South Karelia still spends millions on contract doctors

South Karelia Wellbeing Services County spends more than 10 million euros a year on contract doctors despite its financial difficulties, Yle reports. Recruitment problems have forced the county to buy particularly specialist medical services.

The county will spend about 350,000 euros on dermatologists this year. The contracts cover 16 to 20 working days by specialist dermatologists each month.

“It is a high price, but the benefit we get is worth the money,” said Jarno Gauffin, director of South Karelia Central Hospital.

The alternative would be to transport patients to Helsinki for treatment, which would cost even more, Gauffin said. The price in the framework agreements is a maximum, he added, and the county pays only for work that is carried out.

If the county had its own dermatologists, the work could be done for about 250,000 euros. However, the long-serving head physician of the dermatology outpatient clinic retired early this year, and the county struggled to find a replacement. The clinic is now operating with a remote head physician, contract doctors and nurses.

Eye specialists cost millions

Contract doctors are mainly used when the county cannot find qualified staff or recruitment is proving difficult.

In 2023, it emerged that the county was paying 315,000 euros a month for the equivalent of three ophthalmologists. South Karelia still has the same contract with Mehiläinen for eye specialists.

“The work is done by a pool of about 15 ophthalmologists. Most of them come to Lappeenranta from the Helsinki metropolitan area,” Gauffin said.

Contract doctors are also used in primary healthcare, in addition to the county’s own doctors. Follow-up care wards in Taipalsaari and Parikkala have been difficult to recruit for over a long period, so doctors are procured for those locations through service contracts, Gauffin said.

County aims to reduce spending

In recent years, South Karelia Wellbeing Services County has spent just under 20 million euros a year on contract doctors. The county, which is facing financial difficulties and is under state supervision, aims to reduce the figure as close to zero as possible.

The costs have already fallen significantly this year. The county no longer uses contract general practitioners in emergency services. Those shifts are now covered by its own doctors who volunteer for the work, Gauffin said.

In 2024, the county paid slightly more than 3 million euros for emergency service doctors obtained through external contracts.

Specialist recruitment remains difficult

According to Gauffin, recruitment problems are the underlying reason for using contract doctors. Recruiting specialists is particularly difficult.

One reason is that university hospitals are highly attractive workplaces. Doctors may also become established in those locations during their years of study.

Medical studies take about six years, followed by another five to six years of specialist training.

Gauffin said contract doctors are easily portrayed negatively in the media, creating the impression that a company simply supplies an impersonal workforce. In reality, he said, the doctors are essential to the county. The county also signs contracts directly with specialists without intermediaries.