Doctor Shortage Pushes Latvian Regions to Open Feldsher Points Again
Because of a shortage of family doctors, Latvian municipalities are setting up feldsher points, and more than 120 now operate. Specialists warn they cannot fully replace family doctor practices.
In rural parts of Latvia where family doctors are in short supply, local authorities are increasingly opening feldsher points, which are small medical posts staffed by a feldsher (a paramedic-level health worker) rather than a physician. According to 360TV News, more than 120 such points now operate across the country. Specialists say they cannot fully replace family doctor practices and may create health risks for patients in the long run.
Municipal incentives often fall short
To attract family doctors to the regions, municipalities offer scholarships, housing and even funding to set up a practice. Frequently this is still not enough, and doctors remain scarce. To keep primary health care available, municipalities are therefore creating feldsher points.
In Rudzāti, a family doctor's practice closed six months ago, and a feldsher point started work so residents would not be left without care. It covers most everyday needs, but unlike a doctor, a feldsher cannot prescribe reimbursable medicines or issue referrals to specialists. Ingrīda Zaķe, a doctor's assistant with the outpatient service in Rudzāti, says residents often phone to renew prescriptions, as travelling to town is not always convenient for rural people. She began working at a feldsher point 40 years ago and expects to end her career at one.
A challenge for local governments
Setting up a feldsher point is a major task for a municipality: a lack of experience with medicine procurement and hazardous medical waste management requires extra resources. Dāvids Rubens, chair of the Līvāni municipality council, says a similar situation has arisen in Jersika parish, where the family doctor will not continue working and the next point is being planned.
The association's view
The Latvian Association of Rural Family Doctors describes feldsher points as a temporary fix. It says a family doctor's team can address 70–90% of a patient's health needs and detect serious illnesses in good time. Association head Ainis Dzalbs says health indicators outside Riga may be worse because services are unavailable.
The association argues the answer is not a return to the Soviet-era feldsher point model, but a higher rural coefficient and converting the points into branches of family doctor practices, ensuring equal care in the capital and on a remote farmstead alike.
