The state of primary medical care in Bulgaria

This paper describes the state of primary medical care in Bulgaria and related issues. This component of the state health system is based on the so-called principle of the 'district physician'. It is built on the idea of establishing long-lasting contact between the physician and the patients. Primary care is provided by a district therapist (for populations of up to 3000 inhabitants), a paediatrician (for 800-1200 children aged up to 14 years) and an obstetrician-gynaecologist (for 16,000-18,000 female inhabitants), as well as by numerous freely accessible narrow-profile specialists. The main disadvantages of the existing system of primary medical care are the lack of opportunity for personal choice of physician, division of responsibilities among numerous physicians and other medical staff, expensive medical care owing to abundant polyclinical specialists, reduced physician's motivation and hampered users' influence on the quality of medical care. Questions about the future status of polyclinics and both children's and female health centres, as well as about the optimal ratio between family physicians and specialists, remain unresolved.