{"id":44152,"date":"2024-12-24T06:30:00","date_gmt":"2024-12-24T05:30:00","guid":{"rendered":"https:\/\/trendsanita.it\/?p=44152"},"modified":"2026-04-14T17:04:32","modified_gmt":"2026-04-14T15:04:32","slug":"make-general-practice-great-again","status":"publish","type":"post","link":"https:\/\/trendsanita.it\/en\/make-general-practice-great-again\/","title":{"rendered":"Make general practice great again"},"content":{"rendered":"\n

A stark warning from the World Health Organization (WHO) reveals<\/a> that Europe faces a critical shortfall of health and social care workers, projected to reach 1.6 million by 2024 and 4 million by 2030.<\/p>\n\n\n\n

According to WHO estimates, the looming crisis includes deficits of 600,000 doctors, 2.3 million nurses, and 1.1 million social and welfare workers if urgent action is not taken to reverse the trend.<\/p>\n\n\n\n

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When we think of doctors, our minds often turn to those in hospitals, yet General Practitioners (GPs) face similar challenges in their roles.<\/p>\n\n\n\n

\u201cThe main challenge right now is recruitment and retention of healthcare professionals. In the case of GPs, in Europe even Countries that have very good working conditions and very good remuneration are grappling with shortages\u201d. Tiago Villanueva<\/strong> is the President of UEMO<\/a>, the European Union of General Practitioners\/Family Physicians. It is a not-for-profit organisation of the most representative national, non-governmental, independent organisations representing GPs in Europe.<\/p>\n\n\n\n

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Tiago Villanueva<\/figcaption><\/figure>\n<\/div>\n\n\n

Villanueva has some recent data interviewing the association\u2019s members: \u201cAt least 2.000 GP’s are needed in Romania, in Spain about 5.000, in the UK they need about 70.000 GP’s and they have 43.000. it’s pretty incredible even in Norway there are 160.000 patients without a GP and Norway is a small country, so 160.000 people is already considerable\u201d. And more: \u201cIreland needs 1.400 to 1.600 GP\u2019s; next year in Italy there will be approximately as short as the 4.000 GP\u2019s and at least 500 GP’s in Croatia; even in Iceland, a tiny country, they need 200 GP\u2019s. In North Macedonia they have right now 1.200 GP’s but 30% of them are over 65 and the young doctors work as GP\u2019s for two to three years. And after that they go to other specializations or move to other countries for better salary and better future\u201d.<\/p>\n\n\n\n

Even in Finland, they need 1.000 GP\u2019s and in Sweden they need about 5.000. \u201cAnd the list goes on and on and on\u201d, Villanueva tells TrendSanit\u00e0<\/em>.<\/p>\n\n\n\n

Rethinking the profession<\/h2>\n\n\n\n

\u201cI would say that this situation is of course better in northern Europe, where working conditions and remuneration are better, but in southern and eastern Europe the situation is even worse. However, if it was a problem for remuneration, we would have sorted it by now. It’s more about that. <\/strong>It’s also about the attractiveness of the career\u201d.<\/p>\n\n\n\n

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For Villanueva \u201cGPs are still very much a patient facing specialty where almost 100% of your time is dedicated to patient care. And I think you need to make it more attractive to have protected time for other activities like non-clinical activities: academic activities, research, teaching. It\u2019s important to make it an attractive package, and not just clinical care. Any GP knows that when you start the day you start with the first patient then do and then it’s non-stop until the last question. Often you don’t even have time to go to eat or to go to the toilet. It\u2019s a very hard job. In the hospital there’s a different dynamic because you work in a team. I think we need to rethink how to make the profession attractive for medical students and young doctors and I don’t think we’re doing a good job\u201d.<\/p>\n\n\n\n

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Even the places that offer very attractive conditions have a lack of GPs: \u201cFor example in the southern France, if you go to work in remote areas called medical deserts<\/strong> they pay you very well, they even give you tax incentives. So you don’t pay taxes for like 10 years and they give you accommodation. But even then it’s still hard to recruit doctors because they would be alone in a small town and this wouldn\u2019t be good for their professional development\u201d.<\/p>\n\n\n\n

Differences among European countries<\/h2>\n\n\n\n

\u201cHere in Portugal I tend to learn about medicine shortages through my patients. You get a little piece from the Secretary saying the patient needs a prescription but his medicine is over: he can’t get it in the pharmacy, please find the replacement. That immediately puts me under a lot of pressure and then I spend a lot of time thinking\u201d.<\/p>\n\n\n\n

Shortages are a problem for all European countries and although we can predict pretty much anything these days, like earthquakes and floods, as a physician you can’t predict medicine shortages. <\/p>\n\n\n\n

