A Greek malady: Too many doctors, too few GPs

Greece has a surplus of at least 20,000 specialized doctors and the number is growing by the year. Greece has produced a number of doctors which is disproportionate to its population of about 10.7 million – a trend that intensified in the past two decades. A substantial percentage of these professionals are either unemployed or underemployed. The rate stands at 28 percent among Athens doctors.

It is no coincidence that, today, about 17,500 Greek doctors work outside the country. The irony is that, in spite of the surplus of doctors, the ongoing financial crisis has left the National Health System (ESY) with shortages of doctors and health professionals. It is estimated that there are up to 6,000 vacant posts for doctors at Greek public hospitals. At the same time, unlike other European countries, there is a shortage of general practitioners, or family doctors – a fact which reflects the state of primary healthcare in Greece.

The oversupply of specialized doctors and the shortage of general practitioners is confirmed by a study conducted by the Greek Health Ministry and the World Health Organization (WHO) which was published under the title “National Health Strategy and actions of the health sector in the National Strategic Reference Framework 2014-2020.” According to the study, in Greece there are currently about 3,800 general practitioners when, according to the European Union average, there should be around 8,140. Greece, in other words, needs an extra 4,350 family doctors.

Meanwhile, the number of specialized doctors stands far above the EU average. In 2014, there were 42,647 specialized doctors in Greece when, according to the EU average, their number should have been around 20,283.

The same study shows a surplus of laboratory physicians, who number about 4,500 when the country should have around 600, again, compared to the EU average.

According to the study, “in total, taking into account the country’s particularities, it is estimated that there is a surplus of more than 20,000 specialized doctors in the country, a figure which continues to rise every year.”

The total number of doctors in Greece (specialized and general practitioners) is approximately 69,000. This figure puts Greece in top place among member-countries of the Organization for Economic Cooperation and Development (OECD) in the ratio of doctors to population. Thus, in Greece there are 6.3 doctors per 1,000 inhabitants, when the average in OECD countries is 3.3 doctors per 1,000. China, Turkey and Colombia have fewer than 2 doctors per 1,000 people.

Since 2000, the number of doctors has increased across nearly all OECD countries, both in absolute figures as well as in proportion to the national population. This increase has been acute in countries that started out with a small number of doctors, such as Turkey, Korea and Mexico, but also in countries such as Greece and Austria. In Greece, the number of doctors increased significantly between 2000 and 2008, jumping from 47,250 to 68,000, but the number has stabilized somewhat in recent years.

At the same time, Greece has very few nurses in proportion to its population compared to other states in the West. In Greece there are 3.6 nurses for every 1,000 inhabitants, when the OECD average is 9.1 nurses per 1,000. In countries such as Switzerland, Norway and Denmark there are more than 16 nurses for every 1,000 inhabitants – Switzerland has the highest ratio, with 17.4 nurses per 1,000 residents.

In OECD countries, the nurses to doctors ratio is 3 to 1, whereas in Greece it is 0.6 to 1. In countries including Finland, Japan, Ireland and Denmark, the ratio is at least 4.5 nurses for every doctor.

Greece has the highest number of pharmacies per inhabitant in all of Europe. According to the Panhellenic Pharmacists’ Association, the number of pharmacists who could run a private pharmacy stands at 10,800, while the number of actual pharmacies is 9,500.

According to the Pharmaceutical Group of the European Union, most pharmacies can be found in Turkey (24,827), France (22,455), Spain (21,854) and Germany (20,441). Greece is in seventh place with 9,500, ahead of Belgium, which has 4,929. The countries with the smallest number of pharmacies are Luxembourg (101), Slovenia (324) and Denmark (368).

With 84 pharmacies per 100,000 inhabitants, Greece has the highest pharmacy density per inhabitant. Cyprus is in second place with 55.5 pharmacies per 100,000 inhabitants and Bulgaria third with 51 per 100,000 inhabitants. The smallest ratio is found in Denmark, the Netherlands and Sweden, which have 6.5, 11.8 and 14 pharmacies per 100,000 population respectively.