What can a family doctor do in different EU countries and how much he is paid for it?

 

"Salary, apparently, is one of the main indicators reflecting how the state assesses a particular profession, its importance and necessity for the country. Of course, the money earned also shows the social status of a particular person, the opportunities to create optimal living conditions for themselves and their family. By the way, everyone will probably agree that it would be naive to expect that there will be at least one person who would declare that they earn too much and ask for a salary reduction. Therefore, in all countries and at all times, the issue of salary has been and will remain relevant.

 

It is no secret that after independence and especially after joining the Schengen area, a mass of people left Lithuania in search of a better life. Unfortunately, some doctors and nurses also emigrated. I personally had to write recommendations for more than one family doctor, because at that time the salaries of doctors were 5-6 times lower compared to Western countries by European standards, so for some young families it was simply a matter of survival. In Lithuania, doctors' salaries have been steadily rising for 35 years, but even now there are still many who think and write that the workload of doctors is too high, and their salaries could be raised more, especially considering that we spend almost half as much on healthcare compared to European averages. But are we really falling out of the European context when it comes to assessing the salaries and work performed by Lithuanian family doctors? Well, let's try to see what salaries are in Europe. By the way, we will show the currencies of all countries converted to Euros. Statistical data is provided for 2023-2024. Doctors' salaries are indicated before taxes. Although the prevailing title in Europe is "general practitioner", in this article we will use the officially legalized synonym "family doctor" in Lithuania. Well, let's talk about the facts and start with the richest countries.

 

Switzerland. A family doctor earns 140-220 thousand EUR per year, and 6-10 thousand EUR per month. The salary depends on the region, the number of patients and the procedures performed. In Swiss cities, medical care for children is in the hands of pediatricians. In rural regions, the family doctor is responsible for children. In addition to routine therapist work, a family doctor also performs minimal surgical and gynecological procedures. Most Swiss doctors try to work in private institutions due to better salaries.

 

The social status of a family doctor is very high. The salary received allows you to fully satisfy all household and cultural needs.

 

Norway. A family doctor, depending on the region, earns 80-150 thousand EUR per year, 5-7 thousand EUR per month. The salary consists of a basic salary and income from patient premiums. A family doctor performs such minimal surgical operations as the removal of cysts, moles, ingrown toenails, etc. Also responsible for gynecological care - takes cervical smears, inserts spirals, etc. In rural regions, after additional training, a family doctor can also accept births.

 

In order to maintain high qualifications, medical institutions fully pay for participation in scientific conferences.

 

Doctors who have left to work in Norway are bribed primarily by creating an excellent psychological environment, showing care and respect from the administration.

 

Netherlands. The annual salary of a family doctor, depending on the region and the procedures performed, varies from 100 to 140 thousand EUR. In addition to the usual work of a therapist, a family doctor performs outpatient surgical procedures, gynecological care, takes cervical smears, and consults on contraception. When working in rural regions, he can accept births together with a midwife.

 

The Netherlands is characterized by a particularly optimized work and rest regime for doctors, which is why doctors indicate that they are maximally satisfied with their work.

 

United Kingdom. In a state or municipal institution, the annual salary of a family doctor ranges from 87 thousand EUR to 115 thousand EUR. Monthly income ranges from 6.6 to 10 thousand EUR. If a family doctor is self-employed, his annual income can increase to 173 thousand EUR. In the United Kingdom, the scope of work of a family doctor is really large. In addition to the usual work of a district therapist, a family doctor in the UK provides full medical care for children and full gynecological care for women. After special courses, he receives permission to insert spirals into the uterus. In addition, he performs limited surgical procedures (drainage of cysts, abscesses, suturing and caring for wounds, injections into joints).

 

In the opinion of doctors, their salaries are too low and the workload is too high, which is why doctors have repeatedly gone on strike.

 

Germany. The annual income of a family doctor ranges from 80 thousand to 120 thousand EUR. The monthly salary ranges from 4.5 to 6.5 thousand EUR. Most doctors choose private medical institutions because of the higher salary, although there are more social security benefits when employed in public institutions. The surgical activity of family doctors is minimal (wound care and suturing of small incisions, removal of warts and moles). They do not perform any gynecological procedures. They provide pediatric care practically only in rural areas, because in cities pediatricians are chosen for child care. Family doctors seem to be satisfied with this situation.

 

France. Annual income ranges from 80 thousand to 120 thousand EUR. A family doctor earns from 3.5 thousand to 5.5 thousand EUR per month. Additional supplements are paid in rural areas.

 

Many family doctors run their own offices or small clinics (self-employed), which is why the so-called "solo" practice is very popular in France.

