leave the afternoons without family doctors

Francisco Jose Saez.

catch a sliding shift to reconcile work and family life It is increasingly complicated for family doctors. A problem that, according to the Spanish Society of General and Family Physicians (SEMG), is going to increase over time unless rotating shifts are chosen or pay more to those professionals who consult in the followingnoon shift.

“It is a problem that is going to lengthen and It is going to generate a very serious problem of lack of Family doctors”, warns Francisco José Sáez, family doctor in Vallecas (Madrid) and member of the SEMG. “Right now in my health center we have two positions for Family and one for Pediatrics that have not been filled for a long time. This means that of the 25,000 patients associated with us there are almost 4,200 without an assigned doctor and to whom they are attended as possible and without continuity, ”explains the specialist, who assures that in some cases they even give up taking a place and opt for temporary contracts in the morning shift.

Given this, the doctor believes “necessary” to address another model such as abolishing the followingnoon shifts and that the doctors who attend in the morning rotate each day to provide a care service in the followingnoon. “A good option for improve reconciliation would be to put rotating evening shiftss, although in the end this will depend on the patient accepting it”, he assures.

Another measure would be economic compensation: “In 2016, it was even proposed to pay people who had an followingnoon shift in a special way and it was even approved that they charge 20 percent more. This might motivate people with economic need will sign up for these shiftsbut it did not start up”, claims José Sáez.

Do all health centers offer sliding shifts?

For the physician, in the absence of organizational alternatives or extra remuneration, it is “logical” that problems arise between colleagues that they have to carry out consultations in the followingnoon shift if the only thing the administration does is “force” you to carry out this service. “The fundamental problem is that the legislation contemplates that the sliding shifts are a responsibility agreement of the director of the center, that is, It is not a right that workers have”, explains José Sáez.

In this way there is produced a lack of equity in access to sliding shifts. “There are centers where it is easier and they are granted, but there are others where there is either a blockage within the center or they have staffing difficulties. Literally they do not fit and cannot be granted”, details the doctor.

According to a recent survey of the Primary Care Forum, it moves, where 258 responses were obtained with information from 157 centers and 18 local offices, in 79.9 percent there were sliding shifts and in 48.2 percent they were riding. However, within the group where there are sliders, 24.8 percent cannot enjoy it for everyone who wants to; in 20.3 percent there is not a room for each professional in the morning; in 26 percent it slips a single day, another 26 percent 1 or 2 days, another 26 percent 2 days; and 80 percent say they are removed at some point.

Lack of companionship and space

For the doctor, the problems in accessing a sliding shift vary a lot depending on the health center, but he points to two reasons that occur in a generalized way. “One of them is that there is a clear problem of spaces. The reform of the health centers that are being carried out is partial and there are no possibilities”, explains José Sáez.

The second problem is a “malfunctioning” within teams and teammates who “don’t want” to give in so that there are sliding shifts. “There are even colleagues from the followingnoon shift who don’t want to slip into the morning. All this creates problems for patients, who come and go”, claims the specialist.

For José Sáez, the “clearest” example is a family doctor who wants a sliding shift to be able to care for her children and a nurse who is not willing to do so. “In the end, the patient goes to see her doctor in the morning and if he has to go to the nurse, someone else attends to him. Then the one in the followingnoon protests and says that he doesn’t want that”, explains the doctor.

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