Video consultation trial connects Haapsalu patients with doctors

Doctor's stethoscope.
Doctor's stethoscope. Source: Creative Commons

Patients in Haapsalu are testing online video consultations to help provide a solution to the lack of medical professionals in the region, a problem that is spreading across the country.

The Health Board has been unable to find new family doctors to replace those retiring in the western city of Haapsalu "Aktuaalne kaamera" (AK) reported on Monday night, leaving more than 1,800 patients without a doctor.

The situation is part of a growing problem where many family doctors are reaching retirement age but cannot be replaced due to a lack of doctors or because young doctors do not want to move away from big cities.

Officials think video consultations developed for small islands such as Vormsi may have to be implemented elsewhere in the country. A video consultation is carried out in a health center with an experienced nurse on hand and connects the patient with a doctor.

Currently, in Haapsalu, patients can see a family nurse, visit a doctor 150 kilometers away in the central Estonian town of Paide if they have serious issues, or seek a video consultation.

There are limited possibilities to see a doctor in person. Paediatrician Dr. Katrin Raidla currently visits patients two hours a week and Dr. Madis Tiik visits for one day. Three days a week, Dr. Kadri Riivik, a GP from Järva Rural Municipality, can be consulted by video consultation, the Health Board said.

The Health Board sought help from Tiik, and his family practice Terviseagentuur OÜ, in October. He has dealt with similar situations before and was contacted after two rounds of applications to find new family doctors for Haapsalu failed.

Tiik also could not find a young doctor to take up the vacant position, so video consultations have been introduced. He said this situation does not have to be permanent if a doctor could be found. A doctor was needed to start in Haapsalu on January 1.

Head of the Health Services Department of the Health Board Pille Saar said in a situation where family doctors often do not want to work outside Tallinn and Tartu, they now have to look for new solutions to provide people with medical care.

She called the current situation a pilot project but acknowledged video consultation is probably the future of family medicine.

Head of the Ministry of Social Affairs's health network Heli Paluste said analysis of how the system will work and will be funded is needed.

Speaking about the situation in Haapsalu, she said: "To reassure people, I would like to say that help is actually provided on the spot, an experienced nurse is in the office. Doctor's appointments are not daily, but the doctor does come to the office during the week."

Tiik said people's preference for living in cities has created a new situation. Five years ago there were concerns about finding new family doctors to work in the countryside, now, he says it is important to take into consideration large towns such as Pärnu, Valga, or Viljandi may well be unable to attract doctors in the coming years.

"There are no doctors in rural towns and you can't dream of getting anyone to go there," he told AK.

In September, ERR News reported every fifth family doctor has reached retirement age in Estonia, and with a lack of young people looking to take their places, the Ministry of Social Affairs is preparing for a crisis.

There are almost 800 family doctors' lists of patients in Estonia, of which nearly 280 are in Tallinn. More than 40 lists currently have a temporary replacement and many people have to travel a long way to see a doctor or nurse.

Of the 13 doctors who finished their residency last year, only two took new lists of patients afterwards. One was in Tallinn and the other in Rae parish, Harju County, AK reported on Monday.


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Editor: Helen Wright

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