The Republic of Serbia

04/02/2019 907 Views
The Republic of Serbia

 

Role of  General practitioners  in Serbia Healthcare system

Dr Branka Lazić

Serbian Medical Chamber

 

The Republic of  Serbia is a country situated at the crossroads of Central  and Southeast Europe with a population of about 7 000 000 citizens covering an area of  88 361 km2.  Its capital, Belgrade, ranks among the oldest   and largest cities in Southeastern Europe. Serbia is a member of numerous organizations such as the United Nations, Council of Europe, Organisation for Security and Co-operation  in Europe, Partnership for Peace, Organisation of  the Black  Sea Economic Cooperation , and Central Europian Free Trade Agreement , it has been  an EU membership candidate since 2012.

Serbia is a parliamentary  constitutional  republic  composed of municipalities/cities, districts, and two autonomous provinces –  Vojvodina in the north, and Kosovo and Metohija in the south.There are 138 municipalities  and 23 cities , which form the basic units of local self-government. Apart from municipalities, there are 24 districts, with the City of Belgrade constituting an additional district.

 

Organisation and financing of health care

Serbia’s health care system  is organised by the Ministry of Health  and  is managed   by the National Health Insurance Fund, which covers all citizens and permanent residents. All employees, self-employed persons, and pensioners must pay contributions to it. Contributions are based on a sliding scale, with wealthier members of society paying higher percentages of their income.

The state fund covers most medical services including treatment by specialists, hospitalisation, prescriptions, pregnancy and childbirth, and rehabilitation.

The aim of the organisation is to make the health system equal for every citizen no matter what their status.

Private healthcare is also available for those citizens who can afford it (pay from pocket and private insurance). The largest number of private institutions are small specialized clinics.  Private practice still not included in national healthcare system. Still there is  lot of space for developing in private practice.

Hospitals and clinics exist in all major towns and cities of Serbia. Patients are admitted to hospital either through the emergency department or through a referral by their doctor.

Dental care in Serbia is in the private ownership  and is of a good standard. Prescription medicine is only available from a qualified and registered  pharmacy  or from a hospital pharmacy. There are two types of pharmacy, state-owned and private.

Primary level of health care in the Republic of Serbia is provided in 157 state-owned primary health centres  (PHC) , which cover the territory of one or more municipalities or towns . PHC is based on a selected doctor, or “chosen doctor”, and a team of chosen physicians, which consists of doctors of general medicine and occupational medicine specialist for the adult population, pediatrician for children of preschool and school age (including antenatal care, immunizations, preventive programs in the health care of children ), gynecologists for women over 15 years and dentists  for children and students under the age of 26 . Citizens can register  with the doctor of their choice.

In addition there are emergency services, diagnostic services, certain specialist-consultative out-patient health care services, community nursing services etc.

A selection of various services in a primary (community) health centre depends on the number of citizens in a municipality, as well as on their health needs and distance to the nearest general hospital. From about 20.000 doctors (public service) in Serbia, 18{cabf78295431282ca1bec49ffbe2c87b89a1285ae102b2d0687184fc21af24ba} are working in PHC. Per doctor in PHC there are approximately  1450 citizens ( in urban area about 2000 and in rural  400). Total visits per doctor in PHC are 5876 (varies from service to service).

Position of GP

GPs make referrals, prescribe drugs, treat acute and chronic illnesses, and provide preventive care and health education. The 4031 doctor works in general medicine in state institutions, only 44{cabf78295431282ca1bec49ffbe2c87b89a1285ae102b2d0687184fc21af24ba} are general practitioner specialist.

The strengthening of the Department and the Health Center as a teaching base would increase the interest of young doctors for the specialization in general medicine and the acquisition of academic titles.

There is a shortage of all kinds of doctors in Serbia  especially GPs, so there is an urgent need to create the way to keep young doctors in family medicine in Serbia.

Education and training for GP

There are five undergraduate medical schools in Serbia. They are situated in Belgrade  and the regional centers Kragujevac, Niš , Novi sad  and  Priština. The University of Belgrade was founded in 1808. Since 2012. it has held a place on the Shanghai world ranking list of 500 best universities, in 2016. it was listed among the top 300 World universities

Medical school is completed over six years. Before  practicing, graduates must take a half-year internship and pass the state exam. Further specialization takes place after the internship.

Medical training for a GP specialist  according to the new law lasts 4 years. It consists of a theoretical part  ( 12 months ), a period of visiting hospital departments (12 months)  and a period with a teacher (“mentor”) in family practice (24 months  ). At the end of training there is a specialist final exam.However, a licenced doctor can practice as a GP without postgraduate medical training and without a mentor.

CME and relicensing

A GP gets the license for work by the Serbian Medical Chamber (SMC) and the SMC is a national authority for the CME. The condition for relicensing is collecting 140 points  during 7  years. It can be done through a few ways – CME courses, participating in local or international professional medical meetings or conferences, publishing  papers in magazines or books. In case of not collecting the needed points a GP  needs to pass the exam after a period of 7 years.

Medical Chamber of Serbia

MCS is an independent, professional, self-contained,self-financed  organization, re-established in 2006 together with the chambers of other healthcare workers. Its status is defined by the Law on Chambers of Health Workers published in the “Official Gazette of the Republic of Serbia” 107/2005. All doctors of medicine who, as a profession, perform healthcare activity must be members of the SMC . In Serbia, the Medical Chamber was founded in 1901. at a time when chambers were established in other European countries, as professional associations, which can perform self-regulation and control of their membership. But  at 1945.  SMC`s work was subsequently interrupted by the decision of the Goverment

At present,  32 643 doctors are registered in the directory of medical practitioners, who hold a valid license, who carry out health care activities in state and private health institutions and private practice as a profession. One of the main strategic goals is to improve the status of a doctor of medicine as well as raising the level of expertise and ethics within the  proofs. SMC  join and actively participate in all international medical organizations such as CPME, WMA, ZEVA, EFMA, UEMS, and  UEMO.

 

Related articles