Physicians resources in Lithuania: change comes slowly.

Abstract

AIM: To analyze the structure of the physician workforce in Lithuania at the time when the country gained independence, changes it has undergone since 1990, and physician resource planning activities. METHODS: National and international databases were examined to determine the changes in the structure of physician workforce after 1990. Studies and reports, funded by international and national governmental organizations, were reviewed to examine the recommendations for physician resource planning and the rate of their acceptance. Since there was no government plan, a study using Delphi technique was conducted to find consensus among practitioners and policy makers on the physician-to-population ratio needed in Lithuania. Medical residents and physicians in Lithuania were surveyed to assess their emigration intentions. RESULTS: In comparison with other Baltic countries, the number of physicians in Lithuania has remained high despite dramatic reductions in the number of students enrolled to medical schools. There is still a maldistribution of physician resources geographically and by specialty. The government has accepted few recommendations based on the international studies. None of the internal databases provided all the needed information on the physician workforce and the existing databases could not be linked to gain access to all required information. CONCLUSIONS: The physician-to-population ratio remained high after Lithuania had gained independence. There has been little planning at the government level to determine the number of physicians needed in a reformed health system. Changes in the number of students admitted to medical schools did not follow from a well thought-out long-term plan for physician workforce the country will need in the future. To develop a frequently updated database of physicians is essential for the successful planning of future physician workforce.