by Filippo Sanna
17 NOV – Dear Director,
today throughout Italy SIMEU, a scientific society, has decided to demonstrate for the extinction of the figure of the emergency doctor. Starting from the pre-hospital emergency, we have been witnessing the patronage of task-shifting for years, or rather of a task shifting not shared by most of the medical professionals of the emergency who, while recognizing the importance and enhancement of team work , they also know very well what is appropriate and what not, both from a clinical point of view, of the patient’s interest, and from a medico-legal point of view.
In a context in which for years the graduates in medicine and surgery, qualified after 6 years of studies, were immolated on the altar of the precarious emergency because already victims of the indecency of the training funnel, they were left with atypical and precarious contracts useful only to plug the holes in the absence of any professional, educational and academic recognition, “brutalizing” the value of the medical profession while likewise, scientific societies included, they promoted task shifting as if to say “dear doctor you are the useful idiot, use and throws in anticipation of the bright future of task shifting “.
We realize that the same scientific societies that are demonstrating today, no later than a few months ago, sponsored events in which the internal clash within the profession was sustained between territorial emergency doctors and hospital emergency doctors only in function of the mere administrative framework, apparently badly concealing those that are interpreted by many as envy or jealousy of the subordinate worker with respect to the self-employed.
Many of those who cry crocodile tears today are the same who have promoted models in the ideological vision of the single doctor of emergency-urgency.
Like the single thought, the single doctor does not exist either. There are different paths, different backgrounds, different aspirations and expectations, different career prospects that must be respected because having pursued this fundamentalism today has made the discipline unapproachable for us young doctors who have come to the awareness of these pathological-dysfunctional mechanisms.
It is clear that the scarcity of primary degrees has made career prospects in the NHS very bad in the face of enormous expenditure of public money for other non-medical managers of dubious practical utility.
Not all young doctors are willing to be uncritical employees, managers on paper but too often a badly paid and exploited stopgap in practice.
The worrying shift that sees the transit of doctors, employees and non-employees, towards the potentate of cooperatives should lead the NHS and the same companies today in tears, to favor the attribution of different forms of management such as conventional ones (example: outpatient specialist ), or vice versa to profoundly change the structure of the CCNL by removing all those limitations and rigidities to professional initiative that today lead the doctor to escape from the NHS.
It makes us smile to hear some members of the scientific societies of emergency medicine externalize unrealistically integralist positions in which they profess the obligatory nature of the specialty as the only channel of access but denied for over twenty years in fact.
The specialization school has obvious problems ignored by those who only a few years ago instead of promoting the recognition of skills and competences in fact preferred to demonstrate towards the extraordinary expansion of specialization places as the only and right solution, without changing the problems by one iota known and known, finding themselves today with the proverbial fist of flies in hand. Among all, who would choose a longer and more bumpy path that in the end guarantees a narrowness of career opportunities compared to other schools with identical and sometimes higher perspectives?
The emergency doctor can be considered a “general practitioner of the acute phase” who embraces the genuinely specialized branches of organs and systems at 360 degrees and that is why many believe that the contrast with general medicine that he shares with is illogical and inappropriate. the emergency-urgency not only 118 but a large part of the clinical and professional contents.
All this can be demonstrated with the volumes of activity of the emergency-urgency services to make up for the structural, technological and organizational deficiencies of the local services.
I can only tell those who cry crocodile tears today what Winston Churchill said “Whoever never changes his mind will never change anything”.
Dr. Filippo Sanna
Territorial Emergency Doctor
MEU Doctor in Specialized Training
SNAMI contact person in Bologna Medical Training
November 17, 2021
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