Where to put the back office

Poland, Czechia, Hungary, Bulgaria and Romania share a shape: mature e-prescription infrastructure, low physician and support-staff costs, and either an outright ban on Rx mail order or an unconfirmed one. They are excellent locations for a telemedicine, clinical-operations or customer-support back office serving other markets, and unusable as the jurisdiction of record for dispensing.

The mistake to avoid is treating a cheap operating base as a cheap legal base.

Hungary is the cheapest confirmed: a specialist physician with about ten years' experience earns roughly 1,231,000 HUF gross per month (about €3,080), an entry-level resident about 687,000 HUF (about €1,720). No sector-wide 2026 rise was budgeted.

Bulgaria: the average doctor salary in state hospitals was 1,998 BGN (about €1,022/month) in 2024, with a new regulatory minimum of €1,860/month for an unspecialised doctor reported in October 2025. National average salary reached about €1,407/month in Q1 2026.

Romania: a 2026 public-sector scale gives a medic primar 17,300 RON gross (about €3,400) and a principal nurse 8,218 RON (about €1,620), in a tightening labour market with over 8,200 healthcare jobs advertised in 2026.

Czechia: 2026 tabular salaries run 42,780 CZK for a fresh graduate to 55,080 CZK after full attestation, with actual pay reportedly 40,000–50,000 CZK above tabular once overtime is counted.

Poland has the deepest telemedicine labour market, one job board listed 6,386 open telemedycyna postings in mid-2026, but no clean per-consult benchmark could be obtained.

English and German language capacity among physicians in each market is the obvious gap, and it is the thing that actually determines whether a back office can serve a German or UK front end. None of the sources addressed it. That is a question for recruiters, not for desk research.