Pulmonologist in Latviawhere to get treatment, how to verify certification, what this doctor does

A pulmonologist is a doctor for lung and airway disease in adults. They work up persistent cough and breathlessness, perform or order lung function tests and imaging, treat chronic airway disease, and manage tuberculosis care. In Latvia the pulmonologist is a secondary-level specialist seen on referral.

• Asthma and chronic obstructive pulmonary disease
• Persistent cough and breathlessness of unclear cause
• Pneumonia and its aftermath
• Tuberculosis, including multidrug-resistant forms
• Lung cancer and abnormal chest X-rays
• Pleural disease and mediastinal conditions

The family doctor is enough for ordinary airway infections and stable asthma. A pulmonologist is needed when a cough runs for weeks, when treatment is not working, when an X-ray shows changes, or when tuberculosis is suspected.

• Six years of medical study and a doctor's degree, at RSU or the University of Latvia.
• Residency in pulmonology. The RSU programme runs 5 years, 330 ECTS, tuition 5,800 EUR per year, with 3 state-funded places. It is led by Assoc. Prof. Dace Žentiņa. Programme page: RSU residency programme.
• The programme covers lung disease and tuberculosis in both theory and clinical practice, including on-call duties and required procedures.
• The state examination consists of 560 test items, 55 theory questions, and a clinical case with radiograph interpretation.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• Languages. Consultations run in Latvian, and many pulmonologists also work in Russian. Confirm English when booking.
• Tests on site. If spirometry with a bronchodilator test or chest imaging is likely, a provider that does them at the same visit saves a trip.
• Disease profile. Tuberculosis and complex lung disease are concentrated at the Centre of Tuberculosis and Lung Diseases rather than in private clinics.
• Age groups. Pulmonologists see adults. Children have a separate specialty, paediatric pulmonology.
• Second opinion. Patients may freely choose the doctor and institution. With a valid referral, a state-funded consultation can be taken at any provider delivering that service from state funds.

• Bring previous X-ray and CT reports, test results, and a full list of medicines including inhalers.
• If spirometry is planned, avoid using inhalers on the day of the consultation where possible, since they affect the result.
• Family history matters here: lung cancer, asthma and allergy in close relatives shape the diagnostic path.
• At the visit the doctor asks about cough, breathlessness and exercise tolerance, listens to the lungs, and orders spirometry, sputum tests or imaging as needed.
• Where deeper investigation is required, the patient can be referred to the Centre of Tuberculosis and Lung Diseases.

For lung disease patients with a family doctor's referral the patient co-payment is 4.00 EUR. Investigation for suspected tuberculosis is free: this covers patients with suspected disease, contacts of known cases, and patients on the register. Inpatient treatment for tuberculosis is also free. Other patients pay the standard co-payments, capped at 570.00 EUR per calendar year.

• Internist, pulmonologist or allergist, first consultationPrice EUR: 70.00Provider: ARS medicīnas klīnika
• Internist, pulmonologist or allergist, repeat consultationPrice EUR: 60.00Provider: ARS medicīnas klīnika
• Patient co-payment with a family doctor referralPrice EUR: 4.00Provider: RAKUS
• Investigation and treatment where tuberculosis is suspectedPrice EUR: 0.00Provider: RAKUS Centre of Tuberculosis and Lung Diseases
• State-funded X-ray without contrastPrice EUR: 3.00Provider: NVD
• State-funded CT without contrastPrice EUR: 14.00Provider: NVD

The specialty body is the association "Latvijas Tuberkulozes un plaušu slimību ārstu asociācija" (Latvian Association of Tuberculosis and Lung Disease Physicians), registration number 40008004602, registered address Upeslejas, Stopiņi parish, Ropaži municipality, LV-2118. Contact: Alvils Krams, email alvils.krams@aslimnica.lv.

Invasive work is represented by "Latvijas Invazīvās pneimonoloģijas un respiratorās medicīnas asociācija", registration number 40008314425, address Saules iela 2-2, Mārupe, Mārupe municipality, LV-2167, contact Mārtiņš Purenkovs, email liprimasociacija@gmail.com.

The paediatric side is represented by "Latvijas Bērnu alergologu un pneimonologu biedrība", registration number 40008061291, address Vienības gatve 45, Rīga, LV-1004.

The parent body is the Latvian Medical Association, founded in 1988, whose Certification Council issues certificates. The sector regulator is the Health Inspectorate.

If you have doubts about the quality of care, raise them first with the institution's management, which must operate a complaints and suggestions system. If that does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The procedure is set out on the Health Inspectorate site.