José Polo García, president of Semergen.
Almost 6,000 doctors have gathered at the 44th edition of the National Congress of the Spanish Society of Primary Care Physicians (Semergen) which started this Wednesday and will last until next Saturday, October 8. An appointment that will have 147 activities and from which Jose Polo Garcia, president of Semergen, analyzes with Medical Writing the current moment that the first level of care is experiencing and how to design a future that once once more makes Spanish Family Medicine a world reference.
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“A Familia will always use us as a method to capture votes” |
In addition, the specialist details the training priorities of Family doctors following having focused for two years on covid, how to approach the increase in mental health consultationsthe methods to improve the Consultation time and resolution capacity with access to more diagnostic tests.
The 44th edition of the National Congress of Semergen following recovering normality in healthcare activity. Is it a good time for the family doctor to update himself on the most prevalent pathologies?
It is a key moment. The last two years we have spent thinking and working only on covid. The follow-up of the chronic patient has been somewhat abandoned, since we have not been able to carry out various controls. Also, research and training have slowed down a bit. Now the time has come to resume this training and research interest.
Why have you decided to focus part of the Congress on the care of chronic patients?
This chronic patient is fundamental, the entire health system has been thinking for years that we must make a transformation to care for and follow him better. The chronic, multi-pathological and elderly patient is the most frequent in Primary Care consultations and the one that demands the most assistance.
Should new health care methods be adapted for these patients?
Healthcare must be transformed. You have to approach the patient trying to get the precise treatments and controls. This care should be given mostly at home and punctually go to the hospital. It must be taken into account that the frail elderly person runs the risk of suffering more pathologies due to hospital admissions.
Should the Family doctor be updated in mental health in the face of the rise of this pathology and be Primary the first step to diagnose it?
Physicians must be trained and have an active attitude in order to detect mental health problems as soon as possible. The only tool we need is time, without it we cannot take a good history. Unlike other diseases, we do not have a diagnostic or laboratory test that can help us, which makes dialogue and anamnesis essential tests. However, this requires time and we do not have it.
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“Doctors must be trained and have an active attitude in order to detect mental health problems as soon as possible” |
As for the economic endowment by the Government and the autonomous communities, in recent times we have seen that the items destined for Primary are increasing. The figures are still far from what they claim, but do you consider that this reflects a turning point and the problems of the Family are already taken into account?
They know the problem and we know it, I doubt that they are considering the solutions. We are talking regarding 172 million, but there are 17 autonomous communities, that is, 17 health services plus two autonomous cities. If we divide how much do we touch? Ten million each? What do we put with that? The staircase of the health center? Nothing has changed.
Currently, Primary has several strategies and action plans agreed between the Government and autonomous communities, however, the situation of Primary remains unchanged. Do you think that a law should be created for Primary and that thus the proposals were mandatory?
The first thing to do is talk to the professionals, who are the ones who are in the trenches having a consultation and can contribute to the design of Family, not others who are in the offices. Once we have seen where we can go, we must plan in the short, medium and long term. Any plan that is short-term is bread for today and hunger for tomorrow, that is, it will be a patchwork. We have to plan as we did in the 1980s and 1990s with the transformation of the health system. We must set ourselves an objective and take into account that unpopular measures will have to be taken and that in other cases the restructuring of health services will be necessary because health resources are going to be fewer and fewer. Currently, 30 percent of doctors are over 60 years old and in a short period of time we are going to retire and there is no possibility of replacement.
Are you afraid that with the elections in sight they will be used as a method to capture votes?
They will always use us as a method of capturing votes. We are going to enter the political debate and all the party programs are going to talk regarding the reform and its necessity. I hope that this is not false promises.
If there were a change in the Government of Spain, do you fear that the planned investments will not be taken into account?
I believe that political will is needed. The changes in government in the 1980s and 1990s did not prevent further investment in the SNS and health care. From health transfers, we see it in the political spectrum of the two main parties, their level of involvement is varied. The investment varies from 11 to 18 percent, but it is not the right one for one party or another.
“30% of family doctors are going to retire and there is no |
One of the problems experienced by family doctors is the lack of consultation time. What actions should be carried out so that they have effective time and do not dedicate part of it to issues that they might delegate?
From Semergen we claim that the comprehensive management of healthcare demand should be advocated. When the family doctor receives a patient, it is already with a pathology and not to solve administrative problems.
Another relevant issue is resolution capacity and access to diagnostic tests. In this sense, a new version of the Service Portfolio is being worked on. What should be included?
You have to make a precise analysis of everything. One thing is the service portfolio of the benefits that the SNS can cover and another thing is to increase the resolution capacity of the Family doctor through access to diagnostic tests. I am not referring to expensive tests, but economic ones, such as laboratory tests. For example, we cannot be made difficult in carrying out a diagnostic test for the management or control of heart failure in an analytical test whose extraction is done in the health center and that the family doctor does not have access to. I am not referring to CT scans or resonances, which can be more complicated tests to request or open agendas in the SNS.
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“It is necessary to work on joint protocols and coordination of the SNS between the first and second level of care” |
The number of tests is expected to triple. Do you think this is enough?
Every time a service is offered, the demand increases exponentially. So, it is necessary to work on joint protocols and coordination of the SNS between the first and second levels of care. It is also very important, and it is a pending issue, the empowerment of health education. Patients must be well educated so that they do not seek health care in cases that are not necessary.
Iván Fernández, editor of Specialties, and José Polo García, during the interview with Medical Writing. |
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