88 years before primary care reaches full staffing

It will take 88 years for Sweden to reach full staffing in primary care, a new report states.
On average, the regions need to hire at least twice as many specialists in general medicine compared to today.
– There has been a reluctance to tackle the problem, says Ylva Sandström, chairman of the Swedish District Medical Association (DLF).

The outlook for primary care is bleak. According to DLF’s report, primary care will not be fully staffed for ten years and some regions will never reach full staffing. Among these are Örebro, Kronoberg and Dalarna. In the regions mentioned, the investments are too small for the target value to ever be achieved. In other regions, it has not been possible to disclose information about how many doctors they have or will need in the future.

Ylva Sandström is now appealing to responsible politicians to invest in training and hiring.

– You need to greatly increase the number of ST positions – and not just add ten more positions. Those are too small numbers. Without that, a strong expansion of the number of ST doctors is needed.

The National Board of Health and Welfare’s benchmark for physician staffing in primary care came in April 2022. The benchmark means that a specialist in general medicine must be responsible for 1,100 residents and each ST doctor (doctor under specialist training) for 550 residents. It is on the basis of these figures that DLF has calculated how many must be employed in the regions for care to be considered fully staffed.

Jämtland-Härjedalen is an exception

Only a few of the country’s regions have made decisions to try to follow the target values, even fewer have set up action plans for how to reach them in time. The only region that DLF feels is in balance is Jämtland-Härjedalen. In the region, there are 103 specialists in general medicine compared to the benchmark of 104.

The reason is that the region saw the warning bells early. In 2013, Jämtland-Härjedalen introduced a moratorium on chartered physicians, something that led to a health care crisis. The region then realized that it was no longer possible to continue as it had previously done, and invested in training its own staff instead of recruiting from other regions.

– Now they can staff their health centers with the people they trained and the region now has by far the most ST doctors per resident, says Ylva Sandström.

Educating a specialist in general medicine takes an average of eight years, excluding the medical program. The regions must dare to invest over time to solve the staffing issue. Ylva Sandström believes that Jämtland-Härjedalen can be an example for other regions.

– In a small region, you might think that it is impossible. But it’s not about big numbers. Jämtland has shown that it works.