Læknablaðið - 01.02.1974, Page 24

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LÆKNABLAÐIÐ
6) Changes in the organization of primary
health care are discussed as well as some
new approaches in medical training.
Conclusion
1) The number of active physicians (basic
examined doctors included) in Iceland is now
one physician per 600 inhabitants or more than
in most of our neighboring countries except
Denmark.
There has been a proportional reduction in
the number of general practitioners.
In 1941 they were 77% but 35,5% in 1971.
64,7% of all physicians are now specialists.
In Reykjavík (84.000 inhabitants out of a
total population of 211.000) 85,7% of all doc-
tors are specialists (1971). In spite of the fact
that a medical school was established in Ice-
land as early as in 1876 there is still no or-
ganized post-graduate training in specialised
medicine. Hence most graduates study abroad,
mainly in the Nordic countries, the U.K. and
U.S.A. Since 1960 on the average almost 30%
of all Icelandic physicians are staying abroad
for shorter or longer periods for this purpose.
According to a regulation from 1970, require-
ments for certified specialists in Iceland are
comparable to those of the other Nordic coun-
tries i. e. specialised training for 4-5 years.
These doctors are only certified as specialists
on condition that they have been trained at
authorized health institutes in these countries.
Planning and organization of post graduate
training for doctors and other health personnel
in Iceland is imperative.
2) The number of general practitioners and
district physicians has declined drastically in
the last few years and several explanations
are listed for this trend including the under-
valuation of tlie work of general practitioners
poorer working conditions, lack of equipment
and auxilliary personal as compared to doctors
working in hospitals, professional and social
isoiation, very long hours of work and having
to be permanentiy on duty.
Emphasis is placed on the early construc-
tion of health centres which was passed in the
Parliament 1974 and combining to greater ex-
tent the work oi general practitioners and
hospital doctors. In an earlier article, the
point was made that the teaching of general
practice in various countries does not appear
to have notably encouraged young men to
take up general practice.
3) At the end of 1972 the doctor/patient
ratio was 1/371 in Reykjavik but in sparsely
populated areas, i. e. in health districts with
less than 4000 inhabitants it was 1/1335.
Between 1968-1972 the number of doctors
increased by 50, but all this increase is con-
fined to the Reykjavik area.
4) The number of medical graduates in-
creases rapidly and will increase from less
than 10 per 100.000 inhabitants to almost 30
per 100.000 inhabitants in 1976.
Hence the number of doctors will increase
in 1970-1978 from 493 to approximately 800 or
by a good 60%.
In 1978 the doctor/patient ratio will pro-
bably be 1/270-1/280 but if 30% of all gradu-
ates stay abroad as hitherto it will be 1/410-
420.
Finally, no study has been made of the de-
mand for doctors and other health personal
in Iceland. Such study is badly needed.
The most realistic plan for the future is
probably to combine the training of all health
personal in one basic course and subsequently
allow the students a choice between alternative
fields within the health sector.