Health professions in Europe: more or less?

Abstract

Health systems in Europe are under growing budgetary pressures to provide appropriate and affordable healthcare for their populations. At the same time, there is a worsening workforce crisis from the supply side among clinical roles, and there has been an expansion of new health professions in many countries. The current shortage of physicians in many European countries has become a matter of widespread concern at political and societal level. Meanwhile, the shortage of nurses has become an even higher concern. Allied health professionals are the third largest healthcare workforce, and the WHO has promoted their training as a priority to compensate the increasing shortage of physicians and nurses. The workforce crisis in the European health systems could somehow reflect the growing issue of dual practicing followed by many professionals working inside them. Although legally allowed, any form of dual practice inevitably raises financial conflicts of interest. Moreover, the workforce organization in health care is quite peculiar because of the greater influence that health professionals placed at the delivery of care have over daily decision-making. Since a hierarchical approach is not recommended in health care, the increasing number of health professions could undermine multi-professional team building and deter inter-professional knowledge. Finally, clinical activity is expected to be a professional mission aimed at caring patients. Since the most productive and fulfilling strategy for health professionals is to work together in integrated workplaces, the growing number of graduations and specializations in health professions is likely to favor fragmentation.