Portuguese Medical Association regrets lack of investment in General Practice

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

Speaking to the Lusa news agency about Family Doctor’s Day, which is being celebrated today, the president of the Portuguese Medical Association (OM), Carlos Cortes, recalled the importance of General and Family Medicine (FGM) in healthcare, not only because of the activity it performs, but also because it ends up “relieving hospitals”.

“Health care in Portugal has a lot of weight (…) not only because of its direct activity in literacy, promotion, prevention, humanized medicine, curative medicine and accompanying the person, their family and the community, but also because it relieves the pressure on hospitals,” he said, stressing: “if there is trained primary health care, patients’ health problems will not worsen.”

At the beginning of May 2024, 9,003 doctors with a specialty in FGM were registered with the Portuguese Medical Association, most of them women (5,788). Of those registered, over 45% (4,115) are over 65 years old and 18% are over 70.

He stressed that the ageing of these specialists is related to the lack of attractiveness of the career: “like poor working conditions for doctors, poor training conditions, no development of projects, particularly research”.

Although he points out that this is a trade union issue, he recognizes the importance of “dignifying remuneration”.

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

In 2023, of the 617 vacancies available, 165 (26.7%) remained unfilled.

“Although the Order of Physicians has managed to identify, from a training point of view, a number of specialty vacancies, they have remained deserted, fundamentally (…) due to a lack of attractiveness,” he noted.

The president also stressed the importance of FGM in “proximity medicine”, revealing that this was the specialty that “has evolved the most and the 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 over 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, stressed the “generational gap” of these specialists: “there are many family doctors over 60 and many from 45 downwards”.

He attributed this situation to the way in which entry to medical courses has been oriented 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 vacancies, it’s also colleagues at the beginning of their internship who prefer not to do the internship at all and stay on to do other things,” he warned.

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

“We’ve changed the rules for calculating incentives, the way these indicators are applied to remuneration and we’ve changed a number of things which, on the one hand, make access to these incentives more difficult and, on the other, create rules that are at least questionable,” he said, giving the example of the relationship between the remuneration of all USF professionals and the prescription of tests and medicines.

“This means that these teams can’t get to where the others [from the previous ULS] were and the others risk lowering what they had (…). It doesn’t end up pleasing anyone,” he insisted.

He said that “the outlook remains unattractive” and, even with the measures taken so far, he didn’t expect any changes to be made in terms of possible vacancies in the next competition.

Hervé Hubert
Hervé Hubert
Hervé Hubert is a 55-year-old writer and journalist based in Porto, Portugal. Born in France, he brings a unique blend of French and Portuguese perspectives to his work. Education Hervé studied Journalism and Literature at the University of Lyon in France. After completing his studies, he gained valuable experience working with various French media outlets (Portugal France also). Career He worked for several years as a journalist in France before making the move to Portugal. In Porto, he joined the Portugal Pulse team as a staff writer. Skills Hervé specializes in storytelling, investigative journalism, and cultural commentary. He has a flair for capturing complex issues in a relatable way. Personal Life He currently resides in Porto and enjoys the city's rich culture, from Fado music to Francesinha cuisine. Hervé continues to maintain strong ties to his French heritage, often traveling back to France for family visits and cultural exploration. With his unique background and diverse skill set, Hervé Hubert adds a layered, multicultural lens to every story he covers.

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