Doctors in Spain influence the search for imaginative formulas to free the doctors of tasks that were not so care-giving and more administrative that they had been carrying out up to now. The new figure that helps them is the clinical assistanta role that It has been established in other countries for a long time but which has been released in the public health system with a pilot test in the Sardenya Primary Care Team (Barcelona), at the initiative of its director, Jaume Sellarès.
Sellarès himself, family doctor by training, explains to Medical Writing the experience of daily work with this bureaucratic assistant, who sometimes It is often confused with the health administration, a professional “who helps clinicians a lot, but helps them above all with administrative tasks”. The clinical assistant can help “with administrative tasks, but also in clinical taskswho are at the limit”, begins to describe Sellarès.
“There is a clear barrier that only the doctor can dolike diagnosis and prescription, but when the doctor makes a prescription or gives a clinical order, the execution does not have to be done by him, and this is where enters the role of the clinical assistant“, says the family doctor. Thus, the main difference between the clinical assistant and the health administrator is that the first has access and can consult the information in the medical historywhile the second has it banned.
What does the pilot test consist of?
The pilot test that launched for a year the EAP Sardenya It consists of comparing a group of doctors that has a clinical assistant and another that does not. “We are seeing the results to analyze how it has gone”, says Sellarès, who points out that he is aware that the figure of the clinical assistant is also present in other health centers in Catalonia, such as the Hospital Sant Joan de Déu in Barcelonaother Primary Care centers in Barcelona and also in Vic.
In the field in which the role of the clinical assistant is most important for Primary Care Family doctors “is in red tape, repetitionthat once you have done them, the follow-up is more or less automated”, points out the doctor. For the moment, the preliminary results show that this figure “frees up time for the practitionerespecially with chronic pathology, which is highly protocolized”.
In the case of a diabetic patient, instead of being the doctor or nurse who checks that they have carried out all the corresponding analyzes and tests, it is the clinical assistant who monitors their condition, always by delegation of the healthcare provider. “It is very different that the patient comes with everything done that you find him in the consultation, you see what he lacks and you have to ask him for it and he has to come back another day. The success is spectacular in reducing the number of visits performed by the patient,” says Sellarès.
What advantages does it bring?
Sellarès acknowledges that “the shortage of doctors is one of the incentives most important to promote the figure of the clinical assistant, who has come to stay”. The doctor reflects that in an environment in which there is a lack of physicians, these they can’t be “playing papers” that can process administrative.
At the moment, the figure of the clinical assistant It is not typified nor is specific training requiredbut its function is limited by delegation of the professional, be it a doctor or a nurse, who is responsible for any act. The delegation is made to a specific person and all activity is recorded, after the authorization and informed consent of the patient.
In addition, the Family doctor gives examples of other formulas to remove non-clinical tasks from physicians, as in the case of surgeonswhich between intervention and intervention dictate the result of the previous. “Family doctors can also incorporate this,” she adds. In this sense, she assures that patients often regret that doctors do not look at them in the consultation and instead are watching the computer, but the reason is that “we have to record the interview or the physical examination.” For all these reasons, he also proposes that mechanisms be enabled so that Family doctors can dictate the interview and a program or device converts it to text.
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