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General practitioners retired, risk of collapse – breaking latest news

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General practitioners retired, risk of collapse – breaking latest news

In the next 6 years, 36,000 people including general practitioners and paediatricians in free choice will retireand not all of them will be replaced. The risk of a collapse of the system, all the data and proposals in the interview with Luca Foresti, physicist, disseminator and CEO of Santagostino, one of the most important centers for the provision of medical services in Lombardy. There will be an increasing lack of general practitioners, the services provided will lose quality. The losers will be citizens, doctors and the country system in its entirety. All this for lack of answers from the political class. Yet data that photograph the condition and give way to predict problems and solutions are there.

Foresti, what is the current situation with respect to the numbers of family doctors?

“We know how old GPs are, so we have the statistical distribution. This distribution is shaped like a hump. It means that in the final part (ie who will retire soon) we have a huge hump. We will have many more people retiring than doctors entering service. Among other things, doctors are forced to retire at 70, but we don’t know how many people choose to go first. This is one of the reasons why the doctors problem was talked about with Quota 100 “.

Can we make estimates?

“The reasonable estimate is that in the next 6 years 36,000 people will retire, including general practitioners and paediatricians in free choice. The total today is 50,000 operating doctors”.

How many will enter?
“Before the covid they had access to GP’s grants 1000 people a year, if we use this number, they will enter 6000 doctors in the next 6 years. The regions have increased the scholarships, it is not easy to have an exact accounting but we can reasonably estimate that less than 10,000 general practitioners and pediatricians of free choice will enter in the next 6 years. So 36,000 will leave and 10,000 will enter.
Doctors will be halved “.

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What impact will it have on the quality of the service, considering that today General Practitioners have a maximum number of patients?

“Today the legislation says that the maximum number of patients per GP is 1500. And already now, as is well known, the quality level of service delivery to these numbers is not good. The state is trying to persuade doctors to go to community houses, but the major unions are against it and a negotiation is underway. The simplest answer to the problem, and the most wrong one, will be that the number of patients per doctor will increase. ”

Are there any differences between northern and southern Italy?

“There is a small but important gap. In the South the number of GPs per citizen is slightly higher than in the North, probably due to the fact that the wages are the same but the cost of living is different and the professional opportunities also change. Then there are disparities within the regions. In places where it is “nice” to live and work, there are more doctors. In the suburbs less. There are small countries where when a general practitioner retires he is not replaced, and patients do not know where to go. This thing is happening under the eyes of the citizens without the State and the Regions giving an answer “.

What is your proposal?

“In Italy there is an accreditation system: private providers are accredited by the regions for services such as radiology, specialist or sampling. In the context of General Medicine this has never been used as a tool. The proposal I made is to accredit public and private institutions to provide basic medical services. It is not necessary to ask that the service be provided only by general practitioners but you can use teams of different professionals and above all many technologies to support the service, and then leave patients free to choose who to go to or not. This proposal can be applied in no time and would put a buffer to the problem by creating a piece of new offering. No politician has ever responded. Then in the long term the specialty grants should be increased, maintaining an integrated reasoning among all the needs “.

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Telemedicine canhelp?

“Not as defined in the official documentation of the Ministry, or as a video visit. The video visit does not save time for the doctor. The tool that the doctor could use is the chat but it has not been included as a possible tool. In Finland 80% of interactions between GPs and patients are chat, and the physical meeting takes place only out of necessity. Often the interaction with the doctor is a prescription or answers to a question, since primary care requires knowledge of the patient and the medical history should already have been taken. This, however, requires a typical technological and managerial apparatusā€™company and at the moment the Italian GPs do not have it “.

Where are we with community houses?

“The road is marked. We know how many community houses are, how much money has been allocated. These are structures from 2000 to 5000 square meters. Which should provide all the social and health services of the district within them. However, there is a shortage of 60,000 nurses. The NRR foresees 20,000 community nurses in homes, but if you add those for home services to 70,000. So according to the plan there should be 150,000 nurses in staff, only that every year they enter the hospital. ‘university 17,000 nurses but 10,000 graduate, and about 9,000 retire. Attracting foreigners is impossible, because we pay too little. We have designed the organic plants, but there are no numbers. Again it is impossible to get an answer from politics”.

Are we at risk of losing European funds?

“The EU allows access to funds on the basis of the operational plan, and the results obtained. It seems that the political class is putting its head in the sand, waiting for the problem to explode. But when a mass of citizens need a doctor and are unable to get one, the problem exists and risks causing chain reactions, such as the clogging of emergency services “.

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Why is there no political discussion on healthcare in Italy?

“The discussion on healthcare is highly ideological. There are people who a priori oppose the integration of the private sector on an ideological basis. It is necessary to negotiate, acknowledge, acknowledge that theā€™there is something else that can lend a hand and then the negotiation can lead to a result “.

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