Apinis: nurses and paramedics, not doctors, are aging fastest — and that's the real risk to healthcare

Physician and columnist Pēteris Apinis has addressed why Latvia faces a shortage of healthcare staff and why many experienced medical workers keep working well past retirement age.

Apinis argues that public attention has focused mostly on the aging of doctors, but the average age of nurses and paramedics — around 50 to 55 — is actually higher than that of doctors, and their work is physically harder: lifting patients, long shifts, and constant emotional pressure. Unlike doctors, who often continue working after retirement in lighter roles as consultants, nurses typically leave the profession entirely once they reach retirement age, and no replacements are available.

A global pattern

According to the World Health Organization and the OECD, on average a third of doctors across OECD countries are over 55. Lengthy training — six years of study plus several more in residency — means young doctors often cannot start families or build savings until their early thirties, pushing some toward burnout or emigration.

Crisis in rural practices

Apinis notes the situation is worse in Latvia's rural areas, where the average age of family doctors has reached 55 to 60, and a practice needs at least 1,200 to 1,600 registered patients to remain financially viable. Shrinking rural populations make many practices economically unsustainable, and once an aging doctor retires, finding a replacement can take months or years — during which patients register with doctors elsewhere, permanently eroding the practice's patient base.

Apinis opposes forcing young doctors into mandatory regional placements, warning this would disproportionately harm women, who make up more than 70% of young doctors. He calls on the incoming health minister to prioritize raising pay for nurses, midwives, paramedics and lab technicians, since this group — not doctors — poses the greatest risk to the system's continued operation.