England and Germany to learn about these systems, but that was over ten years ago, and things have evolved. I am interested to hear at the Sciana meetings how the problems that we have in Switzerland are dealt with in the UK and Germany.

SN: You've attended two residential meetings. How would you reflect on your experience as a Sciana Fellow so far and the discussions you've participated in?

UB: I'm impressed by the people, the selection of participants, their positions, and the thoughts they share within the group. I enjoy the open discussions, and it feels relaxed.

The style is relaxed, but the conversations are at a high level. David Behan and Mary Helen Pombo are fantastic leaders of this programme, and I also learn a lot from them.

SN: Tell us more about your working group challenge and why this is a subject you wanted to focus on.

UB: Our group challenge is about end-of-life care. The original idea was to focus on waste and overuse in healthcare. Healthcare costs at the end of life are often very high and, in many cases, result from expensive treatments that neither prolong life nor improve quality of life. 

Healthcare professionals report that necessary and difficult conversations with patients and families to provide careful information and clarify the patient's wishes are often missed. 

With this in mind, our focus has now moved away from waste and overuse, and we are now interested in the question of what care people actually need and want at the end of life and the gap between this and the care they actually receive.

Everyone in our group is now really engaged in this issue because it affects everyone. Death and dying is probably one of the biggest taboo topics that still exist in our society. Personally, I am starting to think more about this topic, and maybe it has something to do with the fact that I turn 60 this year, and I'm realising that life and health are gifts, and it all has an end.

SN: What are your hopes for Cohort 6's third residential meeting in May?

UB: I hope that we will make good progress with our challenge and that there will be follow-up on other issues that we started to discuss in the first two meetings - all sorts of aspects of leadership.

I hope that we will have more guest speakers, as they are always very inspiring, and I look forward to meeting Cohort 7.

SN: Your first residential meeting coincided with European Mental Health Week. What's one thing you do to support or protect your mental health?

UB: For me, it is physical activity. I like outdoor sports, such as mountain biking or ski touring, which are both good exercise and an experience in nature. And, recently, I started doing yoga.