Study finds stark gaps in Swiss paediatric care

Switzerland has too few paediatricians, with major differences between cantons, Swiss broadcaster SRF reported. There is an average of one paediatrician for every 1,600 children, compared with the 1,000-to-one ratio recommended by the Swiss Medical Association, FMH.

A study by the University of Bern found that the shortages are particularly severe in central and eastern Switzerland. In Appenzell Ausserrhoden, one paediatrician serves about 4,750 children, more than six times the average in Geneva, where one doctor is responsible for around 750 children.

Claudia Kuehni, who led the study at the University of Bern’s Institute of Social and Preventive Medicine, said the differences between cantons were much greater than expected. Urban cantons and the French- and Italian-speaking parts of Switzerland generally have better provision, while rural regions are below average.

The shortage also affects consultations. A routine check-up takes an average of 20 minutes in Schaffhausen, compared with 45 minutes in Geneva and Valais. Practices in undersupplied regions are also increasingly accepting new patients only selectively, for example siblings or children from nearby. According to the study, just 31 percent of paediatric practices still accept new patients without restrictions.

Stefan Roth, a board member of mfe Haus- und Kinderärzte Schweiz, said practices were constantly adding urgent cases to their schedules. Three planned consultations per hour could quickly become six, leaving little time to discuss other problems or answer questions. He said the pressure was frustrating for parents and created significant stress for doctors.

Kuehni attributed the shortage to several factors, including Switzerland’s failure to train enough doctors domestically and the growing administrative workload in practices. An increasing share of working time is being spent on bureaucracy rather than patients.

The study identified urbanisation and differences in financial compensation as the main reasons for the cantonal disparities. Its calculations found that compensation alone explained 39 percent of the differences: the higher the remuneration, the greater the density of paediatricians.

Kuehni said equalising fees across Switzerland, or raising them specifically in shortage regions, could make rural practices more attractive.