In Portugal, the first-point healthcare system is really struggling, and the ongoing Portugal GP shortage shows how deep the Portugal primary care crisis has become. One big issue is that many people don’t have a family doctor. A 2024 study found that about 1.5 million people in Portugal were living without a family doctor, highlighting the growing shortage of family doctors in Portugal. In some areas, just one doctor might be responsible for up to 14,000 patients.
Because of this, things like regular health check-ups and managing long-term illnesses become hard, especially in the more remote or less well-served regions.
By early 2025, the number of residents without a GP had risen to over 1.56 million, indicating the problem is growing.
The government is trying to fix these Portuguese healthcare problems, but long-standing issues with the Portuguese healthcare system mean progress has been slow. For many people, it still means long waits to see a doctor, trouble registering with one, and very uneven access across different parts of the country.
Why Portugal Is Facing a Growing GP Shortage
Several long-term workforce and structural issues have combined, making it increasingly difficult for Portugal to train, retain, and distribute enough family doctors.
Ageing GP workforce
Many of Portugal’s GPs are close to retirement. A large group of doctors joined the system years ago, and now many of them are stepping back from work at around the same time. This means the number of doctors is falling quickly, and new trainees cannot replace them fast enough.
More retirements than new doctors
Even though more students have been accepted into medical school, not enough choose family medicine. Some prefer higher-paid specialties or hospital jobs. As a result, more GPs leave each year than join.
Big differences between regions
Many residents openly ask why it is hard to get a GP in Portugal, especially in crowded urban areas. Cities such as Lisbon and Porto keep more doctors because they have better transport, hospitals, and career options. Inland areas like Alentejo, Azores and parts of the Central region have far fewer doctors. This creates places where it is tough for people to get regular primary care.
|
Region |
Situation |
Impact Level |
|
Lisbon |
Overcrowded health centres |
High |
|
Porto |
High demand and limited GP slots |
High |
|
Algarve |
Seasonal population increases strain services |
High |
|
Alentejo |
Large inland areas lack GPs |
Very High |
|
Central Portugal |
Difficult to attract new doctors |
Medium to High |
Problems with funding and contracts
Many family doctors say they feel overloaded with work and paperwork. They also worry about the terms of their contracts. These issues push some doctors away from primary care and make the job less appealing to new graduates.
Doctors leaving Portugal
For many years, Portugal has seen doctors leave for other European countries. These countries often offer higher pay or better working conditions. This makes it harder for Portugal to retain young doctors, particularly in primary care.
All of these challenges together have led to a system that struggles to retain experienced GPs, attract new ones, or distribute doctors fairly across the country.
|
Cause |
Short Explanation |
|
Ageing GP workforce |
Many family doctors retire at the same time, which quickly reduces capacity. |
|
More retirements than new trainees |
Not enough new doctors choose family medicine to replace those leaving. |
|
Regional inequalities |
Cities retain more doctors, while rural areas struggle to fill positions. |
|
Funding and contract issues |
Heavy workloads and contract concerns push doctors away from primary care. |
|
Doctors leaving Portugal |
Higher pay and better conditions abroad attract younger GPs to other countries. |
How the GP Shortage Affects Patients in Portugal
Portugal is trying multiple reforms, training expansion, incentives, digital tools, and organisational changes, to stabilise primary care, but progress remains slow.
The shortage of family doctors in Portugal affects people in very real ways. It makes it harder to sign up with a GP, health centres become crowded, waiting times get longer, and some parts of the country have far less access than others.
Official information shows that around 1.5 to 1.6 million people in Portugal still do not have a family doctor. That is about one in seven people. Reports from the national health system, research groups, and international health organisations all show the same pattern. Some months, the number is even closer to 1.6 million.
Difficulty signing up with a family doctor
When someone moves house, changes region, or tries to join the national health system, getting a family doctor can be very slow. Many health centres already have complete lists, so new patients are placed on general waiting lists with no clear idea of when they will get a doctor.
Research shows that even though more family health units have been created, the number of people without a GP has increased again in recent years. Many patients are seen by whichever doctor is on duty, rather than by their regular GP, who knows their history. For long-term conditions like diabetes or asthma, this makes it harder to keep track of treatment and notice early warning signs.
Long waits for routine or urgent primary care
Even people with a GP often struggle to get an appointment, and GP waiting times in Portugal continue to rise as clinics become overwhelmed. Many doctors have far too many patients. They may officially meet waiting time targets, but in daily practice, the pressure is high, and appointments take longer to get.
Recent reports show that unmet medical needs have increased compared with before the pandemic, especially for people with low incomes. A shortage of GPs leads to delays in follow-up visits, preventive checks, and the treatment of non-urgent problems. Many patients say it can take weeks to get GP appointments in Portugal, especially for routine or follow-up care.
For patients, these delays can lead to:
- Late reviews for long-term conditions
- Problems getting prescriptions renewed on time
- Difficulty booking appointments for contraceptive or maternal health care
- More people are going to urgent care or hospital emergency departments for issues that should be handled in primary care
Medical deserts and unequal access
The shortage is not the same across the whole country. Some regions have far fewer doctors. Research shows that rural and island regions, including Madeira, often struggle to attract enough GPs, making it harder for residents to access consistent primary care. Cities may have more clinics, but also more people, so they stay crowded.
