The Swedish General Practice Conference in 2021 kicked off on Wednesday. The first item on the agenda was a panel discussion entitled “Primary care for the future – are we there soon?”.
The committee mentioned that we are not there yet and that there are a number of things to work on in the future. Some of the proposals are, for example, to move more resources from hospitals to primary care, to attract more physicians to become managers and to make it easier for physicians who want to start staff-managed health centers.
The committee also agreed that provision of skills is a very important topic, not the least of which is ST education in general medicine. Here, the state can take on greater responsibility, says Anders Annell, professor of health care regulation and financial management at Lund University.
– If you look in the rearview mirror, I can think there might be a reason to have more National Plan and Control ST. Anders Annell said that one implication is that there is a risk that there is too much of a production perspective in ST education.
– That you then assign an ST because it is cheaper than appointing a GP and because there is a skew in health centers with too many STs with respect to supervisors. I do not think your listing in ST. One needs to think of this as part of the country’s long-term investments in enhancing the skills supply.
Emma Spaak, director of the Swedish Municipalities and Regions’ Health and Welfare Department, disagreed, and noted that it would be difficult for the state to enter, for example, operating Dimensions of ST services.
– This is about services, you must be an employee. There must be a plan for the future. You have to know that you have judgments for professionals and that you don’t just put in a group to be trained. Emma Plumber said, “You have to be able to know that there are people who can supervise and that you’re going to run the whole chain.
She also emphasized that in the future it would not only be ST doctors in general medicine who would go to primary care.
In the new medical education, you have to go out and see more primary care so you can work there. You also need to secure what it would be like for AT and BT and secure routing for these groups as well.
Magnus Isacson, President of the Swedish Society for General Practice (Sfam), stated that the number of ST doctors in general practice has increased over the past 10 years and is positive.
– Now it seems that the biggest problem is the lack of funds to hire specialists in health centers. You have many ST doctors but you don’t have specialists and it’s not going to be good. Then supervision suffers and ST doctors do not have the same skills as a specialist.
When it comes to supervision, Magnus Isacson also emphasized that it has to be a specialist in the right place to work.
You cannot moderate digitally. There are some currents in this direction. The rule of thumb should be that your supervisor must be on site and available. This is something we must preserve.
Marina Totma, president of the District Physicians’ Union, shares the view that the economy is a problem around ST.
– We see that the number of ST places is increasing, but the economy is not keeping pace. In Västra Götaland, for example, they had to put a stop to it because there was a disparity between money and the number of people who were in ST, Marina Totma said.
Another thing I highlighted as a major problem is that no one is fully responsible for providing the skills.
– All regions are only training according to their own needs, but unfortunately they do not know what the need looks like.
Marina Tuutma cites a recent DLF survey. In the survey, DLF asked all districts questions about the availability of physicians in primary care. The results show that few districts were able to answer questions about their shape, for example, retirements and the degree of service of district physicians.
The few districts that can report this can only do so to public health centers. But according to the Health Care Act, districts must dimension the entirety of primary care. Then you have to keep track of how many people work in private and public health centers, what it’s like with retirement, and how many places you need in five or seven years. Unfortunately, it is missing.
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