Croatian Demographic Crisis Forcing Retired Doctors to Care for Patients

By 2 January 2020

The Croatian demographic crisis continues to bite, and it's far from plumbers, electricians, mechanics and drivers that Croatia is rapidly running out of, but nurses, dentists and doctors too.

As Novac writes on the 2nd of January, 2020, for more than forty years, Dr. Željka Perić has been working in the Slavonian village of Zdenci, in the east of Virovitica-Podravina County. She acquired the conditions for early retirement back in 2010, but due to a lack of doctors owing to the Croatian demographic crisis, she has continued to work in the same office.

She is of course sorry to leave her patients without primary medical care in their village because that would mean that they have to travel ten kilometres for their care to Orahovica, and for some of them that simply isn't viable.

''Next year in September, I will turn 65 and be able to retire fully, but I'm afraid that nothing will come from that as there are no young family doctors and the clinic will be closed. If something does get organised, it will be the ''flying'' doctors who are changed every day. That type of thing is done just to put out fires and has nothing to do with medicine because the sense of family doctors is continuity,'' explained Perić, who was named the best doctor in Croatia in 2014 by the Association of Croatian Patients.

She's not the only one feeling the strain of the Croatian demographic crisis and who doesn't want to be left stranded, either. Another dozen doctors in Virovitica-Podravina County are on an ''extension'' as they say in health circles when referring to those who remain in work after 65 years of age. The average age of family doctors in Croatia is 55, and in Virovitica-Podravina County, they are older. According to the records of the Croatian Medical Chamber, the loss of doctors that will occur during this year and next year is just over 25 percent due to the age of retirement in that particular continental Croatian county.

At the moment, eight primary care clinics are stuck without a doctor, two are on specialisation and as many as fifteen of them are retiring. The Virovitica-Podravina County Health Centre has not concluded a specialist training contract with any doctor for many years, proving that the Croatian demographic crisis is not only damaging to the country's overall economy, but to the health of its waining population, too.

"In October, my office had about twenty sixth year students from the Faculty of Medicine in Osijek and none expressed a desire to stay in primary health care. They see their future in hospital specialties, meaning that the whole of Croatia will soon have major problems on the front line when it comes to health,'' Perić pointed out disappointingly.

''We had an example of a shortage of doctors in family medicine recently after the closure of Zdravko Sertić's office in Virovitica. Hundreds of his patients are now trying to enroll in the remaining teams that are already double-packed. None of the newly graduated doctors of medicine at the Health Centre requested work under supervision, which was introduced as a new form of work instead of an internship. More young doctors still working in that institution without specialisation, and even a few with completed specialisations, are preparing documentation for moving to other institutions,'' notes Berislav Bulat, president of the County Commission of the Croatian Chamber of Physicians and President of the Croatian Family Medicine Coordination Branch (KoHOM) for Virovitica-Podravina County.

The Croatian demographic crisis has caused a problem with doctors of other specialisations, too. Currently, a tender for the specialist training of doctors of medicine at Virovitica General Hospital is underway. Such tenders are repeated year after year with a demand of over thirty doctors. The actual expected turnout can be counted using the fingertips of one hand, Deutsche Welle writes.

''Although in recent years we have more and more medical doctors graduating from this area of ​​origin (in 2017 there were five, in 2018 there were eight, in 2019 there were thirteen), only a few want to stay in institutions here. They go off to other hospitals, usually to Bjelovar or to Zagreb. Similar to family medicine, there remain those who should retire because of the needs of the system, and because of poor pensions,'' said Bulat.

Virovitica-Podravina County is not far from an isolated case. The situation is similar in other parts of Croatia, but in that county, when referring to statistics, the situation is the most unfavourable.

For example, in Virovitica-Podravina County there is one doctor per 425 inhabitants, in Požega-Slavonia, one doctor for 318 patients, and in Osijek-Baranja, one doctor for 303 patients. Virovitica-Podravina County has the oldest doctors, 22 percent of them are over 60 years old, while 17 percent of doctors in Požega-Slavonia County are over 60, and in 11 percent of doctors in Osijek-Baranja are over 60.

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