Roughly 2,500 doctors would be enough to handle all of the 14 million basic healthcare consultations provided annually in Finland, says a director at the Finnish Innovation Fund (Sitra). (Emmi Korhonen – Lehtikuva)


INCREASING the number of doctors is not the panacea it has been made out to be for the ills of the healthcare system in Finland, states Antti Kivelä, the director of the capacity for renewal theme at the Finnish Innovation Fund (Sitra).

Kivelä on Saturday stated in a blog that the number of doctors could contrastively be slashed dramatically.

“In practice, roughly 2,500 doctors could probably take care of all basic healthcare consultations nationwide. As the number of doctors is currently around 22,000, this would be around 10–15 per cent of the pool of doctors,” he argued.

He pointed out that the roughly 14 million basic healthcare consultations provided annually to individuals are scattered between four separate components of the system: public healthcare centres, occupational healthcare providers, private healthcare clinics and the Finnish Student Health Service (YTHS).

“There is no other place in the world where the state has actively developed a system with as many as four different [channels], three of which are supported substantially by the state, and where […] the use of insurance and self-funded services is growing, because the three others do not suffice to meet the needs of the public,” he stated.

Kivelä added that if the number of consultations was divided evenly between 2,500 doctors, it would amount to 5,600 consultations per year – or 20 patient contacts per day – per doctor.

“If the client was known in advance, some of the consultations could be carried out by phone, e-mail or other electronic channels. I believe that around 20 is a low number of contacts per day, as Estonian doctors have around 100 contacts a day,” he wrote.

The Finnish Medical Association in April reported that almost 4,000 doctors are currently employed in municipal basic healthcare and an additional 2,000 doctors at occupational and private healthcare clinics providing basic-level services. The rest of the doctors are employed in special healthcare.

Kivelä highlighted that the number of doctors jumped by 35 per cent between 2000 and 2015 – from roughly 16,000 to 22,000 – while special healthcare consultations rose from seven to 10 million.

“The numbers suggest that doctor resources have been allocated not to basic healthcare but especially to special healthcare, which is the cause of the chronic basic healthcare shortage,” he said.

Kivelä voiced his concern that patients are an afterthought for the current administrative system.

The solution he proposed is a system based on family doctors and long doctor-patient relationships, the costs of which would be covered partly by patient contributions and partly by the Social Insurance Institution of Finland (Kela).

“The producers in this system could be the family doctors, who could be self-employed, part of the public sector or on the payroll of [healthcare] chains,” he envisioned.

Aleksi Teivainen – HT
Source: Uusi Suomi