The Presidential Administration of Romania hosted the national debate “Prevention as a National Priority – Family Medicine at the Centre of Health Policy and Healthcare System Resilience”, organised in partnership with the Carol Davila University of Medicine and Pharmacy in Bucharest and the AMAS University Society of Family Medicine Foundation.
The event brought together representatives of public authorities, academia and professional organisations, family doctors and residents, health policy experts and medical organisations for a discussion on making prevention a central pillar of Romania’s healthcare policies.
Romania’s First Lady, Mirabela Grădinaru, called for prevention to be placed at the centre of the healthcare system and highlighted the essential role of family doctors in achieving this goal: “The family doctor is on the front line of prevention, and prevention is undoubtedly one of the smartest investments a society can make.”
She stressed that improving population health, reducing the cost of illness and raising quality of life require a shift from a predominantly reactive healthcare model to one in which prevention becomes “a strategic priority and a moral responsibility.”
Two major challenges were also highlighted: the shortage of doctors, particularly in rural areas, and the growing spread of medical misinformation. For many people, the family doctor is their main point of contact with the healthcare system, making it essential to find solutions that reduce the gap between rural and urban communities and make family medicine attractive and sustainable across the country.
On misinformation, the First Lady called for stronger health education, greater support for doctors and medical experts, and renewed public trust in science. Retaining young doctors in Romania, she added, requires not only recognition of their contribution but also genuine opportunities to build successful careers in the country.
Continuing the call to make prevention a strategic priority, Professor Viorel Jinga, Rector of the Carol Davila University of Medicine and Pharmacy in Bucharest, outlined the role that medical universities can play in reshaping prevention. His presentation examined the current shortcomings of the system and proposed concrete directions for reforming prevention through family medicine.
The role of a medical university extends beyond training highly qualified healthcare professionals. Through its academic community, research, education and innovation capabilities, as well as its ability to bring together expertise from multiple medical disciplines, Carol Davila University can play an important institutional role in developing prevention programmes based on scientific evidence.
Professor Jinga argued that Romania’s main challenge is not the absence of a legislative framework for prevention, but the gap between existing regulations and their implementation in practice. This includes important measures introduced through the expansion of preventive consultations under the 2023 Framework Contract.
Compared with more advanced European healthcare systems, where the family doctor acts as a genuine “prevention manager” for the registered population, prevention in Romania remains largely reactive. It is often triggered when a patient visits a medical practice rather than through proactive identification of risks, population risk stratification and systematic follow-up.
Based on this assessment, Professor Jinga outlined several priorities for reforming family medicine and stressed that moving from a reactive to a proactive system will require coordinated action on several levels:
- A dedicated legislative framework for prevention – including a separate chapter in Law 95/2006 defining prevention as a core responsibility of family medicine, identifying the population eligible for different preventive services, setting responsibilities for the Ministry of Health and the National Health Insurance House (CNAS), and establishing national indicators and dedicated funding.
- An individualised prevention package for every person registered with a family doctor, adapted to age, sex and risk factors and supported by an annual preventive care agreement between doctor and patient.
- Digitalising prevention by introducing a universal electronic preventive health record with automated reminders for vaccinations, screening and risk factors. Health applications could also include a simple and accessible “preventive health passport” showing each person’s prevention status without turning prevention into a compulsory system.
- A dedicated funding mechanism for prevention, alongside existing per-capita and fee-for-service payments. The mechanism would reward population coverage and preventive outcomes – including vaccination, screening, control of cardiovascular risk factors, diabetes and hypertension, and smoking cessation – rather than simply the number of consultations delivered. Professor Jinga also proposed a national prevention fund separate from the curative healthcare budget, with its impact measured through savings generated by reducing hospitalisations and complications from chronic diseases.
- Expanding the prevention team around the family doctor, with medical assistants taking on explicit responsibilities for patient recalls, health education and chronic disease monitoring, and psychologists, nutritionists and physiotherapists involved where appropriate.
- System-level monitoring and accountability, through an annual national prevention report published by the Ministry of Health and CNAS. The report would track indicators such as vaccination coverage, participation in screening programmes, chronic disease control and rural-urban disparities, allowing Romania to measure prevention outcomes rather than simply the volume of services provided.
These priorities are consistent with recent recommendations from EUROPREV/WONCA Europe, which emphasise evidence-based and risk-based prevention targeted at specific populations and supported by digital tools, systematic follow-up, clear indicators and adequate funding, rather than the indiscriminate expansion of medical investigations across the entire population.
Prevention needs to be viewed as a continuum, starting with health education and the early identification of risk factors and extending to screening, early diagnosis, disease monitoring and the prevention of complications from chronic conditions.
Making this approach work requires close cooperation between family medicine, other medical specialties, universities, public authorities and local communities.
Strengthening prevention must also go hand in hand with investment in the healthcare workforce. Training and retaining young doctors in Romania, improving the attractiveness of understaffed specialties and creating professional opportunities in underserved communities are essential to reducing inequalities in access to healthcare.
Through education, research and innovation, the Carol Davila University of Medicine and Pharmacy in Bucharest aims to contribute to the development of a national culture of prevention and to building a more equitable, efficient and resilient healthcare system.
Professor Ana Maria Alexandra Stănescu, President of the AMAS University Society of Family Medicine Foundation and coordinator of the debate, reinforced the message that family medicine has a fundamental role to play in the prevention system.
Public strategies, programmes and policies can achieve their objectives only when they effectively reach citizens. Family doctors are uniquely positioned to turn prevention from a public policy concept into a practical, continuous and personalised approach to patient care.
Through long-term relationships with patients and their families, family doctors can identify risk factors early, encourage vaccination and participation in screening programmes, monitor chronic conditions and refer patients to other levels of care when necessary. Just as importantly, they can build the trust that is essential for effective prevention.
Strengthening family medicine is therefore not simply a matter for one medical specialty. It is a prerequisite for developing a healthcare system focused on prevention, accessibility, continuity of care and reducing health inequalities.
This is also a key objective of the institutional dialogue launched through the debate: connecting the expertise of family medicine with the resources of academia and the ability of public authorities to turn scientifically validated solutions into sustainable policies and programmes.
