Sweden has a population of about 9 million people. The Swedish health care system is a public sector responsible for providing and financing health services for the entire population. Responsibility for these services rests primarily within the 21 county councils.

Primary health care in Sweden has since the late 1960/s been provided in health centers which has facilitated teamwork. Most family doctors are salaried employees, and it is most common to work in a health center, side by side and as a team with nurses, midwives and physiotherapists, but there are also some private alternatives. There is no long tradition in doctors listing patients; the doctors working in a health center hold responsibility for the people in the most nearby area. The last ten years though there has been some changes underway in the system of primary care, and there is now more diversity in the way of organizing local primary health care in different parts of the country. A new law stating that all citizens in Sweden has the right to choose a doctor who has qualified as a GP as their own family doctor has led to a more prominent position of the GP in the primary health care system in Sweden. In 2002 the government also put resources into the creation of FAMMI (Institute of Family Medicine, www.fammi.se) which has as its main purpose to enhance the position and provision of primary health care in Sweden in all aspects.

Education and training

Medical school, basic undergraduate medical education, is 5½ years, in which general practice occurs on the curriculum throughout the education. Internship is 18-21 months, of which 6 months in General Practice. Successful completion of this programme gets the doctor a license to practice (full registration). Specialist training is at a minimum 5 years, and is carried out in a salaried position with medical responsibility. There are nationally stipulated goals for what knowledge and skills the trainee shall aquire to become a specialist in family medicine and an individual plan for training is designed for each trainee. The whole time in training the registrar has a personal supervisor with whom the progress in skills and knowledge is continually evaluated and reflected upon.

Tasks in general practice

Primary care in Sweden provides all basic health care that does not demand medical and technical facilities of a hospital. That includes preventive and rehabilitative care, child- and maternity-health care services, healthcare in schools as well as medical care of the elderly in the community. The referral rate from general practitioners to specialists is less than ten percent.