A new stage in primary care?

The 28th National Congress of the Spanish Society of General and Family Medicine (SEMG) It provided space to think about the future of the first level of care. A future in which professionals claim to be involved in decisions in order to put an end to a model they view as exhausting.

In an interview with medical writinghead of SEMG, Antonio Fernandez Pro Ledesma, It reviews the main ideas extracted from the annual event such as decentralization, the application of new models of care, the priority given to chronic patients or diagnostic tests in a health center.

What is your assessment of the 28th National SEMG Conference?

It’s very good. It fulfilled the expectations we had and there was a fairly significant level of interaction with many young people. People really wanted to be personal and this was noted in the rooms, practically everything is full and the level of interaction with the speakers was very important.

The number of broadcast connections made when the nine rooms went live was also very significant, the truth being that there were a thousand questions about whether the presentations would continue like last year and we’ll obviously be up until mid-August with the opening of the conference.

Did the mixed format come to stay?

Yes, of course. It’s an excellent format, although it still needs to be fine-tuned a bit to finish knowing and adopting the online sessions. Removing these things to refine it a bit more, the result is amazing, I mean, it’s a successful format without a doubt.

Were they able to readjust to family values?

We seriously believe that a new phase begins. Primary care in this country should take another course. Occupational instability and professional malaise is a hustle. The politician and the manager must realize once and for all that they have to rely on the professional to do this exercise. This change will start sooner rather than later and from then on the values ​​will remain the same.

The roadmap to follow is very easy. Stop doing what we’re doing wrong. If we keep doing the same things, we’ll keep getting the same results. We saw that it was not about money, it was encouraged in Catalonia with 9,000 euros, and despite this, 20% of vacancies remained empty. Something more is needed.

In the Raphael Bengoa’s lecture He said it clearly without any hesitation and I totally agree with him. We must start the clear and obvious decentralization, leaving the initiative to professionals. This doesn’t mean messing around or saving yourself who can and not everyone does what they think is good, but you really have to have managerial independence. We have to apply other models because we are not going anywhere on this path

How is the gap between the politician and the family doctor?

It’s a gap that takes many years, and not living everyday reality makes you not see things the way you see them. There was a great distance between the director and the ordinary doctor. Therefore, there was a lack of understanding and a lack of communication. Another evil in our profession is the lack of communication or understanding between levels of care. We have to be interconnected, this has to be transversal and it can’t be a system and control without professionals.

How can this gap be reduced?

Like everything in life, communication increases. That is, simply take into account professionals. When a decision is made to a certain depth, agreeing with it … It is not complicated at all, it is like a big family and what it is about is the search for the common good, not the search for quick and quick solutions to complex problems, they are not so easy. The paper backs everything up, but later you go into the trenches fact and it’s not easy to hook up these protocols.

It’s reckless, I think such thinking is due to ignorance and not really knowing the truth. When the technological systems that we have are completely obsolete, when there hasn’t been any renovation in years, we say the technological renovation will be carried out and the primary doesn’t need it because if we do it in the hospital we reduce the waiting lists for the primary… Really, the only thing I think Is that whoever did this does not know very well what the system is because the problem is that it is difficult to get to the second level.

“We must start clear and visible decentralization, and let professionals take the lead”

Should diagnostic devices be given to health centers?

Yes, family medicine has been saying that for a long time. One of the goals of this community has always been to remove as much technology as possible from the hospital and bring all technology closer to the GP. Not because we have a desire to compete, but because what we do is bring the diagnosis closer to the patient. This way we reduce waiting times and uncertainty, thus increasing patient safety by being more accurate in diagnosis.

I think there is a time when there is no turning back. Cancers appear in later situations that we’ve diagnosed before. You should put your batteries and distinguish some priority criteria from the query. We should have time to be able to talk and look for that patient who had no control two years ago. The main tool we need is time.

How do you get more time?

The last major crisis we had in primary care in the sixth wave was due to bureaucratic problems, due to sick leave, something that could have been resolved in another way. We need sick time, if I spend as much as 35% or 40% of my time on bureaucratic issues, it makes no sense. We also dedicate a lot of time from medical transfers to solving Intermediate Level 2 consultations or supplemental Level 2 test requests. It is a situation that we must put an end to, and in addition, we have to improve the flow of the patient within the system, through individual consultations, critical consultations and much more.

What is the hopeful message for the future that you can pass on to your family doctor?

There is a lot. I always say the same thing, we are in a difficult profession and the situation is complicated, but we are also in the most beautiful profession in the world. It is the only discipline that has ideology, not politics, but communication, brotherhood, and has an accompanying ideology. And this intimate moment of being with the patient face to face, just the two of them, is so intense and so emotional that I personally wouldn’t change it for anything.

Antonio Fernandez Pro Ledesma during the interview at the 28th National Congress of General and Family Medicine.