five

Spain will suffer a deficit of 9,000 doctors in 2027, especially with regard to graduates in family and community medicine. If things do not change, the needs will increase, so that in 2035 there will be a shortage of 17,765 specialists, which represents an increase of 9% in relation to the allocations of 2021. Year after year, the specialty of family and community medicine is left for last in the elections carried out by the Internal Resident Doctors (MIR), so that in rural areas and in small cities there are always vacancies that are not filled. All these problems are reflected in the document ‘Study Offer-Need for Medical Specialists 2021-2035’, prepared by the EcoSalud team of the University of Las Palmas de Gran Canaria, directed by Patricia Barber Pérez and Beatriz González López-Valcárcel.

As the proportion of children will decrease in coming years due to the fall in the birth rate, while the population over 75 years of age will grow, in the future there will be a need for fewer paediatricians and specialists who treat chronic diseases associated with aging and polypathological patients . In this sense, family doctors, whose number is insufficient, are the ones who will suffer most harshly from the paucity of means.

The year 2027 is the turning point. On that date, the deficit of medical specialists reached the figure of 9,000, which represents 4.6%. As of that year, the gap has been reduced, although areas such as family and community medicine, occupational medicine, immunology, urgencies and emergencies, psychiatry, clinical analysis, and biochemistry and microbiology are the ones with deficits of over 10%.

The specialties of anesthesiology and resuscitation and radiodiagnosis will suffer from a shortage of between 5% and 10%. To cite a case with problems, the deficit of psychiatrists will be greater than 10% of the available professionals. One of the reasons is the limited growth in the number of MIR vacancies in recent years.

The greatest balance between supply and demand arises in specialties such as oral and maxillofacial surgery, geriatrics, ophthalmology, radiation oncology, pediatrics, physical medicine and rehabilitation, preventive medicine and public health and clinical pharmacology. These plots offer gaps between supply and demand of -5% and 5%.

Pediatrics has changed the trend. It maintained deficit projections that in the current model become balanced. The main reason for such stability lies in the constant drop in the population between the ages of zero and 14, of almost 20% between 2021 and 2035 according to the National Institute of Statistics (INE). It is the specialty, after family medicine, that offers the most training places annually and the one that suffers the least abandonment.

primary care

The report reveals that in June 2021 there were 136,344 doctors working in the national health system. 31% of them belong to primary care (42,114), 59.5% to specialized care (81,112) and 9.5% to other tasks (13,118), of which 80% work in urgent care and emergencies, either in hospitals or primary care centers.

Despite the pandemic, the number of doctors fell by 1.77% between 2018 and 2021. By areas, the distribution was uneven: a decrease of 2.14% was recorded in primary care and an increase of almost 6% in specialized care. Since 2007, the global number of doctors in the public network has increased by 33%, while women have increased their participation from 45% to 61% of the total. Otherwise, the doctors have aged, so that those over 60 represent 21%, in contrast to 9.7% in 2007.

The document confirms the strength of the private health sector in Spain, which has experienced a very expansive decade in terms of activity and employment. Not surprisingly, private health spending now reaches 29.5%, significantly above the OECD average, which is 23.1%.

For the rest, it is estimated that the total number of active professionals in Spain amounts to 192,484, which presents a ratio of 406.13 per 100,000 inhabitants in 2021. Employment corresponding to the private sector accounts for around 30%, with an increase since 2018 of 7%, compared to the fall in public employment, which fell by 1.7%.

In view of the data, the migration of doctors plays an insignificant role in quantitative terms. Thus, in 2021, 4,293 medical degrees were approved, which must be interpreted as the market’s response to the need for doctors, especially since 2019. In this sense, Spain is attractive to Latin American doctors because there is no barrier of language.