Sağlık-Sen Issues Urgent Call for Family Medicine: "Equitable Regulations Are Essential, Grievances Must Be Addressed!"

ANKARA – On Tuesday, May 27, 2025, Sağlık-Sen, a leading health union confederation in Turkey, issued a critical statement regarding the ongoing issues within the Family Medicine System and the grievances stemming from the Payment Regulation. Sağlık-Sen General President Mahmut Faruk Doğan, in a call made via his social media account, emphasized the urgent need for revisions to the Family Medicine Payment Regulation, specifically addressing issues arising from criteria such as "satisfaction rate," "population not visiting a family physician in the last 6 months," and injustices experienced through the Disease Management Platform (HYP). Doğan declared, "We are committed to following up on the rightful demands of our family physicians, midwives, and nurses. We will resolutely continue our struggle to address these grievances. Equitable regulations in Family Medicine are essential."

Turkey's healthcare system adopted the Family Medicine System with the aim of providing more accessible and localized services to citizens. However, over time, certain implementation issues have led to significant grievances, particularly for physicians, midwives, and nurses. Sağlık-Sen continues its pursuit of solutions by voicing these grievances at the highest level.

Controversial Articles of the Payment Regulation Under Scrutiny

At the core of General President Mahmut Faruk Doğan's statements are the articles of the Family Medicine Payment Regulation that cause injustice in practice. Doğan stated that these articles, which they have frequently raised and offered solutions for, urgently need to be revised:

1. 'Satisfaction Rate' Criterion: The inclusion of subjective and uncontrollable criteria like "satisfaction rate," which directly impacts the performance of physicians and healthcare professionals, creates undue pressure on these professionals.
2. 'Population Not Visiting a Family Physician in the Last 6 Months' Criterion: It is considered a major injustice that a situation beyond the direct control of the physician, such as a citizen not visiting a family physician due to health awareness or personal preference, leads to a reduction in the physician's income.
3. 'Exclusion from 2nd and 3rd Level Referrals' Issue: The exclusion of patients referred by the family physician or who made appointments via the Central Physician Appointment System (MHRS) from the family physician's performance evaluation for 2nd and 3rd level referrals is contrary to the logic of the referral chain and results in loss of rights. This situation can also negatively affect family physicians' motivation to refer patients appropriately.

HYP Grievance: Family Health Nurses and Midwives Demand Independent Coefficient

Doğan also highlighted another significant issue within the Family Medicine Contract and Payment Regulation: the grievances experienced by family health midwives and nurses through the Disease Management Platform (HYP) system. He stated that the coefficient application directly linked to the HYP system unfairly penalizes these employees who lack direct entry and intervention authority within the system.

Sağlık-Sen's General President advocated for family health nurses and midwives to be evaluated with an independent coefficient, based on a "positive performance principle," as a solution. He argued that this approach would increase the motivation of these healthcare professionals and ensure fairness in the payment system. It is known that Sağlık-Sen has a comprehensive HYP report containing its recommendations on this matter, which was previously submitted to the relevant authorities.

Sağlık-Sen: "We Will Not Give Up Our Fight!"

At the conclusion of his statement, Mahmut Faruk Doğan reiterated the union's unwavering determination: "We are committed to following up on the rightful demands of our family physicians, midwives, and nurses. We will resolutely continue our struggle to address these grievances. Equitable regulations in Family Medicine are essential."

Sağlık-Sen's call holds significant importance for the quality and sustainability of primary healthcare services. The protection of healthcare professionals' motivation and rights directly affects the quality of healthcare services received by citizens. Public anticipation is high regarding how the Ministry of Health will respond to these rightful demands.