by Ornella Mancin
26 APR –
Dear Director,
the meeting organized last week by Fnomceo in Rome on the “Medical Question” was undoubtedly an event of great importance that allowed a direct confrontation between the medical unions and the political party represented at its highest levels by the Minister of Health Speranza and by the president of the Conference of Regions and Autonomous Provinces Massimo Fedigra.
In fact, there are not many occasions in which politics listens in such a careful and available way and this has allowed the many trade union representatives present to ask the minister burning questions that are hoped for a prompt response from politics: training, safety. of work, shortage of doctors, gender equality, homogeneity of contract between public and private, extension of the LEA in dentistry … and many others indicated in the 20 points of the Manifesto published by Fnomceo and signed by the trade unions present, as a basis for a project of renewal of national health policy thanks to the resources that the PNRR is making available.
The issues dealt with were all of the utmost importance but in my opinion the “medical question” played a marginal role in the debate.
A survey was presented showing that many doctors would like to leave the profession even at a young age. The data is disturbing: 25% of doctors between the ages of 25 and 34 and 31% of those between 35 and 44 would leave the profession if they could. The pandemic has certainly exacerbated the situation but the problem existed even before.
Being a doctor is no longer a sought-after, prestigious and well-paid profession. Today, those who are doctors risk in most cases of not having a minimum of private life whether they work in the hospital or in the territory, with similar or even lower salaries than many other professionals who are still allowed to live affections, friendships, free time.
But what is destroying the profession is above all an unprecedented bureaucratic burden that the pandemic has made unsustainable and which instead of decreasing continues to grow inexorably and which is increasingly compressing clinical activity.
We have lost all decision-making autonomy because others decide our actions, we work according to the dictates of politics and economics: we are administered doctors, who have lost their identity characteristics.
Anelli concluded his speech by saying that “Doctors are not replaceable! Their skills and abilities, the result of many years of study and training, must be valued and not trivialized! “
But this is not enough to repeat!
The States General promoted in 2018 were a great opportunity to redefine doctors and medicine. The path then begun was blocked by the advent of the pandemic but the conference of the Fnomceo in recent days has only scrutinized the basic issues of the medical question.
More investments are certainly needed for health personnel and health policies that take into account the various points announced in the manifesto but the underlying question remains the need:
- to be first of all doctors, capable of managing the complexity and challenges that our profession poses to us every day, called to combine scientific technical skills with the doctor-patient relationship;
- to define the identity of the doctor and his role in this constantly changing society, regaining the value and authority of an intellectual profession that has been increasingly de-legitimized over the years;
- to recover autonomy, avoiding those mechanisms that have gradually replaced health objectives with economic objectives, because it is indisputable that if the doctor’s work cannot be neutral with respect to the sustainability of the system, professional ethics require us to put patient care always comes first.
We need a “change of pace”, as Anelli said at the opening of the States General and in the preface to his One hundred theses written for the occasion by prof. Cavicchi specified that “it was decided to make the General States because it is a question of fielding a new idea of medicine and physician”.
Here after 4 years and after two years of work and a pandemic, I still do not see this new idea of doctor and medicine and the medical question still appears open and unresolved.
Last Thursday’s conference at the Argentina Theater was an excellent event to pose trade union questions to politics but it did not answer the deeper questions about the meaning of being doctors today, about the future of our profession, about our identity as doctors.
Ornella Mancin
April 26, 2022
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