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Choosing a doctor - public or private facility

Looking for an idea to deal with the shortage of doctors, the government is working on regulations that will allow bonuses for those doctors who choose to work exclusively in the public sector. By blocking the possibility of working two or more jobs, the government hopes to partially solve this shortage. Some physicians are concerned whether this is a step toward the legislation in place in Germany, for example, under which a doctor must choose whether to work in the public or private sector. The situation is similar in Denmark.

In 2006, the first author of this proposal was then Deputy Health Minister Boleslaw Piecha, today a Law and Justice MP. Nine years later, the premise of separating the private and public sectors was announced by Prime Minister Beata Szydło in her expose. In July this year, the topic was revisited by Law and Justice (PiS) Chairman Jaroslaw Kaczynski during a tour of the country as part of a campaign to mobilize PiS voters. Kaczynski spoke of salaries as high as 80,000 a month, which many doctors commented - please show who can achieve such earnings and at what cost. Most doctors earn in the region of 20,000 a month, provided they take a lot of round-the-clock duty.

Incentives for doctors who would choose to work exclusively in the public sector would have to involve a significant increase in current salaries. And the state of the NFZ budget plus the new tasks just handed over by the government (more than 7 billion in additional spending, including 3 billion for emergency services alone) do not allow one to hope that free funds will be easily found. Such solutions are used in countries where there is no shortage of doctors.

In Poland, there are 2.38 doctors per 1,000 residents. Considering OECD countries, only Turkey (1.88) and Colombia (2.18) are worse. Austria wins the ranking with a score of 5.24 doctors per 1,000 residents. In comparison, the European average is 3.8 doctors ("Health at a Glance: Europe 2020"). According to estimates, 46.7 percent of Polish doctors are employed in one workplace, more than half in two or more. 1 in 10 doctors have three employers. 

The introduction of a new solution would reveal the true scale of the staffing problems we face in Poland. Because the ability to work in multiple locations, significantly more than the prescribed 8 hours a day saves the Polish health care system. Unfortunately, in Poland we still have a choice between an overworked medic and any medic available at a given location. According to analysts, a hastily introduced rule of either public or state would very quickly limit many patients' access to most services. Patients will pay for the lack of access to doctors in the end anyway.

2019. The Supreme Medical Chamber (NIL) conducted a survey of a sample of more than 8,000 doctors. 73 percent of respondents said they were against having to choose between working in the public and private sectors. However, if such a situation were to arise, 74 percent of doctors said they would be willing to work exclusively in the private sector.