An earlier survey (Encuesta de Satisfaction al Usuario 2012-2013) found that users ranked hospital and outpatient care as “satisfactory.” Issues of geographical distribution as well as number and speciality of physicians have been persistent challenges in Costa Rica, and despite several work force planning initiatives, ensuring adequate supply of workforce remains challenging. However, the incentive has been insufficient to attract doctors to more distant localities, and is particularly problematic for specialists such as anaesthesiologists and ophthalmologists.