Overwhelmed by the flight of doctors, money wasted and leaders who never pay. How we are transforming Italian healthcare into a money machine that no longer treats patients
For years you have been talking about the collapse of Italian healthcare and …?
“I am an unheard Cassandra, I am helplessly witnessing the collapse, day after day of the health system and we health professionals are helpless spectators. We have seen everything in recent years, from the senseless amalgamation of departments to radical staff cuts, to the reduction of already insufficient services. Over the years, no political decision-maker has even managed to give birth to a budget law that would counteract diseconomies and waste. Public and para-public health no longer heals people but is part of this business system, which is the business of health. We are at the point that in the operating theaters colleagues find oriental scalpels that do not cut. Biosimilar drugs are imposed that do not have the same effectiveness as the originals. Tell me what this is !? “
You said: there is a ten-year emergency, medicine has become corporate. we are subjected to visiting the sick in 10-15 minutes when a disabled person, an elderly person, a limp, a traumatized person, takes 10 minutes just to go from the clinic door to the bed …
“It is a class society in which those who have money take care of themselves and those who do not have it hard to take care of themselves. A public or accredited specialist visit can cost less than a pedicure. The work of the healthcare professional who takes care of patients on a daily basis has become like Chaplin’s ‘Modern Times’: incorporated into an assembly line! They have to explain to me how I can perform a person-centered treatment, listen to the patient’s story, in just 10 minutes. The sick person has become an organ. The doctor, the nurse, the social health worker will be replaced by telemedicine. But in this way we are condemning entire generations. Above all, empathy is needed to manage the sick, a feeling that cannot be timed and how can I manage it with severe or terminal patients, in just 10 minutes? The truth is that healthcare has never been at the center of the political agenda of various governments. Nobody ever said ‘whatever it takes’. “We will make it effective ‘at any cost’.” We will do the impossible to cure people. Did the politicians understand that we are dealing with humans and not with sterile numbers? I visit the sick, not the disease. But now there is the PNRR … “
Who dedicates very little to healthcare, beyond the bullshit during the pandemic …
“In fact, I wonder who allowed the share destined for health to be only 8% of the PNRR, a ‘miserable’ 15.63 billion euros, when even just for digitization they dedicate 40.32 billion, 22% of 191 , 5 billion euros of the PNRR. this is because we are no longer people but products, as in a company “.
I feel a deep bitterness in her
“He’s right, it no longer makes sense to fight. You resign because the productivity of a healthcare professional should be assessed on the quality of care provided and the results obtained, not on the number of patients visited per unit of time “
‘The patient at the center ‘, says the slogan of every government that we have had in recent years
“Yes, in the middle of a sea of inefficiencies. When a hospital company finds bills that cost it 3 times what it paid a year ago, what do you think it will cut? The answer is easy: services, already collapsing. But in your opinion, can I lower the temperature by 1/2 ° in an intensive care unit or in an emergency room, in an operating room? “
The situation in the emergency rooms is already dramatic, with whole day waiting even in the big cities …
“I worked 15 years as an emergency room doctor in a northern city: I am the mirror of a system. There is never funding, no means, but only exhausting shifts, shortage of specialized personnel, holidays not taken, little gratification; would you be treated by a doctor who has been working incessantly for 24 hours? I do not believe. All general managers should try this experience, only to understand what it means to toil, not to work, but to toil in often cramped places, with chronic inefficiencies and a plethora of people who are pressing to obtain adequate assistance “
There are no more doctors for nefarious choices made in the past …
“The doctors are now fleeing, depressed, frustrated and without motivation, because there is not even the hope of a minimum change. I recently learned that the Directors General of the Reggio Emilia and Ausl Romagna regions have been awarded with about 30,000 euros for the achievement of the objectives, in addition to the 150,000 fixed salary, you see, when you want the money can be found. But I wonder are these awards connected to the recent escape of 11 doctors from the PS in Reggio Emilia or are they perhaps linked to the 11 units who escaped from the PS in Rimini or perhaps for the Rimini PS which recently went haywire, as reported by local newspapers? “
Did he know about the hiring of Cuban doctors in Calabria !? Will it happen in other regions too?
“Yes, it will happen with Argentine and Albanian doctors, in the grave silence of the government, of Minister Speranza and of the various parties, perhaps departed, yes, but for the August holidays. I also propose to replace all the health management, clearly not up to the management tasks, with general managers, Cuban, Albanian, Argentine health and administrative managers, with Co.co.co contracts “
Understandable…
“Doctors flee hospitals because they are enslaved by wicked political choices. This medical transhumance will lead to wage dumping, precarious work, circumvented national contracts, unfair competition, with the use of low-cost medical labor; today Cuba, tomorrow it will be Albania, Argentina or another country! We can’t go on like this. There is no longer the “former” head physician to whom one turned, at night, for pathologies of particular complexity and repository of the greatest experience. Everything has been eliminated, pulverized, fragmented, including the relationship of trust between collaborators. I repeat that the hospital is not a company, it must not produce profit, it must produce health! The hospital must not only be efficient, it must be effective! “
What needs to be done?
“It’s not easy. There is a manifest managerial and political inability at every level. meanwhile, we need to instill hope in healthcare professionals and patients: things can change. but if we continue to invest billions in ‘cathedrals in the desert’, such as 1,430 community homes, 435 community hospitals, 611 territorial operations centers, full of new high-tech electro-medical equipment, without the staff to operate them, we go to the opposite direction. the president of agenas stated that 30,000 nurses and 10,000 doctors are missing, while in the last 3 years the NHS has lost about 21,000 medical specialists and, from 2019 to 2021, 8,000 white coats have left the hospital for voluntary resignations, in addition to 12,645 retirements “
What to do then?
“Rethinking the system and treating people, not just diseases, because the patient is unique! We deal with men and women not with inanimate objects or organs. At the top decision-making it is essential to hire competent managers and not appendages of local politicians and if these directors are not adequate, they must be sent home. People must fight for this, for health as a fundamental right of the individual and in the interest of the community (art.32 cost. !!), not for the latest model of Iphone, otherwise they will be condemned to have 2 health systems: one standard A for the rich and a series B for the poor. Are you happy? Not me! the same goes for governors and health ministers, too interested in propaganda by occupying the media to hide the collapse of their own managements. Show real numbers not propaganda. We should transform negative realities of suffering, stress and pain into positive ones, strengthening the health staff and returning to that passion, with a capital p. For the profession and the care that once was and that still many doctors possess. The time for listening, for anamnesis, for an interview is time for treatment that must not be timed! Even just to dilute the waiting times in the DPs, volunteer staff could be introduced, appropriately trained, who illustrate who is doing what, even if only to alleviate unnecessary suffering to patients and family members. If health professionals are few and unmotivated, who is able to adequately listen to the needs of patients? Listening is an integral part of the cure and without listening the cure becomes a chimera. The hospital has become a place of suffering, frustration and pain, not only for the waiting patient, but also for the doctors who work there and, as soon as possible, resigned, they will quit because they consider the situation unchangeable and unmanageable. Hiring smart people and giving them orders doesn’t make any sense. We have to hire smart people to tell us what to do, as Steve Jobs said ”.
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