Estonia's government approves changes to family doctor rules

The Estonian government on Thursday approved a bill amending primary healthcare rules. Under it, health centers losing a family doctor must keep that doctor's patients covered for up to three months. The amendments still need approval from the parliament (Riigikogu) and are set to take effect on March 1 next year.

Replacement and notice period

If no permanent doctor takes over the practice list within that time, the Estonian Health Insurance Fund will step in. The doctor and the center may also agree on a longer period of cover.

A family doctor who plans to leave a health center with their practice list would generally have to give six months' notice, though an earlier departure can be arranged by agreement. The change is meant to give health centers time to reorganize.

The Health Board will also be able to take over a practice list after 30 days rather than the current 60 if patients have been left without family medical care.

Patient caps

The cap on practice lists will rise to 2,000 patients, or 2,400 if an additional doctor is available. The bill still recommends a maximum of 1,600.

Doctors with more than 1,600 patients will be allowed to turn away new patients if another family doctor in the area has fewer than 1,600. They must also direct patients to information on available practice lists. The aim is to distribute patients more evenly among practices.

Current situation

At the start of this year, 77 practice lists covering more than 132,000 patients in Estonia still lacked a permanent family doctor. Nearly one in 10 residents was receiving primary care from temporary replacements.