Czech Republic facing acute shortage of dentists

Czechs fear that in a few years they will face great trouble finding a dentist. Currently there are about 1500 patients per one dentist, which puts the Czech Republic somewhere in the average within the European Union. However, the prognosis looks dim for future years. The age map of Czech dentists clearly shows that a strong majority of them are between 50 and 54. Czech medical schools, however, do not produce enough graduates to replace the soon to be retired specialists.

Doctor Jiri Pekarek
One might assume that dentistry is an unattractive occupation for young people, so there are not enough applicants. Or even if there are enough applicants and therefore students, the school is so demanding that the majority does not graduate. Lastly, even if the majority of dentistry students graduate, they either do not practice or they leave to work elsewhere. Surprisingly, none of these assumptions is true, as Doctor Jiri Pekarek - president of the Czech Dental Chamber - explains.

"Interest in dentistry studies is huge, but the faculties unfortunately accept small numbers of students. Also, only 66 out of 100 graduate. And among these are also colleagues from Slovakia, who to a considerable degree return to their country. The current numbers of dentistry graduates are not able to cover the high numbers of doctors trained in the seventies, and that is the whole problem."

Great Britain, Ireland and Sweden are known as popular destinations of Czech physicians and dentists. In reality, however, the outflow of Czech dentists is not so dramatic as one might expect.

"Despite the presumption that a lot of young people leave to other countries of the European Union or elsewhere, we cannot confirm this. During the past two years, the Czech Dental Chamber has issued only forty certifications, which entitle them to work abroad, and not all of them actually used it. Bearing in mind that there are 7000 practicing dentists in the Czech Republic, the number of those who have left cannot significantly alter the situation. Moreover, these numbers are balanced by the influx of immigrants coming to the Czech Republic from other countries of the European Union."

According to a study conducted by Professor Jakub Fischer from the Faculty of Statistics, medical schools would have to increase the numbers of accepted applicants by 20 percent every year until 2012, when the number would be twice as high as today. Even this plan, however, does not seem sufficient. Dr Pekarek again.

"I don't think this is realistic because faculties don't currently have capacities to teach such numbers of students. Even if we managed to double the number of students, we would still be lacking 1400 dentists as opposed to 2200 in 15 years. Moreover, I think the only possible way is to found a new school of dentistry, perhaps a private one, which would provide education for a greater number of students."

As Dr Pekarek explains, the Czech Dental Chamber proposes two other pillars of a threefold solution to the problem.

"We need to reform the system of healthcare by founding new specialized dental institutions, which could take care of the most complicated cases. Also, dentists themselves have to change the management of their offices, and employ less qualified dental hygiene specialists. Finally, we should work on a greater motivation of patients by creating a national preventive program and by financial motivation. Certain services should not be covered by insurance, namely those, which can be avoided by proper hygiene and nutrition habits, like dental cavities and their complications."

Doctor Milos Krutina is a young dentist, who founded his own private surgery seven years ago. He says even though the Czech Republic needs young graduates, it is rather difficult to start working.

"I think the greatest difficulty is getting money to start up, because no bank will lend you money if you're not experienced. I had to borrow money from my family and friends. Moreover, the health insurance companies are not helpful at all. Sometimes it can become a real problem to get a contract. I know several colleagues who did not get a contract with a health insurer, and they have to work without it. This is of course not profitable for them. It's also a problem for patients who are insured."

Doctor Krutina believes that this paradoxical situation happens because the health insurance companies are being urged to save money at all costs.

"They do not sign new contracts, not even if the final number of dentists remains the same. They try to save money everywhere. This was especially obvious when the former minister of health David Rath was in office. He reduced the income of stomatologists, which was completely shortsighted."

Of course dentists are not on their own - the Czech Dental Chamber stands up for its members and can be influential in such cases. Dr Jiri Pekarek again.

"The Czech Dental Chamber pleads on behalf of its doctors, especially young dentists. We have our representatives on health insurers' committees, and we always argue for adoption of the contract. If it doesn't work out, the dentists can always contact the Chamber, and we try to help them. From time to time we negotiate with some individuals, but I don't think it is a general problem."

Despite the difficulties of every dentist starting out, and despite the fact that Czech dentists' incomes are below the European average, lots of young people aim at such a career. But the acceptance quotas for the academic year 2007/2008 at the Medical School of Charles University in Prague are even lower than last year. And if that trend continues Czechs may have to hope that their teeth stay healthy in the years to come.