Family doctor in Latviawhere to get treatment, how to verify certification, what this doctor does

A family doctor works in primary care. They follow a patient over years, treat acute and chronic illness within their scope, run preventive check-ups and vaccination, issue prescriptions and sick-leave certificates, and decide when a specialist or a test is needed. One practice can hold up to 1,800 registered adults or 800 children.

• Respiratory infections, fever, cough, blocked nose
• High blood pressure, cholesterol, type 2 diabetes
• Back, joint and abdominal pain
• Skin rashes and allergic reactions
• Vaccination under the national schedule and before travel
• Annual preventive check-up and screening referrals

For most everyday illness the family doctor is enough. A specialist is needed when the diagnosis stays unclear after first-line tests, when the illness does not respond to treatment, or when a procedure is required that primary care does not perform.

Family medicine in Latvia has no official sub-specialties. What differs in practice is the setting rather than the qualification: rural practices have their own association, and some doctors work privately only, without a National Health Service contract.

• Six years of medical study and a doctor's degree, at Rīga Stradiņš University or the University of Latvia.
• Residency in family (general practice) medicine. The RSU programme runs 3 years, 198 ECTS, tuition 5,800 EUR per year. Programme page: RSU residency programme.
• A state examination at the end of residency, including defence of a research paper.
• The certification examination. Exams in this specialty are run by the Latvian Association of Family Physicians, with the certification decision taken by the Certification Council of the Latvian Medical Association.
• The certificate is valid for 5 years. Recertification requires 250 continuing education points, at least 60 per cent of them tied to the base specialty, plus a 48.38 EUR fee.
• Entry in the practitioners register must be renewed every 5 years.

• Languages. Consultations run in Latvian, many doctors also work in Russian, fewer in English. Confirm this when booking rather than at the visit.
• Experience. Where a doctor runs a teaching practice or supervises residents, the practice or university page says so.
• Age groups. Some practices register both adults and children, others adults only.
• Access. Ask about the acute hour, how home visits are requested, and whether remote consultations are offered.
• Second opinion. Patients may freely choose their doctor and institution. To change family doctor, agree the re-registration with the new practice first. Nothing needs to be settled with the previous one.

• Bring an identity document, results of earlier tests, and a list of the medicines you take.
• Book by phone or through the provider's online form. Turning up without an appointment is not allowed, including when you hold a referral.
• In a state practice the wait depends on the practice load, with acute complaints seen the same day during the acute hour. Private clinics offer same-day or next-day slots, as Veselības centrs 4 states on its page.
• At the visit the doctor takes a history, measures blood pressure and pulse, listens to heart and lungs, and issues blood tests, a specialist referral or prescriptions as needed.
• Outside practice hours call the family doctor advice line on 66016001. In a life-threatening situation call 113.

In a state-contracted practice you pay only the patient co-payment: 2.00 EUR per visit under 65 and 1.00 EUR from 65. A home visit in the defined cases is 2.85 EUR. Co-payments in one calendar year are capped at 570.00 EUR, and several population groups are exempt. In a private practice the patient or insurer covers the full fee, and tests ordered by a private doctor are also paid privately.

• Family doctor or therapist, first consultationPrice EUR: 80.00Provider: Veselības centrs 4
• Family doctor or therapist, repeat consultationPrice EUR: 35.00Provider: Veselības centrs 4
• Internist or family doctor, first consultationPrice EUR: 60.00Provider: Veselības centrs 4
• Internist or family doctor, repeat consultationPrice EUR: 50.00Provider: Veselības centrs 4
• Remote repeat consultation for a prescription renewalPrice EUR: 25.00Provider: Veselības centrs 4
• Internist or private family doctor consultationPrice EUR: 58.00Provider: ARS medicīnas klīnika
• Patient co-payment, state practice, under 65Price EUR: 2.00Provider: NVD
• Patient co-payment, state practice, 65 and overPrice EUR: 1.00Provider: NVD

The specialty body is the association "Latvijas Ģimenes ārstu asociācija" (Latvian Association of Family Physicians), registration number 40008009328, registered address Ģertrūdes iela 20-7, Rīga, LV-1011. It was registered with the Latvian Medical Association on 10 June 1992, as a public organisation on 28 September 1994, and in the Register of Associations and Foundations on 25 August 2004. President: Alise Nicmane-Aišpure, email birojs@lgaa.lv, office phone +371 29421426. The association runs certification examinations and decides on certification and recertification in the specialty.

Rural practices are represented by "Latvijas Lauku ģimenes ārstu asociācija", registration number 40008062244, email llgaa@llgaa.lv, llgaa.lv.

The parent body is the Latvian Medical Association, founded in 1988, whose Certification Council issues the certificates. The sector regulator is the Health Inspectorate (Veselības inspekcija).

If you have doubts about the quality of care, raise them first with the institution's management: since 1 October 2017 every treatment institution must operate a complaints and suggestions system. If the answer does not resolve it, a written submission goes to the Health Inspectorate no later than two years after the alleged infringement, and is reviewed within 30 days, extendable to four months in complex cases. The submission must state your name, personal identity number, address, the institution, the treatment dates and contact details, and must be signed. The procedure is set out on the Health Inspectorate site.