Preference for practice – recent evidence

General practice in Denmark, and in many other developed countries, is suffering at the current time due to a shortage of general practitioners (GPs) and a rapidly ageing GP population. At the same time, the demand for healthcare services among Danish citizens is increasing.[1,2] Scientific evidence suggests that the general shortage of GPs is likely to be mitigated over the coming years, primarily due to a generational change in the GP population, with younger GPs preferring to work in (smaller) shared practices compared with already established GPs, where preferences for solo practices are more pronounced. This is expected to enable a more effective utilization of practice personnel and specialization of GPs.[2] Nonetheless, there is a structural problem with shortages of GPs in rural areas – a problem that is not likely to diminish in the years to come. A study has shown that distance to the GP is an important factor for patients.[3] This makes the structural shortage problem even more pertinent. Hence, an important question is how to attract GPs to rural areas in Denmark. An Australian study found that locum relief incentives, retention payments, and rural skills loadings could increase the probability of attracting GPs to stay in rural practices.[4] However, evidence from Denmark suggests that GPs who are already established in a general practice are reluctant to reorganize in other practices, possibly due to the large transaction costs associated with the reorganization.[1] Therefore, it would be more expedient to focus on how to attract young GPs, who have not already established themselves in a general practice, to areas with GP shortages. There has been some research on this lately. A German study found that additional net income to compensate for the disutility of establishing a rural practice was the most effective instrument, but also non-pecuniary factors such as availability of childcare and fewer on-call duties could make rural practices more attractive.[5] A study from Denmark showed that GPs in training on average should receive compensation to establish in a rural area corresponding to DKK 472 500 a year, and even more to settle on some of Denmark's rural islands (e.g. AErø and Samsø). Among GPs in training, 25% were willing to move for a future job, and the most important factor besides pecuniary incentives was that their spouse was offered a job in the same area. Opportunities for professional development and a nice place to live were …