Three doctors, a family nurse and a country that does not give up. Despite the difficulties and despite everything. The inauguration of the new General Medicine Clinic in Rivarolo del Re ed Uniti in via Papa Giovanni XXIII goes far beyond the continuity of an indispensable service for all citizens. The mayor knows this well Luca Zanichelli that so much has been spent precisely so that the country does not lose the possibility of a general practitioner. He did it especially for the elderly and frail subjects but he did it for everyone.
There was the risk of losing a service for a part of the country – even if not for all citizens, but for a large part. When Dr. Giuseppe Manara, having reached the age limit he retired, Rivarolo del Re found himself with only the doctor Enrico Olivani to carry out the profession of general practitioner. 42 years of activity for him who started in July 1979 right in Rivarolo but who already has the maximum number of patients he can follow. Without adequate spaces and with only one doctor for the more than 1800 inhabitants in the municipality. Many, and many over 65s who should have opted for Casalmaggiore or Sabbioneta with all the consequent inconveniences. It will not be so.
The new general medicine clinic serves precisely this, and this is the purpose of the two new young doctors who have settled in Rivarolo del Re and who will provide continuity of care to that segment of the population that needs it most but not only. The municipality will bear the burden of the clinic: in fact, the doctors will not pay at least for these first times, no rent and will not have any expenses.
THE MAYOR’S TALE – “In a short time – Luca Zanichelli explains – about six months, the Municipal Administration succeeded in giving life to the new medical clinic, built near the pre-existing municipal medical clinic. The goal was to bring together in a single structure, both general practice clinics with their respective waiting rooms, with a view to optimizing management costs, totally borne by the Municipality, rents and utilities. , and to give a single point of reference as a medical center to the citizens of Rivarolo del Re and Uniti. The existing clinic has been renovated, according to the new regulations and the new clinic has been created in the adjacent former apartment of the disused conscientious obbiector, the medical center has a single access for both clinics“.
The cost of the work was 56,200 euros financed by the regional decree law n. 160 of 12/27/2019, for energy efficiency works and safety of public buildings and facilities in terms of sustainable territorial development (determination n ° 58 of 14/06/2021) and further 17,782 euros for sanitary adjustments of the pre-existing clinic financed by the administration surplus (determination n. 61 of 24/08/2021). An important investment, as we explained before, that the Administration considered essential to allocate to a work necessary for the country, having the need to create an additional clinic urgently, having acknowledged the retirement of the general practitioner Dr. Giuseppe Manara who carried out his business in his private studio located in the town.
“I take this opportunity – continues the mayor – to wish Dr. Manara a well-deserved rest, thanking him for the many years of medical service carried out in the village and thanking him for having donated part of the medical equipment to the Municipality to be used in the new clinic. The general practitioner Dr. Enrico Olivani, who has been practicing as a doctor in our municipality for 42 years, will continue to practice in the refurbished clinic. Dr. Enrico Olivani is also highly praised for the service he has carried out over the years. I wish the Doctor good work Chiara Mantovani and to Dr. Gianluca Arcari“.
Doctor Chiara Mantovani receives by appointment on Wednesdays from 9.00 to 12.30 (tel. 0375/41641 or 0375/42380 answers to the central switchboard co.me.te.) and Doctor Gianluca Arcari (receives by appointment on Tuesday from 9.00 to 13.00 tel. 0375/41641 or 0375/42380 the co.me.te. center switchboard answers) who will carry out service in the new municipal clinic.
“I thank Dr. Mantovani and Dr. Arcari for their willingness to go to the Rivarolo del Re clinic at least one morning a week to assist in the presence of their local patients who have difficulty moving, as the two general practitioners , being operational at the Co.me.te. of group medicine in Casalmaggiore, they had no obligation to carry out an outpatient clinic with us too. I consider it necessary to underline the sensitivity of the whole group of the Municipal Administration, the Council and the whole majority group, which promptly deemed it essential to take action by restructuring and creating a new clinic, with the aim of not losing, for many users and patients, the local general primary medicine service is very important for our citizens, especially for the frail, chronic and elderly. If it is true that today we are moving towards the concentration of general practitioners and specialists in associated offices of Professionals who guarantee hourly continuity and administrative and nursing staff, however, the proximity medicine that the General Practitioner must guarantee in the areas should not be forgotten. rural and sparsely populated, far from the most populous centers“.
