by Dominic De Felice
16 JUN –
I read Guido Citoni’s letter carefully. I appreciated the underlying motivation that animates at least one innovative proposal for first contact medicine. But the problem is that it would be necessary to get out, in basic medicine, of the now obsolete concept in public health of accredited private individuals.
In the Lombardy Region, for example, we know that 68% of public hospitals are accredited private hospitals which, with the lack of adequate controls, cause problems.
The same thing happens with the general practitioner, as we saw and immediately during the Covid period.
Limited hours, secretaries and/or secretariats impassable.
Then there are the heroes, but they are of no use to medicine.
And often now, not even “the family doctor” is needed as a residual bulwark of what the citizen still considers his “own doctor” as if he could, being a maximalist, remember everything and everyone.
So in my humble opinion it would really be necessary to turn around. How really?
A new faculty of “Territorial Medicine”. 5 years to study symptoms, diagnoses and therapies. First aid notions, food and sports notions. Without specialist and surgical medicine. But without graduating in medicine and having to do a specialist or a regional course. With the obvious limitations with respect to the course of medicine and surgery and subsequent specialties that occupy ten years of life. Not second-degree doctors but important collaborators.
From this point of view, it would be necessary to establish local medicine departments open 24 hours a day, 7 days a week in every accredited public and private health facility with local doctors employed to look after citizens and free up the Emergency Departments for real emergencies. They would thus be in direct contact with specialist doctors to arrive at a complete and in-depth diagnosis where necessary.
Possibility for local doctors to have a private practice within the health facilities beyond working hours. A free choice, not forced, for those who want and can.
Immediate cancellation of the community houses, islands in the desert, which would become useless and incomplete duplications with respect to the hospital world.
We could start from these simple points to make family medicine once again important, understood as trusted medicine. With this in mind, I have long requested a meeting with the Prime Minister to present ideas that are perhaps revolutionary and which take a few years to graduate new lenders of a work that must return to the center of the citizen’s health and illness and not be often relegated, as is the case now, to copying recipe after recipe or filtering services requested by specialists to save the system.
I will continue day after day to send a PEC to be heard in that perspective of involvement of the ministry of culture and health.
June 16, 2023
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