by Chiara Daina
A situation that occurs more and more frequently especially among young people. Transfers to other cities or abroad, changes of residence or retirement of the doctor, the most common cases
Staying without a general practitioner would have been unthinkable twenty years ago. Today, however, when it happens, it’s not even news anymore. It can happen that he finds himself without a family doctor when he returns to Italy, moving his residence here again after a period spent abroad. “Or when you don’t think about choosing a new doctor if yours retires or if you change residence, especially among healthy young adults who live in a metropolitan context with a high supply of private clinics,” says Alberto Magni, who is national head of youth policies for the Italian Society of General Medicine (Simg).
Non-resident family doctor
Then there are those who seem to not have it: university students or workers who have moved to another city while keeping the doctor in the municipality of residence, without requesting medical domicile in the place where they live, which entitles them to temporary assignment of the doctor. Being able to rely on a personal general practitioner for the whole of one’s life is “a cultural issue”, comments Ovidio Brignoli, vice president of Simg.
What does not have one mean? «That for a health problem, if you don’t know what to do, you access the emergency room improperly or you go to the specialist every time for a fee, which can be wrong not knowing which one is responsible for the ailment. The family doctor is the first filter that directs the hypothesis of diagnosis and initiates examinations and follow-up visits only if necessary» underlines Brignoli.
Exams
“In the general practitioner’s office it is also possible to carry out instrumental tests, such as an electrocardiogram, spirometry, first level ultrasound, blood sugar and cholesterol tests, dermatoscopy to identify signs of melanoma and holter to measure pressure or electrical activity of the heart in 24 hours” lists Brignoli. For all the symptoms that the citizen deems urgent, he has the right to contact his personal doctor: “From earache to persistent fever and cough, high blood pressure, tachycardia, headache, conjunctivitis, gastroenteritis, acute musculoskeletal pain, anxiety attacks, painful cycle” recalls Magni.
Prevention
But the family doctor also does prevention. «It is recommended that all healthy adults make an appointment for a general check-up every 4-5 years. An opportunity to correct incorrect lifestyles and evaluate sight, hearing, weight, blood pressure, hidden skin lesions. While for chronic patients the doctor periodically checks the effectiveness of the therapies considering the interactions between pathologies and the possible deprescribing of drugs» concludes Brignoli.
The right way to communicate with him remotely
Being able to communicate regularly with your general practitioner can sometimes be difficult. Alberto Magni, who works at the “Doctors together with Garda” cooperative in Desenzano del Garda, suggests “agreeing with the doctor on the most functional method of contact, which can be the telephone, email, messages via mobile phone. However, it is preferable that the doctor makes dedicated electronic platforms available, for visits, consultations, exchanging tests, which, unlike the usual communication channels, are not at risk of privacy violation”. When to schedule the first meeting? «Around the age of 14, at the transition from taking charge of the pediatrician to the general practitioner, for a general check-up. Blood tests are prescribed, the risk factors of family and chronic diseases are evaluated, such as diabetes, weight, hearing, blood pressure, oral cavity, skin, genital condition and vaccinations are checked» recalls Ovidio Brignoli.
«Exoduses» and retirement
In seven years, about 10% of general practitioners who have retired have not been replaced. The reason? The lack of staff, so that the places offered are not fully filled. The number of doctors in the area increased from 44,436 at the beginning of 2016 to 39,270 at the beginning of 2022 (Enpam data). From 2021 to 2025, Agenas estimates, we will lose another 3,632. To buffer, in the national collective agreement of general medicine of 2022, the possibility of raising the maximum limit of patients per person from 1,500 to 1,800 was envisaged.
When the treating doctor “leaves” three things can happen: that a new doctor arrives, that no one will take his place anymore (and finding one close to home can become a treasure hunt), that the successor arrives after a few months. «The takeover is not always immediate because the new employee has three months to open the clinic. Perhaps he worked in the hospital until the day before and needs time to complete the paperwork and set up the studio – explains Galdino Cassavia, director of the primary care department of the Milan Ats -. A solution to guarantee assistance in peripheral areas in the period between the cessation of the doctor’s activity and the assignment of the next one are the temporary doctors’ surgeries”. In Lazio, on the other hand, there are primary care clinics managed by family doctors who offer assistance on Saturdays, Sundays and holidays regardless of the ASL of origin.
Choice and revocation
There are more than one ways to choose and change your general practitioner. You can go in person to the “Choice and revocation of the doctor” desk of your health district with your tax code. «When you return from abroad, you can request registration with the National Health Service and the issue of a health card at the counter – specifies Cassavia -. The desk manages all the exceptions, such as the possibility of having a doctor who has already reached the maximum number of patients and family reunification”. The choice of doctor can be made online through the electronic health record or the portal or app of the Region. In Lombardy, the service is also available in pharmacies.
July 23, 2023 (change July 23, 2023 | 07:39)
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