Simplicity, egalitarianism, and hygge

Denmark consistently ranks among the three happiest countries in the world. Why is this? What are the Danes doing right that we can’t seem to capture in the United States?

After living in Denmark for two months, I feel that the Danish mindset can be encapsulated by three words: simplicity, egalitarianism, and hygge. If American clinicians can incorporate these three concepts into their practice, they can help patients experience a more positive encounter with medicine.

Simplicity
Danes approach life in a minimalistic yet deliberate way, explained as “slow living.” They value quality over quantity—slowly sipping a refined cup of coffee in a quiet corner kaffebaren, rather than guzzling watered-down coffee from a cheap fast-food chain on the way to work.

Danes also carry a very functional and practical mindset and do everything in moderation. Everything has its purpose—nothing is in excess. Imagine biking to work every day, rain or shine, and picking up fish and vegetables from the local market to cook for dinner each evening, rather than buying bulk from Costco. Instead of eating a pastry every day, Danes enjoy one kanelsnegl a week, consciously savoring each bite. Danish homes are small and modest, and they value humility over flashiness or an accumulation of wealth.

Egalitarianism
Danes view the world with an egalitarian and democratic mindset. When my “Health Economics and Health Policy in Europe” course surveyed 80 Danes in a park, they expressed disbelief with regard to the idea that the amount of money someone has affects their access to healthcare.

“Health is a right,” one Dane said. “Of course non-tax-paying residents should be covered—we can’t have people dying in the streets.”

“If we all share the risk, it strengthens our community. We do it out of solidarity, and it’s there for us if anyone needs it.”

“You can profit off of new shoes or an iPhone, but health isn’t something off of which people should profit.”

“I can’t imagine a system in which the amount of money you have determines whether or not you receive healthcare.”

Danes find it perfectly acceptable that chronic users of the healthcare system pay the same amount as everyone else: “It’s not their fault that they have a disease. We all chip in.”

Every Dane is assigned a general practitioner (GP) at birth whom they can visit at any time, free of charge. A Danish GP praised the continuity of care that this affords: “I know all of my patients exceptionally well and often treat entire families, from grandparents to newborns. I know what’s happening in their lives, what can be impacting their health, and how they prefer to receive their care.”

Extending the concept of equality even further, Danish patients and physicians refer to each other by their first names in contrast to the inherent power differential with the title of “doctor” in the United States. Satisfaction with the Danish healthcare system is about 90%, while satisfaction is about 50% in the US. Clearly, Danes are doing something right when it comes to healthcare.

Hygge
Finally, the concept of hygge is a defining aspect of Danish culture—it roughly translates to “coziness and comfortable companionship that engenders a feeling of contentment or well-being.” Picture three or four people snuggled in fur blankets, sitting on a couch around a crackling fire with candlelight dancing across the walls. Steam rises from mugs of warm elderflower cider nestled in their hands as they laugh softly and enjoy one another’s company while the faint smell of hazelnut lingers in the air.

Danes value their close friends and family very highly. Physicians in Denmark work 37-hour weeks rather than the 80 hours we often work in the US. Because of this, they have more time to spend with the people who mean the most to them.

So, what can American physicians and patients learn from the Danish values of simplicity, egalitarianism, and hygge? Granted, these concepts may be overgeneralizations, and Denmark is a social democracy with high taxes and low inequality, while the United States is a capitalistic society in which the idea of dedicated hard work corresponding to more money is deeply ingrained in our culture. I’m not arguing that everything should change—patients don’t have to start referring to their doctors by their first names, and doctors don’t have to cut working hours to experience hygge. However, I think there are still a few things we can learn from one of the happiest countries in the world:

1. Slow down.
Practice deliberate living and slow medicine. Do everything with a purpose—focus on quality over quantity. Make the most of the time you have with each patient. Enter deeper into the encounter and embrace the rhythm of the conversation. Take that extra minute to ask your patient one more question, to consider their wider social context.

2. Savor each moment, and enjoy things in moderation.
Try advising your patients to cut back on sweets and pastries to only a couple each week—they’ll start valuing each one more. Practice preventative health—biking is good for both you and the environment. The obesity rate in Denmark is about 14%, compared to about 40% in the US.

3. Try approaching life with a mindset of egalitarianism and solidarity.
Remember that your patients are people­—they are more than a disease. Each person comes to you with fears, hopes, and expectations—consider these. Respect each patient’s dignity and integrity, and show regard for their vulnerability.

4. Finally, find your hygge.
Experience that moment of deeper connection in the intimacy of an encounter between physician, patient, and family. Use this mindset to find joy in your practice, and try to practice being content. Maybe we can even be as happy as the Danes.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.