FAMILY MEDICINE IN SCANDINAVIA

family medicine Jobs

The lack of GPs in Sweden, Norway and Denmark means an increase in the need for doctors from other European countries. For this reason, many hospitals have been turning to foreign recruitment.

Working as a GP in Sweden

There are more than 30,000 physicians in Sweden, and around 5,000 (17%) work as GPs, most of whom are specialists in general practice. Team-based primary care facilities with four to six GPs, and other staff categories (district nurses, nurses and often physiotherapists, occupational therapists, psychologists, and social welfare counsellors), are the most common form of primary care practice in Sweden. Private practices with only one GP exist but are rare.

Primary care represents around 20% of the total healthcare budget. Since 2010, patients can register with any public or private provider accredited by the local county council and registration based on the latest visit or shortest geographical distance. This is the case in most county councils for individuals who do not have an active choice of providers. Irrespective of registration, however, primary care has no formal gate-keeping role in most county councils, and patients are free to contact specialists directly. Home-nursing service is in most cases not run by county councils but by the local municipal authority.

At general medicine clinics, there is usually equipment for minor surgery and various types of examinations, which are carried out in hospitals or specialist clinics in many other countries.

Working as a general practitioner in Sweden adds prestige to your CV all over the world, since the education is more extensive and Sweden is in the forefront both scienti­fically and organisa­tionally, says one of our placed doctors in her testimonial. The workplace functions well and you have doctors and nurses working in each district and you work with a good team feeling and an attitude of sticking up for one other. Here, the patients are also positive to the doctor collab­orating with other experts and asking them for advice. 

Working as a GP in Norway

GPs most commonly work in group practices of three to eight GPs. There are 22,500 doctors in Norway and around 4,500 of those work as general practitioners (GPs). Among these, 54% are specialists in general practice and 90% work in group practices.

Another important part of primary care is home-nursing service. Furthermore, inhabitants have access to occupational therapists and physiotherapists. All these services are delivered by municipalities; however, a majority of physiotherapists also deliver care as private practitioners.

In 2001, a registered patient list system was introduced, implying that all citizens are assigned to a general practitioner (GP) of their choice. Over the years this system has been in place, it has become very popular among patients as well as GPs. It secures continuity of the doctor-patient relationship and facilitates appropriate use of healthcare services.

In 2012, a new health reform (the Coordination Reform) was launched which means services now are supposed to be directed more towards preventive care, and measures are taken to reduce the burden of changing demographics (increasingly older population, migration, obesity etc).

Today, GPs tend to work independently, and it is uncommon for general practices to employ professionals other than health secretaries. The closest working partners for GPs outside the office are nurses in home-based services. 

Research in general practice in Norway has traditionally been quite strong in small-scale projects, particularly qualitative research, and register-based research.

Working as a GP in Denmark

General practice is the cornerstone of Danish primary healthcare. Practice units are fairly small: Close to two GPs per unit plus nurses and secretaries. The units are fully computerised, that is, with computer-based patient records and submission of prescriptions digitally to pharmacies, etc. Over the past few years, a decrease in solo practices has occurred and is expected to accelerate, in part because of the GP age structure, with many GPs retiring and new GPs not wanting to practice alone. This latter workforce trend is pointing toward a new model with employed GPs, particularly in rural areas.

In average, Danes have 6.9 contacts per year with their GP (in-person, telephone, or e-mail consultation). General practice is characterised by five key components:

 

  • A list system, with an average of close to 1600 persons on the list of a typical GP
  • The GP as gatekeeper and first-line provider, as a referral from a GP is required for most office-based specialists and always for in- and outpatient hospital treatment
  • An after-hours system staffed by GPs on a rota basis
  • A mixed capitation and fee-for-service system
  • GPs are self-employed, working on contract for the public funder based on a national agreement that details not only services and reimbursement but also opening hours and required postgraduate education. General practice is embedded in a universal tax-funded healthcare system in which GPs and hospital services are free at the point of use. The current system has evolved over the past century and has shown an ability to adapt flexibly to new challenges