“We do a lot of curative medicine and little health education”

Dr. Juan Antonio Divisón Garrote is a veteran in the field of Primary Care, after 39 years of continuous practice as a doctor in the town of Fuentealbilla. Family Medicine and the close relationship with the patient that it represents, which in the case of a town is still greater, has been and is his great passion and vocation. For this reason, the General Council of Official Medical Associations of Spain has just awarded him the Prize for Professional Career in the field of Primary Care. Although he could have already retired since he is 66 years old, he assures that his intention, if his state of health allows it so far, is not to hang up the phonendoscope until he is 70 years old. He was born in Santa Cruz de Tenerife, but because of the work of his father, he came to live in Albacete from a very young age, so he feels from all four sides of La Mancha. Curiosities of his life, now one of his daughters, a nurse by profession and with the specialty of midwife, works at the Hospital de la Candelaria, and his two granddaughters were born there.

This village doctor who studied at the Salesians and later studied Medicine in Murcia has combined the care work of his General Medicine consultation with teaching and research. This last facet, as a member in the last 30 years of the GEVA Cardiovascular Research Group, has allowed him to publish more than 150 articles, and to combine this task with that of a university professor, at the UCAM, in Murcia.

Are you proud to receive the Professional Career Award in the field of Primary Care from the General Council of Medical Associations at 66 years of age and after more than three decades of continuous professional practice?

It is always nice to be recognized for the work of many years, and for me it represents an encouragement for young people, those who come from behind, so that they think and are aware that many things can be done and that the effort and perseverance In the end they have their prize, their recognition.

Has your entire professional career been linked to rural medicine in Fuentealbilla or have you had other destinations?

I have been in Fuentealbilla for the last 39 years, although I was in Alborea for four years before, working as a doctor.

Ever since you were little, did you always have a clear vocation as a doctor or did you wake up later?

Yes it is. I have always had a clear vocation as a doctor and I did what was then called General Medicine because I liked the close relationship with the patient, seeing the evolution of his illness. In the hospital environment it is different, you cannot do the same follow-up. In Primary Medicine it is very nice because you see the patient and follow him over time, his family, you know his environment, his problems.

And how did you end up in Fuentealbilla?

I approved the last national opposition for Primary Care. I had a very good number and I asked for Fuentealbilla, I don’t know why since people told me that with that number I could have chosen another destination, but since it was close to the capital I opted for this town. But Casas Ibáñez and Alcaraz were also pioneers because we launched the Primary Care model, consisting of teamwork, having a head of a health center, and that attracted me and that is why I decided to stay in that area of ​​the Province. That was the time of 24 hours a day, that is to say, rural doctors from Monday to Friday were 24 hours a day in our health center, and among the surrounding towns (Jorquera, Abengibre and Fuentealbilla) we organized ourselves, and every weekend we had two doctors off and one stayed on duty. Shortly after, the basic health zones began to come into operation and then Fuentealbilla became part of the structure of the Primary Care team of the basic zone of Casas Ibáñez and we did shifts there and it continues to function today, where today we are 11 doctors.

At 66, do you plan to retire or will you extend this decision until you are 70?

I am 66 years old and the truth is that I live from day to day. As my wife, who is from Fuentealbilla, is younger than me, I prefer to delay her retirement until she can also enjoy this period. Now we are both alone at home. My daughters already live, each one on her side. In addition, I am happy in the town and I am one of those who at my age continue to go to work happy, and that today Primary Care is fatal.

Has Primary Care evolved for the worse from your point of view or has it improved with respect to the care provided to patients?

We’ve had a few years that we’ve gotten worse. The enthusiasm for working at this first level of care has been lost among new professionals and among many of those who currently work. I have colleagues from 45 to 55 years old who are already burned out and are having a very bad time. I believe that a qualitative change that influenced this situation occurred when Primary Care ceased to have Management independent of Specialized Care and became part of the Integrated Care Management, something that, from my point of view, was a disaster for Primary Care. We have a tremendous lack of material and human resources that shows that Primary Care is very neglected.

And even worse do I understand that the Primary is in rural areas?

Yes, of course, because we have to be doubling queries, on vacation they don’t give us substitutes, a total disaster. We dedicate all the time we can to treating patients, to doing a lot of curative medicine, but we do little health promotion and disease prevention, which is one of the fundamental tasks of Family Medicine in this area. We have a very medicalized society precisely for this reason, because we only dedicate ourselves to treating and we spend little time, because we do not have it, to carry out preventive activities with our patients.


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