GP Recruitment and retention in the Nordic countries

Abstract

Demographic changes and decentralization of health care provision have led to a higher demand for General Practitioners (GP) services in the Nordics. As a result, many countries report that recruiting and retaining GPs are increasingly difficult. Coupled with younger GPs increasingly valuing work/life balance, the Nordic countries are now looking at different policies that can ensure a sustainable GP supply going forward. Relevant policy measures depend on the GP systems in place, which also differs between the countries. We provide an overview of reforms and policies that have been planned or implemented in the last 10 years and use a theoretical framework to discuss their potential effects on recruitment and effort. Our focus is on remuneration schemes, GPs’ working conditions and practice quality as policy levers to incentivize effort and to attract additional GPs. We show that policies that have a positive effect on recruiting GPs can have a negative effect on the effort GPs exert. Since reduced effort might have a negative effect on the services patients receive, the total effects of the policies are uncertain. We further show that the dominating effect is sensitive to preferences and characteristics of the GPs, providing important insights for policy makers who want to increase GP supply.