Prague, April 12, 2023 – Current primary pediatric care in the Czech Republic is in a deep crisis and it is no longer possible to remain silent and wait. This position has long been agreed not only by the Committee of the Czech Pediatric Society ČLS JEP (ČPS), but also by other entities, especially representatives of the Section of Young Pediatricians ČPS, the Czech Neonatological Society ČLS JEP, the Association of Young Doctors, zs and representatives of the Hospital Association of the Czech Republic. The entire system of pediatric care is limited in capacity, i.e. not only general practitioners for children and adolescents in ambulatory care, but the lack of doctors is also very noticeable in some pediatric inpatient wards and in pediatric subspecialties.
Therefore, under the leadership of the ČPS, a joint initiative is being created to open a public professional discussion and strengthen communication about possible functional solutions to the shortage of pediatricians while maintaining the current system.
The current crisis in pediatric primary care is due to the combination of a strong generation of pediatric general practitioners (PLDD) from the 90s now reaching retirement age. At the same time, there was insufficient personnel change in the field as a result of the division of education into two attestations between 2004 and 2017, and thus a reduction in the number of attesting doctors and a limited transfer of doctors from inpatient to primary care.
Another important factor is the growing administrative burden of the PLDD, combined with the overuse of care by the general public. The information now appearing in the professional public, and especially from representatives of PLDD companies, about a possible change in education in pediatrics, is not only worrying in itself, because such a change would bring instability again, but at the same time such a change will significantly worsen the current personnel situation.
"The current system of education, i.e. a single certification in pediatrics, combined with residency positions and a qualification course, generates a sufficient number of doctors for all segments of pediatric care. In addition, the system is variable and ensures full permeability between all segments. In addition, a separate certification in general medicine for children and adolescents does not exist anywhere in Europe, and its introduction would reduce the erudition of these future doctors. At the same time, the stability of the education system is absolutely essential for the young generation of doctors," says Professor Jiří Bronský, chairman of the ČPS committee.
The variability of the current system is given by the option for future PLDDs who can spend up to 17 months in the PLDD practice. In addition, changing the education system would bring a huge and unnecessary administrative burden. This is because there would have to be not only a change in the law and subsequent decrees, but also a reaccreditation of educational workplaces.
"Pediatrics is the second most preferred field among students of medical faculties, and if it were divided into two separate attestations, it would be possible to expect a significant drop in the number of attesting pediatricians in the coming years, and thus there would be a subsequent overload of all segments of the system," adds MUDr. Martin Kočí, chairman of the Mladí lékaři association.
A fundamental starting point for future communication is the collection and evaluation of reliable data and indicators of both primary and inpatient care in the Czech Republic. The acquisition of this data, its analysis and subsequent continuous provision for the creation of predictive models is one of the goals of the ČPS committee for this year. At the same time as data collection, we are appealing for the establishment of a Working Group for the concept of pediatric care at the Ministry of Health with the involvement of young doctors from several different associations, professional societies and other entities, including a representative of UZIS.
"The stability of the education system is essential for young pediatricians. Frequent changes were one of the main factors for the departure of Czech doctors abroad. In addition, young pediatricians interested in primary care are now given the opportunity to spend up to 17 months at the PLDD clinic," states MUDr. Šárka Fingerhutová from the Section of Young Pediatricians of the ČPS.
The best instrument of systemic state support for primary care is residential places. Directing all residential places to primary care, allocating them in time, and increasing their number in the future is one of the ways to strengthen the system even with the current education model. The increase in the number of residential places is also related to the increase in the financial subsidy and the maximization of the possibility of inclusion in the field of all those who show an interest in it. Subsequent steps should include comprehensive and uniform advertising of vacant training positions, relaxation of conditions for accreditation of PLDD ambulances and simplification of application administration.
The current need is for at least 80 new doctors to steadily enter primary pediatric care per year. Since 2017, when it is once again one common field, it now certifies over 100 paediatricians per year for the first time since the XNUMXs, most of whom should enter primary care. Other doctors are coming from children's beds after completing a qualification course, it is also necessary to motivate doctors returning from parental leave to go primarily to primary care.
"Shortening the education of some pediatricians would also lead to a limitation of their stay in inpatient facilities as part of their professional training, including neonatal units. As a result, the young doctor will not acquire sufficient erudition to work in the field, he will not have comparable theoretical or practical skills to doctors with sufficient experience at the bedside, where they can meet the most difficult patients." adds docent Jan Janota from the Czech Society of Neonatology.
Media Contact:
prof. MD Jiří Bronský, Ph.D., phone: 224 432 002,
e-mail: Jiri.Bronsky@fnmotol.cz
Press release for download: Jeopardy of the educational system of young pediatricians (360 kB)
