Welfare regions in Finland face high doctor leasing fees amid shortages in Lapland and Kainuu

In northern Finland, welfare regions operate a doctor leasing company that charges significant fees. Hospitals in Lapland, Kainuu, North Ostrobothnia, and Central Ostrobothnia are paying €1,800 for a specialist doctor for a nearly eight-hour workday, while a resident doctor costs €1,429. These pricing details come from the publicly owned company Tervia osaajat.

Despite widespread reporting on high rates for substitute doctors, the uniqueness of this arrangement in Northern Finland lies in the fact that Tervia is not a private entity; it is owned by a cooperative comprising the welfare regions themselves. Doctors working through Tervia take unpaid leave from their primary roles to fill gaps in hospitals experiencing shortages. Tervia’s medical director, Heikki Wiik, explains that one of the goals is to provide doctors opportunities to earn extra income within the public sector.

Tervia’s doctors mainly flow from Oulu University Hospital to regions including Lapland and Kainuu, with the Lapland welfare region (Lapha) being the primary customer. As of the end of July, Lapland’s central hospital had purchased €660,000 worth of leased doctor services from Tervia, a sharp increase compared to the same amount used throughout the previous year. Interestingly, Katja Hämeenojan, a chief physician, notes that Tervia is not viewed as a financial burden but rather as a solution to control substitute prices, indicating that it has helped mitigate exorbitant rates previously demanded by private doctors.

Despite this growth, Tervia still constitutes only about five percent of the specialist doctor market in Northern Finland. Wiik suggests that they could lower costs if more welfare regions would procure services through Tervia, a notion that has raised eyebrows in Lapland, where the demand for substitute doctors often exceeds availability.