Friday, October 11, 2024

Poland’s Looming Medical Staff Crisis: Addressing Shortages and Ensuring Quality Healthcare

HEALTH & MEDICINEPoland's Looming Medical Staff Crisis: Addressing Shortages and Ensuring Quality Healthcare

The shortage of medical staff has been a continuous problem in Poland over the years. Currently, the deficit is especially noticed among the key specialists for the functioning of the health sector – internists, pediatricians, and obstetricians – as well as in less popular specializations like geriatrics or general surgery, which may result in closing relevant hospital departments in the near future. In addition, the aging of medical personnel in Poland is progressively notable – retired medical practitioners provide essential help to the health care system. On top of that, younger generations are increasingly choosing to work in open health services, which do not require them to be on duty, resulting in further deficiency of doctors in hospital departments, or they prefer working in private facilities that offer them better employment conditions and higher wages.

According to the latest OECD report “Health at a Glance 2023”, there are 3.4 practicing doctors and 5.7 practicing nurses per 1,000 inhabitants in Poland, compared to the OECD average of 3.7 and 9.2, respectively. As for the “World Index of Healthcare Innovation 2023” – prepared by the Foundation for Research on Equal Opportunity advocating for equal opportunities – Poland ranked last, 32nd (falling from 31st in 2021 and 30th in 2020). The report pointed out, among other things, that Poland has the lowest number of general practitioners and nurses among the analyzed countries.

“We’ve had a shortage of doctors in Poland for a long time. We’ve been functioning in a permanent crisis for many years, lacking specialists,” says Krzysztof Żochowski, vice president of the Polish Union of County Hospitals Employers.

According to the Polish Academy of Sciences’ report, in OECD countries, 10% of those actively working are in the healthcare sector, and this proportion has grown even during the crisis of 2008-2009. In contrast, Poland desperately falls behind, with only 6% of those employed working in healthcare. The staff shortage is particularly visible among specialists aged 41-50, including internists, pediatricians, general surgeons, and obstetricians. It’s also worth noting that the percentage of general practitioners in 2020 was 20% in the EU, but only 9% in Poland.

Furthermore, OECD data on the number of doctors per 1,000 inhabitants also include working specialists of retirement age. Consequently, medical practitioners nearing or of retirement age currently make up significant support for the Polish healthcare system.

“Specialities we drastically lack include general surgeons. I will be 60 next year and could join the youth section of the Polish Society of Surgeons because the average age of general surgeons in Poland has reached retirement age,” says Krzysztof Żochowski. “We also lack other specialists, e.g. anaesthesiologists and emergency medicine specialists. Currently, due to the rapid development of diagnostic procedures, we also seriously lack radiologists.”

The deficit of medical personnel in Poland has been increasing for years. A report by ManpowerGroup published before the COVID-19 pandemic showed that, even then, 72% of Polish hospitals were looking for nurses and 68% for doctors of all specializations. Meanwhile, the aging population and the increasing number of chronic and civilization diseases lead to a greater demand for medical services. Combined with staff shortages, this results in long waiting queues to see specialists and extended waiting times for medical services.

“Recently, many new medical schools have been set up, but the effects of these actions will be seen in 10-15 years. There are still open questions regarding the quality of the education provided by these schools and whether they will be able to adequately prepare graduates for this challenging profession,” notes the vice president of the Polish Union of County Hospitals Employers.

As of 2021, over 20 Polish universities are providing medical education, offering slightly over 5,000 full-time places and 1,200 part-time places. In recent years, the number of these schools has grown rapidly, and additional medical faculties are being opened at universities that do not have a teaching background, academic teachers, and usually rely on the hospital resources of county hospitals. This raises justified concerns about the quality of medical education.

“We also need to be aware that a doctor who has just graduated from medical faculty is not yet fully prepared and is not a fully valuable employee. They still need to complete their specialization. A major challenge here is the proper state policy regarding residents, their availability, accurately calculating actual Polish needs when it comes to providing help, how many specialists we need and appropriate financing for this,” emphasizes Krzysztof Żochowski.

According to the Supreme Medical Chamber’s data, 1950 doctors began their specialisation training in the autumn of 2022. Out of the 76 specialisation routes available, the most popular were internal diseases (162), emergency medicine (104), neurology (103), oncology (87) and medical rehabilitation (85).

Statistics show a clear decline in the popularity of specialisations like geriatric medicine or general surgery, which might lead to the necessity of closing such hospital departments in the near future.

“The lack of doctors especially affects smaller centres because larger cities offer greater opportunities for specialists. However, young doctors are increasingly choosing to work in public health services, without the need to perform hospital duties, which deepens the shortage of doctors in hospital departments, and in private facilities, which offer better employment conditions and higher wages,” says the expert.

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