Key messages

• The imperative of strengthening primary health care (PHC) has been widely acknowledged, yet many countries in Europe struggle with shortages and geographical maldistribution of general practitioners (GPs).
• One of the root causes for these challenges is the perception among medical students and doctors that PHC is not an ‘attractive’ career option. In most contexts this is reinforced by substantial pay differentials and perceived low status between GPs and specialists.
• Evidence on effective strategies to improve attractiveness of PHC is somewhat patchy, but a number of effective interventions covering medical education, working conditions, PHC models and workforce planning may nevertheless be distilled.
• There is also some evidence on strategies that can help draw GPs to rural and remote areas. They cover various stages of professional life of a GP and usually aim to improve the work-life balance and reduce professional isolation.
• On the whole, strengthening PHC will require a multifaceted strategy that employs a range of measures and targets not only medical students and physicians, but also nurses and other PHC professions, patients and the general public.
• Crafting such a strategy will require a very good understanding of the local context and a much better understanding of the effectiveness of various interventions as the evidence for most of them is currently either patchy or absent.
• Note that this policy brief presents the results of a literature review conducted in 2018-2019.

Contents

• How do Policy Briefs bring the evidence together?
• Executive summary
• POLICY BRIEF
  • Introduction: a European-wide primary health care problem
  • Why is primary care perceived as not very attractive?
  • What are the strategies that can increase the attractiveness of primary care?
  • Discussion
  • Policy implications
• References
• Appendix: Methodology
• The Policy Brief Series

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What is a Policy Brief?