More than 91% of all surveyed doctors supports the strike and require health authorities to have more dignified attitude towards the doctors;

Over 83% of the doctors supports the strike due to the need to increase the sallaries;

Over 79% of the surveyed doctors employed in the public sector consider that the pay for performance project should be droped;

Skopje - (September  21, 2012) - In the period between 10-20 of September the inernational Internet research project Healthgrouper conducted an electronic survey among doctors working in the public and private health sector in the Republic of Macedonia. It total 312 doctors representing 45 different specialities took part in the survey. This short rerpot sumarizes the results that refer to the pay for performance (P4P) project, as well as the attitude of the doctors towards the scheduled strike for September 24, 2012. The independent union of the Clinical Center in Skopje put forward three main requests to the ministry of health: to increase the sallaries, to drop the pay 4 performance project, and the health authorities to show more respect towards the doctors.

Majority of the surveyed doctors support the three main reasons why the strike was called. The bigest support doctors devote to the need to change the attitude of the health authorities over the doctors. Over 91% of all surveyed doctors regardless of thier place of employment public or private support thier colleagues in the strike. Even 73% of them in total agree with the statement, while additional18% opt for „ i agree” with the above statement. On the second place follows strong support among doctors to increase the sallaries. Majority or 56.5% of all surveyed doctors in total agree with the statement and are in favor of the strike, while additional 27% opt the option "i agree". In total, in favor of the strike due to the need to increase the sallaries are over 83% of the surveyed doctors. Finally, the main reason for which the strike was called pay 4 performance project finds strong support among 34.4% of the doctors, additional 28% are also in favor and support the strike, while the rest of 37.6% don't know or does not approve the strike.

Majority of the doctors are convinced that the workload who they relate with quantity, or the number of performed services has its dominant position in determining the performance. Additional parameters that the model should integrate are the quality and complexity of the work done, that according to them this model does not take into account. The doctors thing that individual skills, experiance, education, the team work as well as other carachteristics shoud be employed in order to provide more just model for pay4 performance. Due to these problmes majority of the doctors consider that the current model is subjective and opens possibilities for bias and missconduct.

Considerations and recommendations

To find compromise solution over dialog that would pelase both the interest of the Government to implement the project, and the need of the doctors to integrate thier remarks;

The ministry of health to develop clear and writen methodology that in details would explain all parameters that are considered in the pay 4 performance model;

To commision independent report that would research the current implementation of the P4P model.

You can download the full report in Macedonian click here.  

Healthgrouper is an Internet research platform for communication between physicinas and it provides information about health providers in South-East Europe to the patients. Healthgrouper conducts surveys in all countries where the project is active, in order to make comparative analyses for the conditions in the health systems in the region and promote the quality of health care. Final results of the surveys are published online and available on following линк. For more information, please visit