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\u201cWe don’t have an alert system with medicine shortages: by the time something is wrong there’s nothing to do, so we just have to find a way to mitigate the damage – Villanueva reflects -. We do know that some regulators in some European countries are doing a very good job and I gave the example of Ireland because you can go on the website of the medicine agency of Ireland and you can look up the shortages you know what medicines are are missing, why they’re missing, when the shortages are going to end. But in other countries you don’t have that kind of information infrastructure\u201d. <\/p>\n\n\n\n

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We have a heterogeneous situation and each country has its own standard: \u201cEuropean authorities don\u2019t like to say a lot because health is a national member state competence <\/strong>and it’s a fact that some countries are more organised than others\u201d. <\/p>\n\n\n\n

Changing medicine<\/h2>\n\n\n\n

\u201cWe have the challenges of the newer generations<\/strong>: they don’t want to work as the previous generations – the President of UEMO notes -. Traditionally, in the last 50 years medicine has been more than a profession: it’s a calling. You even put your profession ahead of your family\u201d.<\/p>\n\n\n\n

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But the younger generations don’t see things like that anymore: \u201cThey don’t want to work full-time, they want to have time for their friends and family, they want to have reasonable working hours, they don’t want to be working nights and weekends. <\/p>\n\n\n\n

And that is a challenge because Europe is getting older and older<\/strong>, the population is growing, but the older you are, more health needs you have\u201d.<\/p>\n\n\n\n

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In addition to this, during the pandemic most of the work was being carried about silently in Primary Care, in which patients had the non severe symptoms. \u201cBecause of the work overload during the pandemic GPs became disillusioned with the profession and I think people felt frustrated that they were not being valued by authorities and a lot of people are leaving the profession\u201d, is Villanueva’s analysis. <\/p>\n\n\n\n

It seems that decision makers all across Europe always go for the negative policies rather than the positive ones<\/p>\n\n\n\n

The Spanish Medical Association produced an infographic about what they call positive policies and negative policies. Positive policies are things like financial incentives, tax incentives, giving housing to physicians\u2026 Negative policies are things that we know that don’t work such as trying to increase the number of places in medical school. <\/p>\n\n\n\n

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\u201cYou can pump thousands and thousands more students into the system, but it won’t work because they won’t go into general practices if they don’t find it attractive – Villanueva reminds -. And unfortunately it seems that decision makers all across Europe always go for the negative policies rather than the positive ones. The solutions have all been identified, but they are not being enforced by the decision maker, so our job as an European Association is to alert European authorities and the Commission and Parliament about this kind of thing\u201d. UEMO is having meetings in January with the people from the European Commission and DG Sante and the European Parliament.<\/p>\n\n\n\n

Challenges for the future <\/h2>\n\n\n\n

\u201cWe’re going to continue banging on the issue of recruitment and retention; we’re going to continue to advocate for the recognition of general practices and family medicine as a specialty in Europe <\/strong>because in the European legislation general practice is not considered a specialty\u201d. <\/p>\n\n\n\n

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For the younger generation, medicine is no longer a calling<\/p>\n\n\n\n

Right now general practice is considered like a qualification but not a specialisation.
Another thing that is an emerging issue is the replacement of GPs by other healthcare professionals<\/strong>. It’s happening in the UK.<\/p>\n\n\n\n

\u201cIronically, in a country where there’s almost 30,000 GPs needed in the system, a lot can’t find work. It’s a contradiction: the UK Government is investing in training healthcare professionals that are less qualified than doctors. But in many cases they are replacing doctors in seeing patients. They’re not nurses. They’re not doctors. They’re called Medical Associate Professionals\u201d.<\/p>\n\n\n\n

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But are GPs replaceable? \u201cWell, I think that a lot of what we do can be delegated, something like admin stuff for example – Villanueva admits -. But patient care is something that should remain with the physician, you can\u2019t cut corners on that. And this is not something you can learn in a short time, with a course. You have to go to medical school, you have to specialise and to be able to provide a very high standard of clinical care. Otherwise you may result in bad outcomes\u201d.<\/p>\n","protected":false},"excerpt":{"rendered":"

There is a shortage of GPs throughout Europe and it is not just a question of remuneration. According to Tiago Villanueva, President of UEMO, ways must be found to keep the younger generation within the general practice pathway<\/p>\n","protected":false},"author":1955,"featured_media":44140,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[544],"tags":[571,550],"rubrica":[],"speciale":[],"class_list":{"0":"post-44152","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-across-europe-en","8":"tag-across-europe-en","9":"tag-drugs"},"yoast_head":"\nMake general practice great again<\/title>\n<meta name=\"description\" content=\"There is a shortage of GPs throughout Europe and it is not just a question of remuneration. 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