Brickebacken’s Health Care Centre now has no permanent doctors. The last one left three weeks ago. The paper reported today that the centre may be closed if doctors are not found.
An opposition politician was reported in the same article to have attributed some of the shortage of general practitioners in Sweden to the lack of opportunities for private practice, which he believes has made it difficult for general practitioners to earn a reasonable income, thus lowering their status. The leader of the Örebro county council responded that the problem cannot be solved by privatisation, but is much more complex.
It has been reported that Örebro county is currently 40 general practitioners short of what is required. However, this figure is dependent on what is regarded as a reasonable doctor patient ratio. The goal in Sweden in general is 1 doctor for every 1500 in the population. It was reported in the same article that if that ratio was changed to 1 to 2000 the shortage would be reduced to 4. I think that the doctor patient ratio in Tamworth is about 1 to 2500, although perhaps it has worsened since I left!
People sometimes wonder why I am not yet working as a GP here, in view of the shortage. One reason is that I don’t particularly want to. Having visited the local Health Centre on one occasion I have to say it did not appear as a very attractive option. Stark, sterile, with no pleasant outlook, and a definitely unappealing atmosphere. The knowledge that the income is low does not help. I am much more interested at present in working at the hospital in the Infectious Diseases department.
However, the main reason I am not working is that I am not registered. In order to be fully registered as a doctor here in Sweden I must first have a certain proficiency in the Swedish language, at a level which is currently still beyond my ability. It is for that reason I am studying Swedish, and I hope to have achieved the required proficiency by June.
After that I will have to work in a test job, under supervision, for 6 months, at the end of which time a report from my supervisor will be sent to the Medical Board. I will then be informed by them about what I must still do to get full registration, which will depend on what problems the supervisor has detected. It will almost certainly involve an 18 month pre-registration (allmänstjänstgöring) period, although in what capacity I will be working during that period I have currently no idea.
So I am not going to be any use to the GP shortage in Sweden for a good while yet. I wonder if we will still be in Sweden by then. It is a long time to be without a proper income, although I presume I will be paid during the pre-registration period.
In the meantime, Sweden persists in training less doctors than they need, despite questions from many as to why this is so. I suspect the issue is economical. If aspiring young medical students go outside Sweden to get their medical education, the government saves megabucks. They assume the young doctors will come back to Sweden to work.
The issue of status and income for general practitioners is an important one. With salaries fixed by the government, and a lack of potential for doctors to run their own practices, the incentive to work hard to build a good practice with a good income is simply not there. In the past I have often thought how nice it would be to be salaried, and have someone else take all the responsibility for practice management. But after a visit to Brickebacken Health Centre, I am not so sure. I certainly have no desire to work there Give me Barton Lane Practice any day…