The main thing is not money, but opportunities
Both daughters of Pēteras Apiņš are doctors, both work in Latvia. Pēteris believes that it is important who they married – Latvians. “But I watched what happened to many other young doctors: mainly Russians and Jews left Latvia. I remember a Russian guy, he also left. Before that I asked him: why? He replied that he had nothing to do here. He did not feel Latvia as his own. Although he spoke Latvian perfectly, although he was a good surgeon.”
However, Pēteris Apinis admits: “Someone like Hosams Abu Meri happens in the middle: he settled in Latvia. I know five Lebanese and they are fine. But the first condition to stay is: are you emotionally connected to the country, to Latvia? Young people feel this connection less and less. Latvians also leave, but there are not many of them in percentage.”
Will it not be the case that Latvia will be left without doctors in the end? “No, it won’t be,” Apinis believes, “most likely, there won’t be people to treat: we’re dying.” It is a popular opinion that doctors leave because salaries are low. However, Apinis emphasizes that doctors’ salaries are mostly high, but the issue of nurses is still not resolved. “That’s why many sisters have been abroad for a long time. Their children are also born abroad. They also stay there. But we are losing our gene pool,” said Apinis.
If we talk about doctors’ salaries, the surveyed doctors whose children have also learned the medical profession claim that their sons and daughters have been earning significantly more than their parents for a long time. Yes, there is still uncertainty and bureaucracy in healthcare, but none of the doctors wanted to claim that the salaries were low.
“In my opinion, money is not the determining factor,” says Apinis, “most likely, it’s opportunities. So, for example, one cardiac surgeon abroad has the opportunity to transplant 50 hearts a year, here – only five. Technological development, comparing Germany and Latvia, is in favor of the Germans. Availability of medication, laboratory diagnostics – also in favor of the Germans.”
Hosam Abu Meri is doing what he can
Dmitrijs Sulzic/MN
“During the meeting with the management of the Association of Young Doctors of Latvia,” said Minister of Health Hosams Abu Meri in a conversation with “Neatsarigo”, “I got acquainted with the data of the survey conducted by the association. About 500 members were surveyed: 11.8% of newly certified doctors were ready to go abroad to work, while among residents, about nine percent had similar thoughts. It seems that there were about eight percent of those who have already decided to build their lives outside of Latvia, but at this time, when the lack of human resources is one of the biggest challenges, this is a significant figure anyway.”
At the same time, there are also positive trends. “For example, one trend, judging by the results of the survey, is: two-thirds of young family doctors plan to go to work in the regions of Latvia, which is very good. And when we reformed primary care, we took this fact into account,” said Abu Meri.
Answering the question about the involvement of young specialists in the health sector, Abu Meri emphasized: “Sufficient provision of human resources in medicine is one of the biggest challenges not only in Latvia, but also in Europe and around the world. The doctor’s profession is unique due to the long process of study and specialty learning (residency), after which doctors rightly want to receive a competitive salary, good working conditions, the opportunity to combine work and private life, the opportunity to work in research and the like. Taking into account Latvia’s high-quality higher education in medicine, it is necessary to compete globally for the retention of young specialists.”
In order to attract doctors and motivate them to work in public health care, there must be several mechanisms, and Hossam Abu Meri says: “It is the solution of the salary issues, investment in the infrastructure of medical institutions, providing modern treatment options for patients, improvements in access to examinations and treatment, a stable industry increase in funding.”
A significant signal to the new doctors has been the significant increase in resident salaries. “At the same time, other mechanisms are implemented – for example, an increase in the number of state-paid residency places, a motivating mechanism for young doctors to move to the regions,” says Abu Meri, “and this means that a medical person who agrees to work outside the capital for at least five years, providing the state paid services, one-time relocation compensation can be received (also for each family member) and for the first two years also financial support to cover living expenses.”
It should be noted that for several years now there has been a procedure that provides for priority admission of state-paid residency to young doctors who have concluded a so-called regional contract, which is concluded with a medical institution or municipality outside of Riga for working in the relevant institution in their profession. Residents who do residency training in medical institutions in the regions have a 30% higher salary than residents in Riga.
“I have met with the Association of Young Doctors of Latvia several times, solving salary issues (both for doctors and residents), because they are important, but no less important and solvable issues in the opinion of the members of the association are the quality of residency programs, the sustainability of the overall funding of the health care industry, and professional burnout problems, including problems of the working environment in medical institutions,” says Abu Meri.
It is known that recently, together with the professional organizations of doctors and medical institutions, they have worked to reduce violence against medical personnel. When Hossam Abu Meri became a minister, he also immediately started strengthening the national language in the treatment process. “These are issues that do not require additional funding, but the political will to solve the problems,” he adds.
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