The family doctors of the Messinese protect in a strong and clear way against the draft reform of the general medicine that could determine a variation of the legal status of this figure, from affiliated to employees, thus making, in fact, disappear an important cornerstone of law 833, which has always put the proximity, domicile and domicile and The trust of the MMGmeasures for certain environments deemed necessary in order to make community houses work.
The Fimmg Messina, Italian Federation of General Medicine Doctorsthrough the provincial secretary Aurelio Lembo, he sent an open letter to mayors and administrators of the province of Messina drawing attention to the problem.
“Community houses will not be able, for obvious reasons, to be places of proximity to the care, as our neighborhood clinics or the principal of continuity of care are – explains Lembo – in fact, worries a possible transition to the dependence of the local doctors of the territory who will do nothing but weaken territorial assistance compared to today, undermining in his deeper structure the relationship of trust that today binds the patient to the doctor of family, as well as the capillarity of assistance itself “.
Precisely the implementation of the DM77, in which general medicine will carry out its part with an initial nucleus of MMG/PLS and administrative/nursing staff, will make community homes functional, while safeguarding the principles of proximity, trustee, capillarity and domicile which have always been the cornerstones of our daily activity. “Those who today support the transition to the dependence of family doctors, in our opinion – concludes Lembo – underestimates the concrete risk of destroying a fundamental pillar of healthcare by denying citizens the right to choose their family doctor, will determine the closure of the doctors’ studies of general medicine“.
The text of the letter
“Dear Mayor,
I turn to his attention to express the strong concern of our category regarding the future of general medicine in Italy and the risk of compromising one of the fundamental pillars of our health service. We learned dismayed from the press that a worrying debate is underway on the passage of the family doctor to addiction, strongly desired by some regions and the attention of the Ministry of Health. This hypothesis, if it were completed, would risk introducing profound changes that would go to the disadvantage of the whole population, in particular of the elderly and more fragile people.
The transition to the dependence of family doctors, in fact, risks compromising on the one hand the relationship of trust on which our relationship of care with the client is based, on the other the capillarity of our presence in the area. The scenario would question the survival of our studies and would favor the dismissal of our study staff with whom many of us daily manage hundreds of requests related to your health needs. It is real the possibility that following a change of this kind we will arrive at a system that, in the depersonalization of our role, orientates and constraints, exclusively within community homes, the work of the family doctor, By forcing the patient to deliver the keys of his health no longer to his doctor, but to the doctor on duty in service, in a structure far from his inhabited center, an event that represents a real risk for access to care, continuity assistance and human support of which citizens have the right. This derives from the false narrative of the regions of an alleged refusal of the category to be able to carry out its business in community homes as required by the DM/77. Many of us, in different regional realities, already exercise within the homes of health or the first community homes and the new family doctors contract, signed in April 2024, already provides that a share of hours can be carried out internal based on the number of clients in charge. However, we must note that, to date, the regional agreements have not yet been applied by the regions signed and many regions are defaulting for the failure to spread the regional agreements that would implement the new national contract discipline.
The current model, based on the convention that provides for the free choice of the citizen and the autonomous organization of the family doctor, an agreement freelancer, guarantees proximity, continuity and customization of care, making possible a fundamental bond of trust for the management of acute pathologies and chronic. Transforming this figure into an employee, inserted into structures far from the peripheral centers, risks translating into an impoverishment of the offer guaranteed currently by the health service, especially in rural and less served areas. In a country of 7904 municipalities, populated by almost 60,000 general medicine studies, how can assistance focus in 1350 community houses? To pay the consequences would be above all our clients. To pay the most expensive expenditure would above all be the weak social groups, the fragile, the last ones. If dependence is the solution of politics to the need for the reorganization of local medicine, the same policy must not have understood that the aforementioned need have given exhaustive response in the national collective agreement of our category that sees us ready to guarantee roles and tasks of the our profession at the service of the community, even in community homes. For these reasons, We strongly want to protect the professional autonomy of family doctors, preserving the trustee relationship with their patients and guaranteeing capillary accessibility to care. As a local administrator I am sure that it will share our own concerns, especially in relation to the proximity and capillarity of assistance that today, despite a situation of serious staff deficiency, the general practitioner guarantees also in the most difficult and dispersed areas “.