 

In addition to the usual outpatient work, a family doctor performs minimal surgical procedures (sutures of small wounds, removal of papillomas, moles, drainage of abscesses) and minimal gynecological procedures (taking a cervical smear, gynecological examination). Since in France parents can freely choose either a family doctor or a pediatrician for the care of their children, the pediatrician is usually chosen. And only in cases where there is no pediatrician, the medical care of children is provided by a family doctor.

 

Finland. This is a country that has constantly advised Estonia on all issues of health care reform, which, apparently, allowed Estonia to carry out all the necessary reforms more quickly. In Finland, a family doctor earns from 90 thousand to 120 thousand EUR per year, depending on the specific region of the country. The monthly salary of a doctor is 4-5 thousand EUR. Traditionally, doctors in the private sector earn more than in the public sector. In Finland, family doctors perform minimal surgical and gynecological procedures, provide prenatal care (medical care provided to a pregnant woman from conception to childbirth) and provide emergency care in rural areas. Family doctors can also provide pediatric services, although this is usually done in maternity and child health clinics.

 

Sweden. A family doctor earns from 80 thousand to 110 thousand EUR per year, depending on the region - more in the north. In addition to the usual functions of a district therapist, doctors perform minimal surgical and gynecological procedures, such as inserting a spiral into the uterus. Family doctors can also provide early pregnancy care.

 

Italy. In Italy, a family doctor earns from 50 thousand to 80 thousand EUR per year. Monthly salary is 2.5-4 thousand EUR. Performs only the functions of a district therapist, so calling him a family doctor is nonsense.

 

Spain. The annual salary of a family doctor is from 45 thousand up to 70 thousand EUR. Monthly salary – 2.3-3.8 thousand EUR. In addition to the functions of a therapist, a doctor performs minimal surgical procedures (removes moles, sutures small incisions, drains abscesses) and performs minimal gynecological functions (takes a cervical smear, prescribes contraceptives). In rural areas and small towns, if there is no pediatrician, he provides childcare.

 

Greece. A family doctor earns from 30 thousand to 50 thousand EUR per year. Monthly salary 2.8 - 3.8 thousand EUR. Only minimal surgical services are provided. Gynecological services are not provided. In cities, childcare is in the hands of pediatricians. In exceptional cases, in villages, when there is no pediatrician, they can also provide services for children. In Greece, you can go directly to a specialist without a referral from a family doctor.

 

Czech Republic. The annual salary of a family doctor is from 30 thousand to 50 thousand EUR. Monthly – 1.8-3.0 thousand EUR. Minimal surgical services are provided. The doctor does not provide pediatric or gynecological care.

 

Poland. A family doctor receives from 25 thousand to 45 thousand EUR per year. Monthly earnings – 1.5-2.8 thousand EUR. Minimal surgical services are provided (wound care, sutures). Does not provide gynecological care. Where there are no pediatricians, they can provide children's health care.

 

Hungary. A family doctor's annual earnings are from 25 thousand to 35 thousand EUR. Monthly salary is 1.2-2.0 thousand EUR. The doctor can perform minimal surgical procedures. Does not provide pediatric or gynecological care.

 

Romania. A family doctor can earn from 15 thousand to 30 thousand EUR per year, and from 1 thousand to 1.8 thousand EUR per month. The doctor performs minimal surgical procedures, is engaged in childcare, especially in rural areas.

 

Bulgaria. The annual income of a family doctor is from 12 thousand to 25 thousand EUR. The monthly salary is only 0.9-1.5 thousand EUR. A family doctor provides childcare (vaccinations), and can also perform minimal surgical procedures.

 

Lithuania. The average monthly salary of a family doctor is 4.935 thousand EUR. Depending on the regions of the country, the number of registered patients, the effectiveness of preventive programs, bonuses received from the institution's administration, and municipal support, monthly salary fluctuations are recorded from 1.4 to 6.2 thousand EUR. Well, it seems that the salaries of family doctors in Lithuania really look good in the European context. If, when the family medicine institution was created, maximum decentralization of family medicine services was expected and plans were made that up to 80 percent of cases would be decided at the family medicine level of all health problems, it is the centralization that has begun at the moment, namely, the creation of health centers in districts, the strengthening of large polyclinics in county towns, where surgical and gynecological departments operate, which also perform functions attributed to primary health care, the possible return of pediatricians to the primary health care chain, plans to prohibit private health care institutions from charging residents an additional fee for more efficient and faster services, force us to rethink the ideological foundations of classical family medicine and finally decide whether we want to move closer to the effective English, Scandinavian or reduced Czech, Hungarian, Greek or Italian models of family medicine, where so-called family doctors actually work as district therapists.” [1]