The number of general practitioners (GPs) in Bulgaria has continued to decline sharply, with healthcare experts warning of growing challenges for primary healthcare accessibility across the country.
The latest annual report by the National Health Insurance Fund (NHIF) for 2024 highlights an alarming shortage of family doctors, combined with rising patient loads, particularly among the elderly population.
According to the NHIF, there were 3,365 GPs practicing under its system in 2024, a significant drop from 3,814 in 2023.
This marks an almost 12 percent decline within just a single year, a trend that health officials fear could undermine the sustainability of Bulgaria’s healthcare system if not addressed urgently.
The decline in the number of doctors is occurring alongside an increase in patient numbers. The NHIF report notes that the average monthly patient count reached approximately 5,755,000 in 2024, which is over 12,000 more than the previous year.
This growing demand for primary healthcare is placing immense pressure on the remaining practitioners, who are being forced to manage larger patient loads.
A major factor behind the rising patient numbers is Bulgaria’s aging population. The report highlights that the largest patient increase was observed among individuals over 64 years of age, a group that traditionally requires more frequent medical attention.
In contrast, the number of children under 18 registered with GPs has decreased, reflecting the country’s ongoing demographic decline and low birth rates.
The combination of fewer doctors and an increasing number of patients, especially elderly ones, is raising concerns about longer waiting times, reduced quality of care, and growing risks of professional burnout among healthcare providers.
Rural and remote communities are likely to be hit hardest by the GP shortage, with some areas already struggling to ensure consistent access to medical services.
Healthcare experts have repeatedly called for urgent measures to tackle the issue. Proposed solutions include improving working conditions and salaries to retain young doctors in Bulgaria, introducing incentives for practitioners to serve in smaller or isolated communities, and expanding the use of digital health technologies.
Telemedicine, in particular, is seen as a promising tool to bridge gaps in healthcare access, allowing patients in remote regions to consult doctors without the need for physical travel.
The Bulgarian Medical Association has also stressed the importance of reforming medical education and residency programs to encourage more graduates to pursue careers as general practitioners.
Without such interventions, experts warn that the situation could deteriorate further, leaving vulnerable populations without adequate primary care.
The NHIF report serves as a stark reminder of the urgent reforms needed to sustain Bulgaria’s healthcare system in the face of demographic shifts and workforce shortages.
Policymakers are being urged to prioritize investment in primary care infrastructure to ensure that all citizens, regardless of location, can access timely and quality medical services.