Two out of three primary care doctors feel unprotected and abandoned

Two out of three primary care doctors feel unprotected and poorly supported by health administrations. This is the stark result of a study conducted by the Spanish Medical Association (OMC) to understand the reality of work and operations in health centres and clinics from the perspective of Spanish family doctors.

The findings, involving 1,784 doctors, point to a "widespread dissatisfaction" and a perception of "institutional neglect" by the regional authorities, who are responsible for direct management, and the ministry, which designs national policy.

The doctors' responses lament the lack of professional recognition, security issues, poor working conditions, and insufficient resources and investment, which result in a decline in the quality of patient care.

Their complaints align with recent data on the functioning of primary care in Spain, such as it being the healthcare area with the highest incidence of assaults on doctors (which increased by 10% last year), the overwhelming bureaucracy and lack of investment saturating many health centres, where 80% of patients must wait an average of 8 to 9 days for an appointment with their GP, the ageing workforce, and the prevalence of precarious employment with high temporary contracts and significant mobility. A study by the Ministry of Health revealed that Spanish health centres and clinics need about 4,500 more doctors than currently available.

Interviews conducted by the OMC indicate that one in five practising family doctors is dissatisfied with their job, a percentage that rises particularly in urban areas. The shortcomings and operational mismatches mean that three out of four, or 75%, claim they are unable to balance work with family life. This issue is especially prevalent among doctors in rural areas, where, they lament, other problems highlighted in previous reports persist, such as frequent travel between clinics, lack of compensation for travel to attend patients, or the absence of time off after on-call shifts, affecting one in four professionals working in these areas.

The lack of institutional commitment to primary care, with administrations still far from investing 25% of their budget in the level of health care closest to the citizen, as international organisations have demanded for years, is also evident in the study. Only one-third of doctors positively assess the infrastructure of their health centre and believe they have the necessary resources and diagnostic equipment to perform quality work. The general complaint is of "continued lack of investment."

The investigation does, however, highlight a positive element. Sixty-five percent of doctors work in centres accredited for teaching. Specifically, there is a higher proportion of accredited tutors in rural areas, which the OMC sees as "a key opportunity to promote specialised training in these environments and attract future professionals" to what are often hard-to-fill positions. However, they add, participation in university teaching and research remains an area "with significant room for improvement in both fields."

For the OMC leaders, the study underscores "the persistence of significant structural and organisational challenges in primary care, especially in rural areas," and they warn "of the urgent need for interventions to improve the working, training, and care conditions of the medical community," which they believe would have "a direct impact" on the quality of care received by Spanish patients.