When Greece introduced the concept of a “personal physician” it was presented as the foundation of a modern primary health care system — a trusted first point of contact meant to guide patients through the country’s public health network. In practice, however, the reform has failed to gain traction, lacking a clear role, a coherent identity and, above all, the trust of the public.

Introduced as a mandatory reform under tight deadlines and external pressure, the personal GP (general practicioner) system lacked a clear framework, sufficient funding and real support for participating doctors from the outset. Instead of acting as a gateway to care within Greece’s National Health System, it has been reduced to a largely bureaucratic role, far removed from everyday medical practice.

Low enrollment, even lower use

Nearly four years after implementation began, participation remains uneven. One in three eligible residents has still not registered with a personal physician. Among those who have, usage is strikingly low: two out of three registered patients rarely or never make use of the service.

According to official Health Ministry data, about 5.2 million people — roughly 62% of those eligible — are currently registered with a personal GP. Yet enrollment has slowed sharply, with just 50,000 new registrations over the past six months. Younger adults under 50 largely stay away, while uptake is far higher among older citizens, with eight in 10 people over 70 enrolled.

This is not the result of a shortage of doctors. On paper, the system has enough capacity to include those who remain outside it, with millions of patient slots still unfilled among more than 5,500 available physicians.

A system that never took hold

This uneven response points to a deeper issue: a reform that never took hold socially or professionally. Many patients continue to turn to doctors they already know and trust, bypassing the personal GP altogether. At the same time, most physicians have opted out of a system they describe as unclear, understaffed and chronically underfunded, with shifting rules and expanding obligations but little institutional support.

“The institution has essentially been devalued,” said Dimitris Kounalakis, a GP, family physician and vice president of the Hellenic Academy of Family Medicine/ General Practice & PHC. “We are no longer talking about a personal GP in the real sense. The role has been reduced to prescription management — sometimes without the patient even being present.”

Contract disputes and rising tensions

Tensions between doctors and the Health Ministry resurfaced recently during the renewal of contracts with the National Organization For Health Care Services (EOPYY). The new framework introduced home visits at a patient’s request but without compensation or reimbursement for travel costs for the doctors participating.

The measure mainly affects private doctors contracted with the public system, who may be required to travel long distances without defined working hours or a clear employment framework. “We’re talking about patients who may live dozens of kilometers away,” Kounalakis said. “There’s no schedule, no reimbursement, nothing.”

Despite criticism, the Health Ministry maintains that the reform is now structurally complete, though it acknowledges that private doctors outside the National Organization For Health Care Services have yet to be fully integrated.

Certification gaps and limited clinical contact

Serious questions also surround how personal GPs are certified. According to Kounalakis, loopholes allow retiring doctors from other specialties — such as cardiology or orthopedics — to obtain general practice certification without meeting standard requirements, further weakening the system.

In reality, many personal physicians function primarily as prescription administrators, overseeing long patient lists with minimal clinical interaction. Only one-third of registered patients have meaningful contact with their personal GP. A comprehensive national electronic health record, meant to be created during a patient’s first visit, exists for just 20% of citizens.

No care team, heavy workload

Another core weakness is the absence of multidisciplinary health care teams. In many other countries, personal doctors work alongside nurses and allied health professionals. In Greece, the system was designed without adequate funding for such support, leaving individual doctors responsible for excessive patient loads.

“In Sweden, a doctor may be responsible for about 1,000 people — but with a full care team,” Kounalakis said. “Here, doctors are required to register up to 2,000 patients, completely on their own.”

Panagiotis Psycharis, president of a national federation representing primary health care professionals, links the low acceptance of the reform to Greece’s broader health care culture. “Greece has a very high number of specialists, and people are used to going directly to the specialist they’ve known for years,” he said. “Changing that mindset is extremely difficult.”

Self-referrals undermine the model

Public skepticism has been reinforced by policy choices that weaken the personal GP’s role as a gateway to care. To ease long waiting times, authorities now allow patients to self-refer directly to specialists, even in critical fields, without prior medical guidance.

Psycharis cited a recent case in which a woman booked an appointment with an oncologist at a public hospital after worrying about a blood test result — without a referral from any other doctor.

According to both experts, this reality strips the personal GP of any meaningful function as a filter or guide. “A personal doctor is not there to close doors,” Kounalakis said. “They’re there to tell you where to go.”

Without a clear framework, multidisciplinary care teams or public trust, that guiding role remains largely theoretical, leaving Greece’s flagship primary care reform unable to deliver on its original promise.