What can we learn from general practitioners who left Spain? A mixed methods international study

Area of Science:

• Health Policy
• Human Resources for Health
• Primary Care Management

Background:

• International health workforce mobility significantly impacts health system performance.
• Research on the drivers of general practitioner (GP) migration is limited.
• Understanding migration patterns is crucial for effective health workforce planning.

Purpose of the Study:

• Investigate the reasons for migration among Spain-trained GPs.
• Develop policy recommendations for GP retention and recruitment in Spanish primary care.

Main Methods:

• Mixed methods study combining surveys and qualitative interviews/focus groups.
• Survey data analyzed quantitatively to identify reasons for leaving and return intentions.
• Thematic analysis of interviews and focus groups for retention and recruitment insights.

Main Results:

• Key reasons for GPs leaving Spain include insufficient salary (75.3%), job insecurity (67.7%), and excessive workload (67.7%).
• Nearly half (48.7%) would return if working conditions improved.
• Qualitative data highlighted needs for better contracts, working conditions, professional development, and governance.

Conclusions:

• Improving salary, job security, flexibility, workload, professional development, and governance are essential for GP retention and recruitment in Spain.
• Ten policy recommendations are proposed to address current and future GP shortages in Spanish primary care.