Planned changes to the Estonian family medicine system are aimed at creating a better quality service and include proposals to discipline doctors who recommend pseudoscience to their patients, writes ERR News.
The Ministry of Social Affairs has drawn up a draft plan for reforms to the Estonian family medicine system to make it more sustainable, more coherent and of higher quality. Social Affairs Minister Karmen Joller acknowledged that there are currently family physicians practicing in Estonia who do not follow science-based medicine and publicly promote the spread of pseudoscience. She said that people are often not convinced by the advice given by a doctor, because they believe that the recommendations given by the doctor are scientific and based on evidence.
The current monitoring system, which is based on patient complaints, makes it difficult to resolve such situations, and timely prevention is even more difficult. Now the ministry wants to introduce licensing requirements for medical centers, which would allow for more effective discipline of family doctors who indulge in pseudoscience. Joller said that at the national level it is unacceptable that if a person owns a family medicine center, they recommend homeopathy to patients. Along with the monitoring measures, the ministry also wants to achieve access to the same quality of medicine throughout Estonia.
In recent years, more and more family medicine practices have been attached to health centers, which provide patients with a wide range of services. Despite this, the quality of family medicine practices varies, and,
according to the minister, there are still practices that do not cooperate with others.
Joller pointed out that, looking more broadly, in the future, she would like to see no solo practices that operate completely independently. For example, if a family doctor wants to attend training, there should be no situation where he cannot go to it or sends a nurse because there is no one to replace him. “We want to encourage situations where even small practices make agreements either with one another or with larger practices,” the minister said.
A significant problem remains despite the changes – about 132,000 people, or one in ten Estonians, do not have a family doctor. Joller said the root of this problem can be found several decades ago, when a decision was made to admit fewer students to medical schools in the specialty of family medicine. Students from that time are now approaching retirement age. The minister explained that one solution is to increase the number of residency places for future family doctors, which is already being done. However, it is also necessary to increase the number of students admitted to medical schools in general so that there will be enough doctors in all specialties in the future.
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