2022: the end of general medicine?

by Mauro Somaschi

16 FEB – Dear Director,
the debate on the future of General Medicine is increasingly articulated. The solutions presented are varied and personally, I believe not all of them can be shared, especially if proposed by those who do not intend to accept the suggestions of those who work in the “field”.
I read the letter from my colleague Morini from Faenza: The truth about “general practitioners” that the media do not tell. Totally shareable and realistic.
It is worrying to see that young GPs colleagues resign from the Convention in the face of the critical issues that the category has been making loudly for years and particularly in recent times.

I am now a long-time GP (agreement 1998) and over the years I have not seen the desired centrality of General Medicine.
Even the title of Training in General Medicine that I obtained in the distant 1995 does not currently have the legal status of a medical specialty.

I consider myself a “peons” of medicine but, if I am not mistaken, for about 20 years there has been a model for the health management of the territory called Chronic Care Model, which few have taken inspiration from for territorial management experiments.

With a very humble and elementary assessment I can however certainly affirm that if the basic organizational tools had been provided: first of all administrative and nursing staff, associated with an articulated structure repeatedly invoked and proposed over the years, the situation of territorial medicine would not would be the current one.

Data in favor of the above have been tested by us with positive objective results on several occasions in the Lecco area.
Unfortunately, after the experimentation phases, there was never a wide-ranging implementation phase.

Ten years before my convention as a GP, you could read an interesting article in Jama: The Future of Family Practice Implications of the Changing Environment of Medicine.
Perhaps it would be useful for someone to read it … the content is certainly current despite 34 years have passed: 1988-2022. I would not like the last date to coincide with the end of general practice which never had a real beginning.

Many and at various levels will have the opportunity to re-examine these events, but perhaps it will be too late. Finally, I quote a sentence from Atul Gawande: “Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try. “

Good survival …. General Medicine

Mauro Somaschi

GP ATS Brianza (former ASL Lecco)

February 16, 2022
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