Order of Doctors regrets lack of investment in General and Family Medicine

Today marks Family Doctor's Day

The Medical Association today lamented the lack of investment for many years in General and Family Medicine, an area “with great weight” in the National Health Service and which has almost half of the doctors over 65 years of age.

Speaking to the Lusa agency regarding Family Doctor's Day, which is celebrated today, the president of the Order of Doctors (OM), Carlos Cortes, recalled the importance of General and Family Medicine (FGM) in healthcare, not only for the activity it performs, but because it ends up “relieving hospitals”.

«It plays a huge role in healthcare in Portugal (…) not only because of its direct activity in literacy, promotion, prevention, humanized medicine, curative medicine and monitoring the person, their family and the community, but also because it alleviates the pressure on hospitals", he stated, highlighting: "if there is qualified primary health care, patients' health problems will not worsen".

At the beginning of May 2024, 9.003 doctors specializing in FGM were registered with the Medical Association, the majority of whom were women (5.788). Of those registered, more than 45% (4.115) are over 65 years old and 18% are over 70 years old.

The president highlighted that the aging of these specialists is related to the lack of attractiveness of the career: «like the poor working conditions for doctors, the poor training conditions, there is no development of projects, particularly research».

Even though he emphasizes that this is a union matter, the chairman recognizes the importance of “remunerative dignity”.

OM figures indicate that FGM is the specialty that has had the most vacancies unfilled in recent years, a reality that the Order considers “worrying”.

In 2023, of the 617 available vacancies, 165 (26,7%) remained unfilled.

«Although the Order of Doctors was able to identify, from a training point of view, a set of specialty vacancies, they have remained deserted, fundamentally (…) due to their lack of attractiveness», he noted.

The president also highlighted the importance of FGM in “proximity medicine”, revealing that this was the specialty that “has evolved the most and best in recent decades”.

Since 2020, 2.704 vacancies have been opened for this specialty, an increase of more than 25% in the number of vacancies in this period. However, especially in the last two years, many have remained empty.

For his part, the president of the Portuguese Association of General and Family Medicine (APMGF), Nuno Jacinto, highlighted the “generational gap” of these specialists: “there are many family doctors over 60 years old and many aged 45 and under”.

He attributed this situation to the way in which entry into the medical course was guided over the years, but agreed that the main cause is the lack of attractiveness of the National Health Service (SNS).

"Now, it's not just FGM specialists who don't choose any vacancy, it's also colleagues at the beginning of internship who prefer not to even do internship and are left doing other things", he warned.

Asked whether the generalization of Family Health Units (USF) model B (with extra payments for objectives) could help attract more specialists, he said that what happened “was not a true generalization of what existed”.

«We changed the rules for calculating incentives, the way these indicators are applied to remuneration and we changed several things that, on the one hand, make access to these incentives difficult and, on the other, create rules that are at least questionable», said the person in charge, giving an example of the relationship between the remuneration of all USF professionals and the prescription of tests and medications.

«This means that these teams cannot reach where the others [from the previous ULS] were and the others risk lowering what they had (…). It ends up not pleasing anyone», he insisted.

He said that “the outlook remains unattractive” and, even with the measures taken so far, he considered that it is not expected that there will be changes regarding any empty vacancies in the next competition.