Andorra Faces Doctor Shortage Crisis in 5-10 Years Due to Retirements

Albert Dorca, president of the Andorran College of Physicians, has highlighted a looming generational replacement crisis across all medical specialities, warning of shortages in the coming 5-10 years as a significant portion of doctors approach retirement age beyond 60.

In an interview, Dorca outlined the challenges in attracting professionals, particularly amid feedback from Andorran doctors working abroad—around 18 currently—who cite uncompetitive pay compared to public systems in Spain. He noted that while Spanish salaries have adjusted over the past 15 years, Andorran tariffs have only been revised three times in the same period and are not indexed to inflation.

Earlier this year, the College presented the Health Ministry with an ambitious action plan built on three pillars: guaranteed, ministry-planned training to streamline efficiency for incoming doctors; performance-based incentives, such as rewards for managing chronic conditions like diabetes or conducting screenings, modelled on French practices; and tariff increases to restore competitiveness, especially against southern neighbours.

Dorca acknowledged the ministry's ongoing efforts to update fees for understaffed specialities, including diagnostic procedures (letters K) and surgical ones (Q). However, he stressed the proposal's urgency, saying it may already be late and that even full approval now might not suffice given current strains.

Primary care physician ratios in Andorra sit below the European average, yet the system's flexibility—allowing extended hours during peaks like flu season—keeps waiting lists shorter than in Catalonia. Not all practices are equally saturated; some doctors handle larger quotas or longstanding patient relationships, complicating load balancing.

Dorca praised the medical on-call service, now in its second year of full Christmas coverage at Meritxell Clinic. Once a low-traffic guard post in Plaça Coprínceps with most cases diverted from emergencies, it now sees 90% direct visits, easing pressure on A&E. Reverse referrals from emergencies back to primary care remain underused, as patients often opt to wait rather than return later.

Quantifying ideal staffing is tricky for Andorra's small population, Dorca explained, due to overlapping roles—such as endocrinologists, internists, and primary care handling diabetes, or rheumatologists sharing autoimmune cases with internal medicine units. The family medicine sector, with its larger volume of around 40 doctors, feels fluctuations less acutely than specialities.