Too many general practitioners work alone, a new reform is coming: “Here are the community houses”

VENICE – In a few years, thanks to funds from the NRP (well 2 billion euros at national level), we will have the Community houses: less than a hospital, more than a clinic, will be structures always open, 24 hours a day, 7 days a week, where in addition to your general practitioner you can also find specialists and carry out tests. The Community Homes will be the top of patient services: 99 have been planned in Veneto, they will have to be built by 2026. But in the meantime? And, anyway, what will patients do in whose territories these “places of excellence” are not provided? This is where the proposal of the Fimmg of Veneto comes in, the Federation of family doctors which, moreover, has recently had somewhat tense relations with the Region, so much so that it has deserted the discussion table. The idea is of favor the aggregation of doctors with the Region which should contribute to the outpatient costs of administrative staff and their training. “This proposal of ours – says the secretary of the Fimmg, Maurizio Scassola – is meant to be an opportunity to relaunch relations and reopen the negotiating tables”.


THE DATA
The reform proposal was illustrated yesterday, May 28, in the assembly of the Venetian Federation, also present the national secretary Silvestro Scotti, and “as soon as possible it will also be presented to the Region, a sign of the will to act as a propositional subject and not an opposition “. The starting point is that today in Veneto 50% of family doctors work alone, they don’t even have a secretary. The reason? “Because having an organized structure with administrative staff costs”, explains Scassola. Objection: with what a general practitioner takes, an employee will also be able to afford it. “But the profession of general practitioner is no longer attractive, the model is primitive, many prefer to do something else. As in the emergency and emergency services, it is the workload that makes doctors flee ». Scassola cites the 17th training course in general medicine, the one that has just begun: “There were 370 new graduates, 70 have already resigned.”
The other data is that only 23% of the Veneto population has as a reference group medicine organized with trained administrative and nursing staff: out of 86 authorized, only 76 activated. “This is inadmissible – says Scassola – because in this way an inequality is created with respect to the population”. Among other things, the secretary of the Fimmg adds, since 2018 the integrated medicines have no longer been financed by the Region. All seasoned by the shortage of doctors: the Fimmg data speak of 2,710 doctors in service with a forecast that 375 will retire in the next three years. “And it could be more if they decide to retire before they turn 70.” Critical situation in the Continuities of assistance, the former medical guards, with 537 vacant positions. As for the decision to use the trainees, the so-called doctors, Scassola has no doubts: “Without a tutoring they are boys sent to the fray.”

THE LEVELS
Given the premises and considerations (“If we are at this point it is because the programming was wrong, both nationally and regionally”), the comparison with Palazzo Balbi does not promise to be downhill. The Fimmg, however, is counting on it and will propose a reform based on three levels to the Region. 1) Microteam (called Aft) that bring together at least 5 doctors from the same territory, where there is the possibility of having administrative staff in at least one of the clinics; 12-hour continuous activities for 5 days a week. 2) Integrated group medicines with at least 10 doctors and, for example, adequate instrumental equipment for first-level diagnostics, with continuous 12-hour activities 7 days a week. 3) Community houses, regulated by the Pnrr; minimum 10 general practitioners plus the full team, open 24 hours a day, 7 days a week.
It goes without saying that, according to the Fimmg, in order to facilitate the aggregation of general practitioners and therefore provide greater services to citizens, the Region and the State must bear the costs of at least the administrative staff of the clinics. «Our proposal for the reform of general medicine – says Scassola – is meant to be an opportunity to relaunch relations and reopen the negotiating tables with the Veneto Region. It is no longer the time for the buffer measures that frantically chase emergencies, which are still there and we recognize. We believe that this reorganization can be a structural and concrete response to the health and assistance needs of the population ».


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