Parts of Portugal are now described as medical deserts, meaning whole towns have no GP or people must travel long distances to see one. This is especially hard for older adults, people without a car, or families with low income.
What it is like to live without a GP
For the more than 1.5 million people without a family doctor, the effects show up every day. People without a GP are more likely to have unmet health needs and to use emergency services for problems that should be treated in a clinic.
This can mean:
- Booking one-time appointments with whichever doctor is on duty
- Waiting a long time on the phone or online to get an appointment
- Repeating their medical history at every visit
- Having trouble getting regular follow-up for long-term conditions
- Relying on emergency departments, private clinics, or paying out of pocket
For people with several health problems, not having a regular GP makes it much harder to coordinate care with hospitals or specialists. Portugal’s primary care system is built around the idea of having a trusted family doctor, so when that link is missing, the whole system becomes more confusing and difficult for patients to navigate.
|
Problem |
Simple Explanation |
|
Difficulty getting a family doctor |
Many people wait months to see a GP in Lisbon, Porto, the Algarve, and other inland regions. |
|
Long waits for routine care |
Check-ups, follow-ups, and screenings are delayed because doctors have too many patients. |
|
Medical deserts |
Rural areas lose GPs and struggle to replace them, forcing patients to travel long distances for basic care. |
|
Over 1.56 million without a GP |
About one in six residents has no family doctor. |
|
Increased use of alternative services |
More people rely on urgent care, private clinics, or online medical support. |
How Authorities Are Responding to the GP Shortage in Portugal
Portugal’s government has been trying for over ten years to fix problems in primary care. But retirements, too few doctors in some areas, and growing demand have made it difficult. The response includes new training plans, digital tools, and changes to the organisation of the national health system. The goal is to make family medicine easier to work in and more appealing to new doctors.
More training places for family doctors
The government has been increasing the number of training spots for new family doctors. They want more young doctors to enter primary care to replace those who are retiring.
To support this, authorities are offering:
- Extra residency places in primary care
- Training programmes in areas that lack doctors
- Updates to medical school courses to show how vital family doctors are
Medical groups say even more training places are needed because retirements are rising.
Incentives to work in underserved regions
Since inland and rural areas have the most significant shortages, the government is trying to encourage doctors to work there. Some of the incentives include:
- Higher pay for working in hard-to-staff regions
- Money to help with relocation
- Pathways that encourage trainees to stay in inland areas after finishing residency
Some local councils also offer support, such as housing help or extra allowances. Even so, retaining doctors in these regions remains difficult. Many say that pay alone is not enough if workloads stay too heavy or career growth is limited.
New primary care units and organisational reforms
Portugal has been expanding Unidades de Saúde Familiar, which are family health units where doctors, nurses, and other staff work together in teams. These units were once seen as a strong example of modern primary care. They offer better organisation and more autonomy.
However, progress has slowed. Some areas struggle to upgrade older clinics due to staffing shortages or lengthy administrative processes. To move things forward, the government plans to:
- Improve old buildings and crowded clinics
- Create new ways of organising work so doctors spend less time on paperwork
- Hire more nurses and administrative staff so doctors can focus on patients
These reforms aim to make primary care a better place to work and to improve patient continuity of care.
Keeping experienced GPs in the system
The government knows that losing experienced family doctors worsens the shortage. To prevent this, they are working on:
- More evident career progression for GPs
- Better rules for workloads and performance goals
- More stable contracts and agreements with professional groups
Some of these measures are still being negotiated, but others are already in place to reduce burnout and stop doctors from leaving for other countries.
Digital health tools and telehealth options
Portugal is expanding digital services within the national health system. SNS 24 now offers remote triage, health advice, and online booking. These tools cannot fully replace an in-person GP, but they help reduce pressure on busy clinics.
- Digital changes include:
- Online renewal of some prescriptions
- Remote triage to guide patients to exemplary service
- Better electronic health record systems across the country
These tools aim to make care faster and more efficient, especially for patients who do not yet have a family doctor.
Where Online Care Fits Into Portugal’s GP System
In Portugal, getting a routine appointment with a family doctor can be difficult, so online care can help fill some of the gaps. It gives people a quick and easy way to speak with a doctor for non-emergency problems without waiting for an in-person visit at a local health centre.
Services like Mobi Doctor connect users with EU-licensed clinicians via online consultations, either via chat or phone. This can be useful for people who have just moved to a new area, including foreigners trying to navigate Portugal expatriate healthcare, who are still learning how to use the national health system, or who cannot get an appointment soon enough.
Online consultations are suitable for simple health concerns that do not need a physical examination. This includes discussing symptoms, reviewing a treatment plan, or prescribing when appropriate. These services align with Portugal’s broader efforts to use digital tools that make care easier to access and help reduce unnecessary trips to clinics.
Online care does not replace emergency services or long-term follow-up. However, it can provide steady support when regular primary care services are slow or have limited availability.
