“Must be designed from requests”
Jose Polo Garcia, President of Semergen.
Almost 6,000 doctors gathered at the 44th edition of the National Congress of the Spanish Society of Primary Care Physicians (Semergen), which began this Wednesday and will continue until next Saturday, October 8. A meeting that will have 147 activities and of which Jose Polo Garcia, president of Semergen, analyzed with Medical writing the current moment experiencing the first level of care and how to design a future which once again turns Spanish family medicine into a world reference.
“Family will always use us as a method of attracting votes”
In addition, the specialist gives details about learning priorities of family doctors, after two years focused on covid, how to approach the increasing mental health counselingthe methods of improvement of Consultation time and resolution capacity with access to more diagnostic tests.
The 44th edition of the Semergen National Congress after the restoration of normality in health activities. Is it a good time for the family doctor to learn about the most common pathologies?
This is a key point. For the last two years we have been thinking and working only about covid. The follow-up of the chronically ill is a little abandoned, since we cannot perform various controls. Also, research and training slowed down a bit. Now is the time to renew this training and research interest.
Why did you decide to direct part of Congress to care for the chronically ill?
This chronic patient is fundamental, the whole healthcare system has been thinking for years that we need to make a transformation to better care and follow him. The chronic, multipathological and elderly patient is the most common in primary care consultations and the one that requires the most help.
Should new health care methods be adapted to these patients?
Healthcare must be transformed. You have to approach the patient trying to get the right treatments and controls. These cares should be done mainly at home and timely visits to the hospital. It should be considered that the frail elderly person risks suffering from more pathologies due to hospital admission.
Should the family physician be made aware of mental health in the face of the rise of this pathology and be the primary first step in diagnosing it?
Doctors must be trained and have a proactive attitude to detect mental health problems as quickly as possible. The only tool we need is time, without it we cannot get a good story. Unlike other diseases, we do not have a diagnostic or laboratory test to help us, which makes the dialogue and history the main investigations. However, this requires time, and we do not have it.
“Doctors need to be trained and have a proactive attitude to detect mental health problems as quickly as possible”
Regarding the economic donation from the government and the autonomous communities, recently we have seen that the subjects intended for the primary school are increasing. The numbers are still far from what they claim, but do you think this reflects a turning point and the Family’s problems are now accounted for?
They know the problem and we know it, I doubt they are considering the solutions. We are talking about 172 million, but there are 17 autonomous communities, that is, 17 health services plus two autonomous cities. If we divide how many do we touch? Ten million each? What are we putting up with this? The health center staircase? Nothing has changed.
Primary currently has several strategies and action plans agreed between the government and the autonomous communities, but Primary’s position remains unchanged. Do you think there should be a law on primary education so that the proposals are mandatory?
The first thing you need to do is talk to the professionals who are the ones who are in the trenches consulting and can contribute to the design of Family, not others who are in the offices. Once we have seen where we can go, we need to 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 mosaic. We need to plan as we did in the 1980s and 1990s with the transformation of the health care system. We need to set a goal and take into account that unpopular measures will have to be taken, and in other cases the restructuring of health services will be necessary because health care resources will be less and less. At the moment, 30 percent of the doctors are over 60 years old and in a short time we will be retiring and there is no possibility of replacement.
Are you afraid that the upcoming elections will be used as a method of capturing votes?
They will always use us as a method of attracting votes. We will enter into a political debate and all party programs will talk about the reform and its necessity. I hope these are not false promises.
If there is a change in the government of Spain, do you fear that the planned investments will not be taken into account?
I think political will is needed. Changes in government in the 1980s and 1990s did not prevent further investment in SNS and healthcare. From health transfers, we see it across the political spectrum of the two main parties, their level of participation is different. The investment varies from 11 to 18 percent, but is not suitable for one party or another.
“30% of family doctors will retire and won’t
One of the problems of family doctors is the lack of time for consultations. What actions should be taken to have their time efficiently and not spend some of it on matters they could delegate?
At Semergen, we argue that comprehensive healthcare demand management should be advocated. When the family doctor admits a patient, he is already with pathology, not to solve administrative problems.
Another important 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?
A precise analysis of everything should be done. One thing is the service portfolio of benefits that the SNS can cover, another thing is to increase the enabling capacity of the family doctor through access to diagnostic tests. I am not referring to expensive studies, but economical ones, such as laboratory ones. For example, we cannot be hampered in conducting a diagnostic test for the management or control of heart failure in an analytical test whose extraction is done in the health center and to which the family doctor does not have access. I don’t mean CT scans or resonances, which can be more complex requirement tests or open programs in SNS.
“It is necessary to work on joint protocols and coordination of SNS between 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 grows exponentially. Therefore, it is necessary to work on joint protocols and coordination of SNS between first and second level of care. Also very important and this is a pending issue, the empowerment of health education. Patients should be well trained not to seek health care in cases that are not necessary.
Ivan Fernandez, editor of Specialties, and Jose Polo Garcia, during the interview with Medical Writing.
Although it may contain statements, data or notes from health institutions or professionals, the information contained in Medical Writing is edited and prepared by journalists. We recommend that the reader consult a health professional for all health-related questions.