A viable country is one that somehow manages to keep its necessary services. Healthcare is important, which is why Zanichelli spent himself from this point of view, well aware of the needs of his citizens, starting with the weakest and most exposed: “The consequence of the concentration of general medicine in the most populous municipalities is a strong discomfort for elderly people, who live in large numbers in our territories and who are also deprived of the autonomy of being able to go to their general practitioner in the country’s outpatient clinic. the Administration led by me with so much determination for the moment has buffered this problem, managing to have the availability of three general practitioners, making a new clinic available in a short time. If we recognize that the General Practitioner is the first actor of the clinic, he must be objectively enabled to be able to make diagnosis, therapy, treatment, assistance and follow-up in the area, this goes to justify even more strongly the investment made. in the new clinic even in a small town like ours. I am also strongly convinced that it is in territorial care “that inequalities are accentuated, where care provided at home can really give meaning to the term take care so much emphasized in the reform of law 23/2015“.
Finding general practitioners willing to provide services directly in the country was not easy. Contacted ATS, from a list of 9 available, two were fortunately found willing to work in the village as well. “Given the enormous difficulties personally encountered in finding general practitioners available to carry out their service in my municipality, as a territory and as mayor together with many other mayors, we launch a cry of alarm: there is no longer the guarantee of the presence of the doctor of General Medicine in the small municipalities that characterize the backbone of our territory and a large part of Lombardy. If we recognize, first of all, that territorial General Medicine is the fundamental link in the hospital / territory integrated care path, the institutional bodies of competence must create the conditions for filling the gap of General Practitioners in the territory national“.
The need has emerged to create a continuity of care between the hospital reality, in which the treatment of acute cases finds its place and the territory that must take care of the phases preceding and following the specialist hospitalization. “This is why an investment in the territorial dimension is needed in terms of better planning, design, organization, as well as strengthening of human resources. From this perspective, hospital-territory continuity would be encouraged, with the request for particular attention to enhance interventions for intermediate / post-acute care so that management can be implemented in a widespread and efficient manner.“.
“In order to facilitate the creation of an exchange channel between the different healthcare contexts to guarantee the continuity of care for chronic / frail patients, the introduction of family and community nurses to facilitate the transition to the home of patients is considered very positive, or in the phases of MultiDimensional Assessment (VMD) and outcome indicators in the frail elderly patient. Family nurses will play an essential role in the area, especially in the detection and management of social assistance needs, in the surveillance and in taking care of the individual with fragility and high socio-health complexities. It will be fundamental to intercept even those needs not yet expressed and to make prevention, for this reason as Mayor I worked with the Social Health Director Asst Cr Doctor Paola Mosa and with the Director of Services for Fragility Territorial Network Asst Cr Doctor Nadia Poli to include in our local outpatient context the presence of a family nurse who will work in a network with our general practitioners and with the social worker of the municipality. I warmly thank the Director of Services for Fragility Territorial Network Asst Cr Dr. Nadia Poli for the collaboration in this regard, soon this significant and important service will also be activated by activating the professional figure of the family nurse also for Rivarolo del Re ed Uniti.“.
The last (but only in order of writing) thanks from the mayor Zanichelli went to the municipal employees. Even from a buricratic point of view, the work was not easy: “I thank the municipal employees for the technical-administrative work carried out on the outpatient work, and I thank the company F.lli Molino sas di Germano Molino & C. di Viadana for carrying out the work in a short time.“.
THE FAMILY NURSE – Thanks to the close collaboration with ASST Cremona and precisely in the wake of the regional reform that sees the importance of home care increased, it was possible to ensure that initially for one or two days a week there is also the presence of the family nurse. “The opening of the clinics in Rivarolo del Re – explained Dr. Nadia Poli, Director of Services for Fragility Territorial Network Asst Cremona – will allow us in agreement with general practitioners to start a project with the family and community nurses of the ASST of Cremona so that at certain times of the week, initially we think of a day, it is possible to have this figure available for citizens and in particular to respond to the needs of people with chronic problems and diseases. This goes in the direction more than ever desired of responding to the needs of local citizens, therefore in their homes with the aim of keeping citizens at home as much as possible. It is a project that responds to the lines and directions that are being followed throughout the region. ASST of Cremona is also implementing this type of planning with the various associations of doctors. This is an important opportunity for which we thank the municipality and all the collaborators, from general practitioners associations to municipal social services with which we have an excellent relationship, with Concass and the whole network.“.
Nazzareno Condina
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