Home Health doctors employed by the National Health Service – breaking latest news

doctors employed by the National Health Service – breaking latest news

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from Silvio Garattini, President and founder of the Mario Negri Irccs Pharmacological Research Institute

Prevention and therapeutic appropriateness, with particular attention to their repercussions on the National Health Service, are the foundations on which training must be carried out.

of family doctors


general practitioner, or family doctor, which acts alone on the territory that is no longer credible in consideration of the growing complexity of medical knowledge and the greater needs of citizens. The family doctor should operate within structures that bring together several doctors with an IT secretariat, the presence of nurses, psychologists, social workers, family pediatricians. The facility must be able to perform routine analyzes, have telemedicine available to communicate with patients and hospital specialists. With the latter, it is important to re-establish relationships of mutual trust, now reduced to a minimum.

All members of the National Health Service (NHS) must be employees, members of the same organization and with the same purposes in which the patient must be at the center. Organizational changes in local medicine require an important cultural revolution.

The NHS has lost an important part of its mission over the course of over 40 years. This has resulted in a significant reduction in the healthy life span. Males and females respectively have 6 and 8 years of poor quality of life due to not having observed the rules of prevention. At least 50 percent of chronic diseases (diabetes, heart, respiratory and kidney failure) are avoidable; 30 percent of senile dementias and even 70 percent of cancers depend on our lifestyles. We all know them, but we do not observe them with the consequent diseases we later complain about. Smoking, alcohol and illicit drugs, obesity and sedentary are harmful to health, while physical and intellectual exercise, a varied but moderate diet and an adequate duration of sleep should be favored. Doctors must also be judged on their ability to reduce the number of smokers, alcoholics and obese people and they must also carry out this mission by example.

Too many doctors smoke, thus affecting behaviors of patients.

A second task in the training of local doctors is to develop the concept of the appropriateness of therapies. Not suitable for scientific knowledge to observe elderly people who have to ingest 15-20 drugs every day. Who has ever proved that 20 drugs are better than 15 or that 15 are better than 10? What are the intersecting interactions between all these chemical compounds? Why don’t we know the gender differences in drug efficacy and toxicity? What is the probability that a drug can affect a single patient? These are often unanswered questions because medical information is now completely a monopoly of the pharmaceutical industry. It is necessary to create significant independent information that allows the doctor to have an objective view of the scientific literature.

Finally, a third training area concerns the knowledge of the National Health Service as an example of the common good. Prevention and therapeutic appropriateness with particular attention to their repercussions on the NHS are the bases on which the training of new doctors in the area must be carried out.

November 21, 2021 (change November 21, 2021 | 20:13)

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