by Lucia Conti
The deterioration in the working conditions of doctors is also wiping out the enthusiasm, so much so that 1 in 3 doctors would retire tomorrow if they could. After all, 71% in the last two years have experienced an increase in stress, 1 in 10 have encountered health problems that they did not have before. Rings: “We love this profession, we ask to be able to practice it with the enthusiasm of the beginnings”. According to President Fnomceo, the establishment of “a National Observatory on the protection of the rights and working conditions of doctors” is also necessary. THE INVESTIGATION, THE MANIFESTO, THE REPORT OF RINGS
21 APR –
A third of Italian doctors, if they could, would retire immediately. Dreaming of being able to instantly swap the white coat for a park bench is precisely the youngest “slice” of the profession: 25% of doctors between 25 and 34 years and 31% of those between 35 and 44 years. This is the data that briefly illustrates how much the working conditions of Italian doctors have deteriorated in recent years, to the point that many of them would abandon the profession if they could.
The quantitative survey “The condition of the Doctors two years after the start of the Covid-19 pandemic” was conducted by the Piepoli Institute on input from Fnomceo and presented today in Rome, as part of the National Conference on Medical Issues promoted precisely to turn the spotlight on the working conditions of Italian medical professionals. On the other hand, they observe, with the PNRR there is a lot of talk about relaunching the NHS, structures and technologies, but little and nothing about relaunching the professions.
“To the increase of the National Health Fund – observed the president of FnomceoFilippo Anelli, in his speech – a similar commitment was not paid, aimed at removing the consequences on the medical profession of that season of cuts in health that today we all together condemn ”. And so the surveys, such as the one promised by Fnomceo, continued to highlight “areas of criticality and malaise in the profession, to the point that there are many health professionals who oppose resignation to the initial enthusiasm for a profession defined as ‘the most beautiful in the world‘ or even the abandonment of this profession by now suffocated by improper tasks, unsustainable workloads also due to the serious shortage of personnel and by directives often not included in the reality of the system “.
For Anelli, therefore, “today it serves the part of the State and the Regions an extraordinary intervention that fills the gaps and restores the role it deserves to the medical profession “. “Resources and reforms are needed to restore dignity to doctors and professionals, guaranteeing their autonomy and rights.” health, equality, autonomous determination on the choices relating to one’s own health, free research and free science “.
Going to the search results, conducted through the administration of 500 interviews between 21 and 28 March last on a representative sample of male and female doctors, the increase in pandemic workloads for 70% of hospital doctors has emerged significantly, for the 75% of local doctors, 36% of outpatient specialists and 23% of dentists, with almost 1 in 5 hospital doctors forced to change wards (a difficult change, in 75% of cases). A heavy commitment that has had repercussions – 40% of both doctors in the area and hospitals think so – also on the relationship of trust with citizens and which has caused, together with organizational difficulties, stress and concern in the vast majority of professionals, 71%. 90% of local doctors, 72% of hospital doctors, 80% of outpatient specialists, 62% of dentists declare themselves “stressed”. One in 10 local doctors has encountered health problems that he did not have before. On the other hand, 53% of doctors say that many citizens have given up on important treatments, often interrupting them after starting them, due to the pandemic.
“They are numerous – explained Anelli – the reports in the literature about doctors’ burnout. ‘Doctors and trainees are running out at an alarming rate’, reads one of the many published works. In fact, ‘historically, medicine has been characterized by difficult working conditions as well as inattention to well-being and self-care on the part of the doctor. health problems, such as sleep disturbances, stress, anxiety and fear, similarly to 10% of mmg, 4% of hospital doctors and 3% of dentists.
The increase in workloads has taken away family time, to rest, to private life. Over the past two years, the majority of local doctors (55%) and hospitals (44%) have had to give up or reduce their vacation days. Reconciling family management with work has become an enterprise for NHS doctors. Nearly three out of four doctors in the area have failed to reconcile work and family during the health emergency. The same happened to 62% of hospital doctors. Still three quarters of local doctors and 66% of hospitals do not have time for private life.
