2023-06-18 22:51:14
Many doctors complain about government pay and some profits in clinics, sanatoriums and private practices can become exorbitant, generally at the expense of the pocket of patients. Although in the private world the crisis is also felt. The social works delay payments and many people are turning to be served in public effectors.
The missing specialties
The Ministry of Health of Entre Ríos confirmed that there is a shortage of health professionals, especially in small cities, and specified which are the most scarce. “We have difficulties covering critical specialties. The most complicated are pediatrics, gynecology, anesthesiology and general medicine,” said the Secretary of Health, Carina Reh.
The situation is neither new nor particular to this province. In 2018, the Federal Health Council, which brings together all the country’s ministers, defined the supply of human resources in these disciplines as critical. The Entre Ríos official added that there is also a shortage in endocrinology, rheumatology and traumatology, of which there are more professionals in the private subsector.
In the health portfolio, the coverage of mental health demand is concerned. “We have psychologists, social workers and occupational therapists, but we need mental health specialists and psychiatrists. There are, but they choose to provide services for the Justice or in a private office,” Reh explained. The deficiency became evident after the coronavirus pandemic, which multiplied pathologies and suffering.
Another critical area is nursing. Last week the Union of Civilian Personnel of the Nation (UPCN) protested in front of the San Martín de Paraná hospital due to the lack of professionals in the effector. The union estimated that about 50 nurses are missing and denounced that 12,000 francs are owed to the staff.
Reh announced that the Ministry will carry out an audit to clarify what the union has said. But he denied an insufficiency in this formation. “The necessary replacements are covered and almost all the positions are covered. The deficit in the institutions has to do with some cases of inadequate planning and in some hospitals there is a high level of absenteeism,” the secretary replied.
Unattracted residents
One of the challenges of the Ministry is to interest and guarantee good professional and personal development to recently graduated doctors who have to do residency in the public subsector to obtain the specialty. The deficit is such that in Entre Ríos last year not all pediatric places were covered.
The provision of the service, meanwhile, is well covered in Paraná, although it suffers throughout the rest of the province. The Ministry is working with the National University of Entre Ríos (UNER) to offer this university specialty in the Faculty of Health Sciences, whose new Medicine degree “has been of great help,” Reh said.
The secretary analyzed that the choice of specialties is related, although it does not directly depend, on the student’s place of residence and the “attractiveness” of the town or city where they do the internship. Another cause of the decrease that the official pointed out is that many graduates today graduate with a conformed family and do not want to work so many hours. “There is another look at medical dedication and sometimes the residences are not convincing,” she estimated.
They are full-time training, with exclusive dedication and registration blocking. “And some scholarships are not so attractive,” Reh acknowledged. Resident doctors work in hospitals on weekdays from 8 a.m. to 5 p.m. and must cover two 12-hour shifts per week, with six hours of rest after each shift. The exclusivity ends after the third year and they can do the fourth by working elsewhere.
Another reason for the deficit is that some specializations are more profitable than others in the private sector and many professionals opt for the one that will ensure more income once they finish their residency.
However, the Secretary of Health clarified that there are doctors who choose to stay in the public system. “The link with the State guarantees a fixed salary, retirement contribution and social work. Private income is tied to the production you have. With the social security crisis and the delay in social work payments, there is an alert”, compared the official.
A recent milestone on the subject was the law that regularized 1,095 charges that were substitutes or contracts with transfers to the plant. It was approved in December and work is still being done on the application throughout the province.
As Reh explained, other lines of work of the Ministry to mitigate or begin to solve the problem of the lack of professionals are a reform of the Law on Residences, which is under study to be submitted to the Legislature; a “Residential Strengthening Program” to make them “more attractive” (still in planning); make calls for tenders – “a great debt”, admitted Reh -; and they even see a need for a reform of the 2008 Health Care Professional Law, which “has become outdated,” she described.
Guards up to $72,000
In general, in the province there is no shortage of doctors to cover general guards, although they have been complicated lately at the New Year’s Eve festivities. To “attract” professionals on these dates, a difference was added to the payment. The services are paid according to the type of complexity of the hospital and if they are “critical”. It also depends if the doctor covers it in the health care provider (active) or if he is available to attend if called (passive). The active guards that are covered on Saturdays, Sundays and holidays (local, provincial and national) are paid with an extra 20%.
The guards are adjusted with the salary recompositions of the public administration parities, as part of the Health ladder. New values were implemented in May, which professionals will receive starting next month.
The scale varies. For example, in more complex hospitals, the minimum on-call will be close to $11,000, passive and for 12 hours, but it will reach up to $72,000 if it is for critical care such as intensive care, obstetrics, general on-call, emergencies, and emergencies.
Remuneration in less complex hospitals and health centers will start at a minimum of $8,000 for 12 hours, $17,000 for 24 hours of general duty and will reach up to $61,000 for a full day in the most critical services. In the middle there are different values according to the complexity of the service and the effector and the hours of the call.
Source: One
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