Most Latvian family doctors are near retirement age
About a third of family doctors in Latvia are of retirement or pre-retirement age, and in regions this proportion is even higher. Despite state support measures, young doctors prefer to work in Riga and its vicinity.
Scope of the problem
Latvia is facing an aging family doctor workforce – approximately every third family doctor is of retirement or pre-retirement age. The situation is particularly critical in several regions. For instance, in Jēkabpils, half of the 14 family doctors are of retirement age; in Aizkraukle municipality, 11 out of 17 doctors are eligible for retirement; in Saldus municipality, 63% of doctors have reached retirement age; in Līvāni municipality, 60% are over 65. In Valka municipality, the average age of family doctors is 65.3 years, and in Smiltene municipality – 60.9 years. These figures indicate a need for hundreds of new doctors to take over practices.
State support measures
To address the issue, the state has increased funding for family medicine residency. The number of residency positions has grown from 14 in 2007 to 55 in 2024. However, not all positions are filled – in 2024, only 37 out of 55 were filled, and 5 out of 48 planned positions for 2025 remain vacant. Moreover, young doctors predominantly choose to work in Riga and Pierīga rather than in the regions.
The Ministry of Health has revised the rural bonus system. Now the bonus is calculated based on distance to the nearest university hospital and population density. For example, a family doctor from Dagda with 1,416 patients now receives €2,045 per month, compared to the previous €560. However, some young doctors argue that such bonuses should be granted only to new doctors to encourage older colleagues to transfer their practices.
Challenges for young doctors
Young family doctors in regions face multiple obstacles. Often there are no schools, kindergartens, or job opportunities for their spouses. Sometimes older doctors are unwilling to leave their practices, and there is no law to force them. Patients tend to deregister from older doctors to register with younger ones, resulting in some practices having only a few hundred patients – the smallest, with 203 patients, is in Saldus.
The European Union Cohesion Policy Programme 2021–2027 provides €5.8 million to support the establishment of new family doctor practices in regions. The maximum amount per practice is €30,000. For example, doctor Reinis Siliņš from Skulte considers this sum sufficient for practice improvement. In Ape municipality, a new practice is being created in a municipal building to facilitate future recruitment. In Bauska municipality, young doctor Anete Ance Buka could not afford the €50,000 renovation of offered premises, so she accepted a hospital job. In Dobele municipality, doctor Sandra Vilne was persuaded to take over a practice and is moving from Jelgava to Dobele.
Despite difficulties, some young medics consciously choose to work in regions. They note that family medicine is a second choice for many, but those who feel a calling are willing to relocate outside the capital.
