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The industry is sounding the alarm because of the lack of staff. How did it come to this? The most important answers.
It’s all about this: It is one of the major construction sites in Swiss health policy – and has been for years: the country is running out of family doctors. Politicians have therefore repeatedly tried to remedy the situation. Little has changed so far. Now practitioners are sounding the alarm. A collapse is imminent, says the president of the family and pediatricians to the “Tages-Anzeiger”.
These are the numbers: One family doctor per 1000 inhabitants: This is the guideline value published by the World Health Organization (WHO). Around 40,000 doctors work in Switzerland. 8500 of them work in general internal medicine. If you compare this with the population of Switzerland (8.8 million), the country is within the WHO guideline. However, if you look at the full-time equivalents, according to the Swiss Health Observatory (Obsan), the supply density falls below the critical value – namely 0.8. Switzerland therefore lacks hundreds of skilled workers every year.
The young talent pipeline is faltering: General practitioners often act as confidants for their patients. Long working hours are traditionally part of the job profile. They are also often responsible for running a small business. A lot of people don’t want to do that anymore. Only about 20 percent of graduates opt for the specialization. According to experts, this number should be twice as high. The result: the number of general practitioners remains the same, while there are more and more specialists.
Those who choose the profession nonetheless no longer want to do so for the same high wages as their predecessors. The Swiss Association of General Practitioners and Paediatricians provides figures: While the working hours in 2005 were 50 hours per week, today the figure is 43 hours per week.
The last reform: In 2012, Federal Councilor Alain Berset presented a master plan to tackle the problem. The family doctor profession should be made more attractive and more training positions should be created. Ten years later spoke the bond of a success. Tilman Slembeck, health economist at the Zurich University of Applied Sciences (ZHAW), is more critical. “There are still far too few training places.” He therefore sees the cantons as having a duty to do more.
This is done: Several universities have created chairs for family medicine in recent years. In addition, in many places there are practical assistance programs in which the cantons bear part of the wage costs. Because many go directly to an emergency instead of to the family doctor, several university hospitals have also set up their own family doctor’s offices. Elsewhere, programs are being experimented with in which nurses increasingly take over the duties of doctors.
Legend:
A family doctor on a home visit in the canton of Zurich (Image: 2009)
KEYSTONE/Gaetan Bally
That’s why this is important: Switzerland has 4.6 physicians per 1000 inhabitants one of the highest concentrations of doctors in the world. There can be no question of an undersupply. Everything is fine, one might think – if it weren’t for the simultaneous cost explosion in healthcare. Expert Slembeck sees the loss of importance of general practitioners as an important cost driver. “They act as gatekeepers by deciding who needs to see a specialist and who doesn’t.”