Will family doctors be civil servants?
Family doctors: freelancers or state employees? Facts, debate and controversy
The Covid-19 pandemic has brought out the difficulties and profound territorial inequalities of our National Health System . In the most difficult weeks of the fight against the virus, about one in three infected went to the emergency room, effectively clogging up the hospitals. This led to the sometimes fatal delays in visits and diagnoses. Out of 21 million accesses to the emergency room , as reported by the Data room of Corriere della Sera , 16 million are white and green codes, and 87% of these do not lead to hospitalization.
The shortcomings of territorial medicine in managing the pandemic
The family doctors, and their role as a local health unit, ended up in the meat grinder, including the media, of the pandemic. General practitioners have been accused of failing to respond to the numerous requests from patients and of merely prescribing drugs according to guidelines and not providing real assistance. In the coming years they could be invested with new responsibilities, having to pay the price of the lack of assistance, due to the pandemic, to 23 million people with chronic diseases.
The reform of the National Health System
For this reason too, the PNRR has foreseen an enhancement of territorial medicine. Firstly, Community Houses will be established, structures that will bring together family doctors, specialists, nurses and social workers in a single neighborhood. Then Community Hospitals will be opened to accommodate patients with low intensity of care, hospitals will be reserved for the most serious cases. Furthermore, the aim is to double the number of patients followed at home, bringing them from 701,844 today to over 1.5 million, in order to guarantee assistance to at least 10% of the most needy over 65 population. Today 5.1% followed.
Family doctors become civil servants
The last point of the reform concerns general practitioners who today are freelancers affiliated with the National Health System and who are thinking of transforming them into public employees. "Thinking that you become part of the National Health System only when you become an employee is false because at this point we should also make the pharmacists and workers of the external accredited employee dependent – Silvestro Scotti, National Secretary said during the Coffee Break program. FIMMG -. It seems clear to me that the National Health Service is based on different contractual models within which the tasks and functions of each category are established. For these reasons we are strongly opposed to the evolution towards an addiction which in my opinion would not be sustainable either economically or in terms of functionality ".
The risk of standardization of care
The proposal met with the opposite opinion of the main union of family doctors who are keen to preserve their independence. “Today, unfortunately, the choice of doctor is called into question by some programming errors with respect to the number of doctors available that do not allow the citizen to exercise a real choice. Furthermore, a large number of doctors will retire, citizens will find themselves choosing among a few doctors – continued Silvestro Scotti -. And it is clear that citizens could be dazzled by a concept of addiction. Because according to them there will be a doctor who will always answer but probably will be a doctor who will not answer in their direct interest but in the interest of the directives that will come from the mechanism of dependence that creates service orders, hierarchies and standardizations of care . When, on the other hand, in Italy we need the personalization of care in the interest of the patient ".
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/primo-piano/i-medici-di-famiglia-saranno-dipendenti-pubblici/ on Sun, 27 Jun 2021 06:21:31 +0000.