Igor Sheiman
The problem of staffing shortage has become acute in the Russian health system. The objective of the article is to study the causes and ways to overcome it. The issues of insufficiency of the current measures of the state workforce policy, the required additional measures and their expected effect are considered. The analysis of draft regulatory documents, domestic and foreign literature, and current periodicals on this issue is carried out. The study demonstrates that the problem is not limited to the outflow of personnel from public service providers; the roots of the personnel shortage go deep into the existing system of service delivery organization and public administration. The main factors are excessive specialization of primary health care, imperfection of structural and investment policy, serious defects in planning of personnel provision and regulation of physician training, insufficiency of measures of social support for medical workers. The possibilities for extensive development in many sectors of healthcare have already been exhausted. Large-scale construction and the inclusion of new types of services in state benefits package are beyond the staffing capabilities of the industry. Current personnel policy measures are insufficient to overcome the personnel shortage because they do not address the root causes of the problem. The development of long-term planning and stronger state regulation of the medical specialty structure can focus the training of doctors on eliminating the shortage of the most in-demand personnel, and in the coming years. Overcoming the excessive specialization of primary care physicians, changing the personnel structure, and increasing the size of remuneration will require additional time.