Juana Carretero, Jesús Díez Manglano and José María Fernández.
The 43rd Congress of the Spanish Society of Internal Medicine (SEMI) has kicked off at the Gijón Conference Center, claiming the “need to transform” the Healthcare System (SNS) to adapt it to an increasingly aging population. A change of focus and structures where the Internal Medicine “has a lot to contribute” and, therefore, encourages administrations to Solve the lack of “generational change” and the current “deficit of internists”.
“Medicine Internal is more essential than ever to face the challenged what chronicity already supposes for the health system. Internists work under the principle that no disease or clinical problem is beyond our concern or responsibility. The health system is now suffering and experiencing a moment of tension. From Internal, nothing is foreign to us, we consider that We are at the moment of rethinking healthcare”claimed Jesús Díez Manglano, president of SEMI, during an inauguration ceremony where he was accompanied by Juana Carretero Gómez, 1st Vice President of SEMI and president of the Scientific Committee, and José María Fernández Rodríguez, Executive President of the Organizing and Scientific Committees.
In this sense, the president of SEMI considers that the hospital structure has become obsolete in relation to the needs of the bulk of the population. “The hospitals are more prepared for acute pathology than for chronicity and this is a challenge in which Internal Medicine has a lot to contribute and should be a key specialty in the transformation of the health system”.
In addition, Manlgano recalls that there has not been a reform of hospital care and it is something that “is pending.” “Probably, hospitals have to have another type of structure. A person who is 80 years old and has broken his hip, goes to traumatology to have an operation, but once he has been operated on, this is the least of his problems because he has other diseases. In fact, the break may have been caused by these pathologies.”
For this reason, the president of Semi considers that the structure of hospitals in divisions “is outdated”. “We must have transversal divisions to care for patients that go beyond what is included in a single specialty. Hospitals have to change”, claims Manlgano
An argument that the internist supports with the data from the Recalmin 2021 survey, which shows that 64 percent of acute hospitals have a palliative care unit, 56 percent a home hospitalization unit, 32 percent a short-stay unit and 23 percent a rapid diagnosis unit. In all cases, the participation of internists is very important, since the 64 percent of the Internal services has a Complex Chronic Patient Care Unit.
How to solve the generational change?
The current and future scenario of the specialty has also marked the opening ceremony of a congress attended by more than 2,300 internists who currently do not see the generational change as guaranteed. “There is a pressing need to respond to the lack of generational replacement of internists in the SNS”, details Manglano, who recalls that there are now open contracts for internists who are not covered because the conditions “are not adequate”.
“There is a pressing need to respond to the lack of generational replacement of internists in the SNS”
In this sense, Manglano believes that the healthcare model should be rethought. “This is a situation that we have now and, therefore, we must rethink our health. We have to improve it and reject actions that do not provide benefits to patients. In the entire health system, public and private, one in four euros spent does not provide any added value to patient care. The population has to know this so as not to do things that do not add value”, claims Manglano, who assures that if these worthless issues were reduced by half the health budget would be improved by 15 percent.
An increase in the budget that could be allocated to the hiring of internists, who despite the difficulties in estimating the real need due to a lack of registration of the specialists in Spain, from the SEMI predict that it would be necessary to “increase between 5 and 10 percent the Internal Medicine templates”.
Avoid healthcare fragmentation
This improvement in efficiency also involves avoiding divisions in healthcare. “We cannot fragment health care, we must be integrators to give the best assistance. This idea of creating new areas of training is detrimental to the population because it causes the citizen to have to see a different doctor for each issue”, Manglano claims.
“We are in favor of the creation of ACE and not of new specialties”
Precisely, with the arrival of the RD for Specialties, a window of opportunity has been opened for the creation of new disciplines and Specific Training Areas, something that could foster fragmentation. For this reason, from the SEMI they allege that they are “in favor of creating new ACE and not specialties, since an ACE is a specific area and it allows that if the needs change, the physicians can reintegrate to another area. While if specific specialties are made, these doctors can return ”.
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