Half of all general practitioners (GPs) for children and adolescents in the Czech Republic have now reached retirement age, the number of surgeries has dropped by 400 in the past five years, and a number of senior doctors are expected to retire soon, according to data from the Institute of Health Information and Statistics (UZIS).
UZIS director Ladislav Dusek told the Czech Medical Chamber’s (CLK) conference yesterday on the ageing of health professionals that the health system will need to hire 1,100 full-time child GPs to plug the gap. The numbers of diabetologists and surgeons are also declining, while it is expected that the number of GPs for adults will begin to grow again within two years.
“As far as the number of full-time doctors is concerned, we are slightly above the European average,” Dusek said.
“But the problem is that our population of doctors is far from optimally distributed among fields, and the population of doctors has aged and is facing a large number of retirements,” he added. Therefore, he said, the Czech Republic must prepare for an inevitable restructuring of care and a drop in capacity.
For example, half of the country’s general practitioners for children and adolescents are currently reaching their retirement age. “There is a risk that in some regions that care will break down,” Dusek said.
Some 390,000 children had to find a new GP in the past five years as nearly 400 surgeries closed.
Meanwhile, children’s GPs are also taking patients from overburdened specialists, especially child psychiatrists, of whom there are only 157 in the whole country, and more than a third of those at retirement age. “It is absolutely obvious that in many regions child psychiatry is practically non-existent,” Dusek said.
The situation is better in adult psychiatry, where the number of young doctors interested in the field has increased. However, the number of people who need mental health professionals is also growing significantly, especially among the young.
The number of patients with diabetes is also increasing, with predictions that it will rise by a fifth to more than a million between 2020 and 2030. Meanwhile, more than 30% of diabetologists are of retirement age and 50 surgeries have closed in the past five years. “Where there is a severe shortage of diabetologists, general practitioners for adults are taking over their work,” Dusek said.
About 40% of GPs for adults are over 60. Currently, only about 200 new doctors enter the field each year. “It’s improving slightly, although there is still a negative balance. That will hopefully be fixed within two years,” Dusek said.
He said a large proportion of medical graduates are going to hospitals, while the share of those going to outpatient clinics is decreasing. There is therefore a shortage of doctors in other fields as well. For example, according to a recent press release from the Association of Outpatient Specialists, a quarter of outpatient specialists may be missing in six years, as 43% of them are already of retirement age.
According to Dusek, half of surgeons are also of retirement age, with around 50 graduating each year, while around 1,000 will retire within ten years. The fields of allergology, internal medicine, clinical neurology, anaesthesiology and intensive care medicine and pathology are also experiencing similar problems.
The data on the ageing of doctors was presented by the Institute of Medical Research in 2018. At that time, Dusek warned that if nothing changes, by 2025, a third of all capacity will be covered by doctors over the age of 60. At that time, the average age of a physician was 49, and that of a general practitioner for children and adolescents was 59.
Since then, the number of graduates in general medicine, which every doctor must complete before choosing a particular medical field, has increased by almost 30% every year. The first graduates from these boosted classes will graduate in 2025.
According to statistics from the Ministry of Education, 21,292 students studied at medical faculties in 2017, with 2,500 Czechs graduating (of whom about 1,100 were doctors) and about 700 foreigners. Currently, the number of students at medical faculties is almost 26,800, according to the Education Ministry.
