12 PERSPECTIVES ON BUSINESS AND ECONOMICS | VOL 41 | 2023 in health-care organization so that elderly people can get the high-quality care they need without overburdening an already overworked and underfunded system. Physician burnout and competition within the private sector Every year, the Danish Immigration Service and the Agency for International Recruitment and Integration release information about Danish industries that are underserved. As part of this information, the Positive List identifies professions experiencing a shortage of qualified professionals in the country. As of July 2022, the health-care roles of medical doctor, nurse, midwife, dentist, and occupational therapist are on the list, revealing an overworked physician workforce (New to Denmark, 2022). A survey conducted by Møller et al. (2022) showed that more than 80% (n = 70) of vascular surgeons and vascular surgical technicians suffered from burnout, of whom 28% (n = 24) suffered from “moderate to severe personal burnout” (Møller, et. al., 2022). Although this study was specifically focused on the vascular surgery specialty, it can be inferred from the long waiting time between GP care, referral to specialists, and diagnosis that these data are similar across other specializations. The incidence and intensity of burnout are negatively reflected in the data, suggesting poor physician engagement with patient care trajectory. In a 2009 survey of patient experience, almost 20% of participants found that their GP had been poorly informed by the hospital of their condition(s), and 17% ranked the hospital–municipality coordination as bad or very bad (Pedersen et al., 2011). This early lack of coordination between public health-care workers in the 2000s has become further complicated by the recent competition posed by private providers in the 2010s. Peter Huntley from Medicoindustrien, a Danish medical technology industry association, shared the point that private and public health-care providers have separate databases; therefore, it is difficult for patients to receive coordinated care between both systems (personal communication, August 15, 2022). This systemic delay of patient data combined with a shortage of physicians compromises the quality of care through the public system. Given that in 2015, 30% of all GPs were at least 60 years old and almost 60% at least 50 years old (Forde et al., 2017), there are additional concerns with sustainability of the physician workforce, which suggests that the Danish public system risks collapse under its own weight of an aging population, physician shortage, and the competitiveness of the private sector. Geographic disparities in GP distribution In Denmark, there are about 3500 GPs for a total population of nearly 6 million citizens, leaving each Figure 2 Total Danish hospital patients, by age group, 2018 Source: Statistics Denmark, 2018.
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