Covid, by imposing social distancing, gave impetus to remote consultations: half of doctors offered them, with peaks of 65% among general practitioners. Seven out of ten doctors do not like remote treatments, online and telephone consultations, which have invaded the private life of the majority, 58%, of Italian doctors. 82% of local doctors, 64% of hospitals, 45% of dentists, 41% of outpatient specialists report this. Nonetheless, four out of ten doctors will continue to offer them to patients, because they consider them a service they like.
“There are many colleagues who no longer recognize themselves in a mortified profession from abnormal workloads, for example in the emergency room and in 118, and bureaucratic intrusiveness that suffocates professional autonomy – said Anelli -. Pharmaceutical prescriptions and diagnostic services are now burdened by trappings, models, therapeutic plans and so on, only useful to steal from the doctor the time that instead should have guaranteed the citizen because, as the law 219 of 2017 recalls, ‘time of communication between doctor and patient constitutes treatment time ‘. There are many – continued the president of Fnomceo – the extra hours spent, often in violation of the rules, without being totally or partially paid. 64% of hospital doctors and 73% of local doctors were not even able to take full or partial vacation. 74% of local doctors and 66% of hospital doctors do not have adequate free time to live their private and family life. The issue of respect for workers’ rights thus becomes crucial to guarantee serenity and working efficiency. Rights not yet fully enforceable by women! “.
38% of women doctors between 25 and 34 years of age feel discriminated against, as women, at work. Half of the younger female doctors believe they are not protected at work in the state of maternity.
“At this point, it appears appropriate to set up a National Observatory on the protection of the rights and working conditions of doctors, with a consultative value, at the Ministry of Health, in order to monitor compliance with the rights of workers – concluded Anelli -. A common effort is needed to recover the mutual trust which in the National Health Service constitutes the prerequisite for ensuring the best possible assistance to citizens. Trust that is based on the citizen’s right to free choice that should be guaranteed in all areas of the health system “.
Until now, however, doctors have felt abandoned by the institutions: they judged the measures adopted inadequate to facilitate daily professional activity. A unanimous opinion, expressed by 72% of the doctors interviewed. A similar opinion was expressed by 52% of doctors and dentists on the safety procedures implemented in the last two years. Processes that have created a disconnect between professionals and institutions, in particular the Regions. A large part of the medical and dentist world, 59%, did not feel protected by the institutions. 75% of the doctors in the area declare this, but also 62% of hospital doctors, 52% of dentists.
To deal with all these critical issues that have emerged, Fnomceo and the medical unions ask for the commitment of the institutions, the Minister of Health Roberto Hope and the president of the Conference of Regions Massimiliano Fedriga first of all, present at the National Conference on Medical Issues. The doctors also presented a Manifesto to the institutions (see separate article) in 20 points, shared by Fnomceo and the main medical and dental unions. “The medical and dental profession must be present in a project for the renewal of the national health policy which is to be implemented with the resources that the PNRR is making available – reads the introduction – A new health care must be built, a new NHS also to overcome inequalities and inhomogeneities in the various areas of the country “.
From a shortage of doctors to burnout, from the recognition of rights to the revision of training courses, from occupational safety to contractual agreements, many are the issues dealt with in the Manifesto (see separate article) signed by ANAAO ASSOMED (Association of executive doctors); ANDI (national association of Italian dentists); CIMO Fesmed; CIMOP (Italian Confederation of private hospital doctors); CISL Doctors; FIMMG (Italian Federation of General Practitioners); FIMP (Italian Federation of pediatricians); FISMU (Italian trade union federation of united doctors); FVM (Federation of medical veterinarians and managers); NUOVA ASCOTI (Italian Union of Orthopedic Traumatologist Surgeons); SBV (Syndicate of medical specialists affiliated for the visiting branches); SMI (Italian doctors union); SNR (National Syndicate of the Radiological Area); SUMAI ASSOPROF (Single Union of Italian Outpatient Medicine and Healthcare Professionalism); UIL FPL MEDICI.
Lucia Conti
April 21, 2022
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