There is a scene in “The health care doctor” in which Dr. Guido Tersilli, Alberto Sordi, passes from one room to another in his clinic, visiting one patient every minute. That movie comes to mind when you consider that general practitioners today have an average of 1,500 assistants each. Sometimes more.
Waiting rooms as crowded as in the pre-pandemic era are now only a memory, but this does not mean that the work of the “family doctor” has decreased, far from it.
Luigi Simonetta (in this photo without the mask) he has been a general practitioner for over thirty years: he receives in the clinics of Cazzago Brabbia, Inarzo and Bodio Lomnago. His patients are far more than the maximum allowed, and the reason is simple: there is a lack of general practitioners in that area. With the retirement of a doctor at the end of last year, a large number of assistants were forced to choose a new doctor and some to “migrate” to Varese. A difficult situation especially for elderly people who have to move and can no longer count on the “proximity” doctor. A spontaneous committee was born in Bodio that collected 700 signatures in Valbossa to ask Asst to have a general practitioner to replace the one who has retired. Ats has announced the arrival of two new doctors, who have yet to complete the training course. In short, we will have to wait a little longer.
Simonetta is very active on social media where he “tells” his profession as a doctor struggling with new technologies and merciless bureaucracy: “First of all let’s clear the field of a damned misconception that the family doctor is a slacker who works three hours a day and makes a lot of money – begins-. It is not so. Perhaps once upon a time this job was seen as an Eldorado but today it is no longer attractive, especially for those who are a doctor in small municipalities ».
The problems are many and of various kinds, so much so that they make Simonetta say that: “Italy is not a country for general practitioners. What happens when colleagues retire? Local politicians give birth to stopgap solutions: the assistants are distributed among the other professionals remaining in service. It matters little if they had already reached the ceiling. As happens to me. A lot of you attend a lot of money? Well, let’s do the math. I take 3 euros gross per month per patient. They are 4500 euros gross per month: obviously I pay the taxes, and with a part I have to pay the rent of the clinics in Cazzago, Inarzo and Bodio; they are not big figures but in any case it is clear that in the end what is left in the pocket is not much. I have two teenage daughters, my wife is my secretary, for free, and in the end, to make ends meet, I also serve in an RSA. Let me be clear: I love my job, I really like working with elderly patients, but I can’t deny that this profession has become really demanding ».
Added to this are the “out-of-pocket expenses” and a contractual framework that Simonetta defines as “squalid”: «We have no sickness and holidays, no thirteenth. The paper, the toners, the PCs are at our expense. Only the software we use costs a thousand euros a year “
But what is the real evil that afflicts general practitioners? Luigi Simonetta has no doubts: the bureaucracy. “We general practitioners are reduced to gods “Administrative authorizers”. In a healthcare where everything is now paid for, the assault we suffer every day is fundamentally due to this. We are victims of nutritionists, cardiologists, physiotherapists, not to mention Inail. Our recipes are used for free medicines but also for examinations of all kinds, wheelchairs, mattresses. We make certificates that allow you to save on acupuncture massages, osteopaths. Take away the “prescriptions” and the clinics will be emptied and I will be able to go back to being a Doctor, with a capital M ».
The pandemic then aggravated the situation: managing appointments and visits requires extra effort and an agenda always at hand: «Whatsapp was of great help – Simonetta says again – but now it’s a damn. The messages arrive at any time of the day and evening. Between messages and calls I happened to receive up to 70 requests in two hours. But how is it conceivable that one can do one’s job well in these conditions? “
But is there a solution? According to Dr. Simonetta, yes: «There is a lot of talk about community houses, about the strengthening of territorial medicine, but how we will be framed is still not clear. The solution could be to encourage associations, I think it is necessary to encourage the establishment of widespread territorial structures where doctors practice group medicine and are technologically supported with investments from the Region. But above all we need to simplify the bureaucracy. I will never tire of saying it: I just want to go back to doing my job well, I want to go back to being a doctor ».