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. As a result, many countries, including the Nordics, report that recruiting and retaining GPs is increasingly difficult. Coupled with younger GPs increasingly valuing work/life balance, countries are ever more concerned about ensuring a sustainable GP supply going forward. In the Nordics, several policies have been implemented to this effect. The purpose of this article is to develop a theoretical framework for informing such policy choices. Our focus is on remuneration schemes, GPs’ working conditions and practice quality as levers to incentivize effort and to attract GPs. We show that policies that have a positive effect on recruiting and retaining 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 the extent that GPs are altruistic and care for patients’ benefit of treatment, providing important insights for policy makers who want to increase GP supply.