A Lack of Doctors Means a Failure to Meet the Basic Needs of the Local Community. How Can We Meet This Challenge?
The panel “A Lack of Doctors Means a Failure to Meet the Basic Needs of the Local Community. How Can We Meet This Challenge?”, co-organized by the Health and Development Foundation, was held as part of the Forum of Local and Regional Authorities and addressed one of the most serious challenges facing the Polish healthcare system – the shortage of medical personnel.
The discussion featured: Marek Materek, Mayor of Starachowice; Przemysław Gliklich, President of Municipal Hospital No. 4 in Gliwice; Marek Pławiak, Chairman of the Nowy Sącz County Council; and Marek Moszczak, President of the Beskid Mental Health Center. The discussion was moderated by Wojciech Andrusiewicz, Director of Communications at the John Paul II Catholic University of Lublin.
The moderator emphasized that this issue, along with funding, is one of the two key crisis areas in the healthcare system. In Poland, depending on the data source, between 120,000 and 140,000 doctors are currently practicing, with as many as 25% of them aged 65+. Over the next decade, the number of doctors is expected to increase by 30,000–40,000; however, despite this growth, shortages of 15–20% are still projected, particularly in specialties such as internal medicine, general surgery, and pulmonology.
The moderator also drew attention to a survey conducted among forum participants – 100% of responses indicated staffing problems in hospitals, and 40% considered them an obstacle to day-to-day patient care. In some cases, shortages even threaten the suspension of ward operations.
Mayor Marek Materek opened with a rhetorical question: “Is there a doctor in the room?”. He pointed out that in his region the problem affects both the hospital and emergency medical services. By decision of the provincial rescue coordination center, ambulances no longer include doctors – and the same applies to neighboring counties. In the hospital, shortages are especially visible in internal medicine wards, although they have been partially mitigated by hiring over a dozen doctors from Belarus. “This was a huge help for us – most of them perform excellently, and some are obtaining Polish credentials,” Materek emphasized. He also cited the example of the closure of the rheumatology ward due to the departure of two doctors. “I drove around the entire province looking for a specialist. I finally found one – he was working privately, agreed to work in the outpatient clinic, and he is still with us today,” he said. The problem affects almost all wards, and an additional challenge is maintaining the infectious diseases ward, where the staff is of retirement age.
President Marek Moszczak noted that psychiatry has long remained “on the sidelines” of the system despite growing needs. “We were close to shutting down both the day and inpatient psychiatric wards due to a lack of doctors,” he admitted. The situation improved thanks to participation in the pilot program of mental health centers, which increased the number of residency positions. “There is an influx of staff, but it does not meet the needs – we serve the Żywiec district with more than 120,000 residents,” he added. Another issue is the outflow of doctors to the private sector after completing their residency.
Marek Pławiak presented alarming data on waiting times for services: “Orthopedist – 61 days, MRI – 77 days, CT scan – 110 days, psychiatric day ward – 113 days.” He noted that although cardiology in the region has developed thanks to collaboration with Kraków professors, there is a lack of internists, surgeons, and radiologists. “Doctors are overworked, they work multiple jobs, and this affects quality,” he said. He also highlighted problems in education – the Academy of Applied Sciences in Nowy Sącz did not receive accreditation for the medical program despite having the necessary infrastructure.
Przemysław Gliklich provided data from the Silesian region: “We have more than 22,000 registered doctors, giving a per-patient ratio higher than the EU average. And yet we lack internists, surgeons, neurologists.” His hospital employs 400 doctors, but the internal medicine ward had to reduce the number of beds. “The biggest problem is migration – just a few extra złoty and a doctor moves to another hospital, often taking the entire team,” he emphasized. He gave an example of a situation where a competing hospital offered surgeons 280 zł per hour, resulting in a staff outflow.
In the second part of the panel, participants sought to identify corrective measures that could be implemented in the short term. Although all agreed that without systemic reform the problem cannot be fully resolved, several specific ideas were presented.
Mayor Marek Materek stressed that in smaller cities the barrier is not only salary but also the lack of social infrastructure. “I talked to municipal leaders – they have official apartments near health centers. We don’t, but we bought land next to the hospital and are building a housing estate with units for doctors. This will be the ‘Housing for Medics’ program,” he said. Previously, the city helped doctors rent apartments on the open market, but that solution was temporary. “Doctors want stability – some have already bought homes and stayed with us permanently,” he added. “Housing is not enough – doctors want to work with high-quality equipment,” Chairman Pławiak emphasized. Nowy Sącz County is planning to purchase a CT scanner and an MRI to attract specialists. “This is just as important to them as salary – young doctors want modern medicine,” added Director Gliklich.
The panelists also agreed that without an influx of staff from countries culturally close to Poland (Ukraine, Belarus, Kazakhstan), the deficit cannot be resolved. Mayor Materek cited the example of a repatriate family: “The husband was a welder, the wife a doctor – today she works in an outpatient clinic, and patients praise her. Another doctor from Belarus tried so hard to speak clearly that my grandmother didn’t even realize he was a foreigner.” However, all emphasized the conditions: a Polish language exam, diploma recognition, and skills certification. “It’s not quantity but quality – we must verify skills just as we do with our own graduates,” stressed Marek Pławiak. Przemysław Gliklich added: “I have a pediatrician who completed diploma recognition and is now in residency. But I also have a surgeon who refuses nostrification – he works under supervision, which is a problem because doctors are reluctant to take full responsibility.”
The panelists also pointed out the need to introduce the possibility of completing residency in county hospitals. “Why should young doctors train only in teaching hospitals, where it’s hard even to get to the operating table? In a county hospital they will see everything – from emergencies to everyday diagnostics,” argued Director Gliklich.
The panelists agreed that clear rules for remuneration and limiting multi-employment are necessary, though without rigid pay caps. “Without money, there will be no specialists,” said Pławiak. He gave the example of a hospital in Krynica, which accumulated over 3 million zł in debt over three years because the National Health Fund reimbursed only 70% of the costs of statutory pay increases. Gliklich pointed to pay chaos: “Removing limits in outpatient specialist care caused doctors to earn more there than during a hospital on-call shift. The result? Migration and poaching of staff – just 10 zł more per hour is enough.”
At the end of the panel, President Marek Moszczak proposed a solution that caused a stir: “We should work either in public or in private healthcare.” In his view, multi-employment deepens the staffing crisis and lowers care quality. “It’s difficult, but without this we will not stop the outflow of doctors from the public system,” he argued.
Although differences of opinion emerged, all panelists agreed that simple measures – housing, diploma recognition, residency positions, investments in equipment – can be implemented faster than systemic reform. “If we don’t start acting, we’re heading for a beautiful catastrophe – and we’re not talking about the system, but about the patients,” Gliklich concluded.
