For some years, there has been a shortage of health professionals in Switzerland. This is demonstrated not only by the difficulties encountered in filling vacant hospital positions but also by the large number of health professionals who qualified abroad. How do physician numbers influence the health system as a whole? What are the chances and limitations of governance? These questions are addressed by the SAMS in a position paper published in 2016.
A sustainable health system depends on adequate numbers of physicians and other health professionals, distributed – both geographically and between professions – in accordance with needs. In a health system whose financing is based on the solidarity principle, governance of human and, in particular, medical resources is vital.
In this context, the term «governance» is to be understood in a broad sense: it covers not only measures determined by the state but also the regulation of incentives (financial or other). At the same time, it should be borne in mind that the health system is extremely complex – and that physicians are just one component. Consequently, it is difficult to predict the wider effects of governance measures implemented within one part of the system. These realities need to be taken into account in any efforts to adjust the management of the system.
The SAMS proposes five sets of measures concerning the governance of the numbers and distribution of physicians in the Swiss health system. At the heart of these recommendations is an awareness of the need to adopt a combination of measures; isolated governance interventions, rather than producing the desired results, are likely to give rise to unwanted side effects.
The SAMS position paper is addressed to a wide range of health system actors, including service providers, health policymakers at the cantonal and federal level, funding bodies and educational institutions.
By encouraging interprofessional collaboration, not only can the quality of medical care be improved, but resources can be better managed.
Find out more about the efforts of the SAMS to promote interprofessional collaboration
Projects supported by the SAMS
Every five years since 2005, the association of Swiss General Practitioners and Paediatricians (mfe) has commissioned a scientific study to collect longitudinal data on primary care physicians’ age, sex, geographical distribution, degree of employment, and the type of practice where they work, together with their degree of job satisfaction and retirement plans. The «Workforce 2020» survey was supported by the SAMS as part of its efforts to promote a sustainable health system.
The 2020 survey, conducted by the BS/BL Centre for Primary Health Care, shows that the measures taken in recent years to encourage medical students to choose a career in general practice are starting to bear fruit. This is demonstrated, for example, by the rise in the number of training places, the increased attractiveness of primary care as a profession, and new working time and practice models. Thus, over the past ten years, job satisfaction has increased and the number of group practices has almost trebled. Solo practices, meanwhile, are declining (from 60 % in 2005 to 33 % in 2020).
Workforce 2020 survey (in French)
mfe website (in French)
Competence Network Health Workforce
The shortage of health professionals poses a significant challenge to the provision of high-quality healthcare for the Swiss population. Between 2017 and 2020, various initiatives aimed at understanding the causes of – and combating – this shortage were developed by the Competence Network Health Workforce (CNHW) of the Swiss Universities of Applied Sciences in Health, with support from the SAMS.