“Italian surgery is suffering at the moment and the reasons are multiple: financial cuts; reduction of beds; shortage of medical and nursing staff; poor rationalization of resources and surgeries; increase in medico-legal disputes which make surgical specialties unattractive for young graduates and, finally, the poor interaction that exists between hospitals and the territory”. Maurizio Brausi, president of Cic, Italian College of Surgeons, said this to Adnkronos Salute, recalling how the organisation, “which includes 60 specialist societies and is headed by around 50 thousand Italian surgeons, has a profound knowledge of the current situation of hospitals and the their problems, presents itself as an active interlocutor of the Ministry of Health proposing possible useful and shared actions” which lead, for example, to the reduction of royal medical disputes, a theme at the center of the congress scheduled in Rome next June.
There are three issues “that the College is discussing and evaluating in a very profound way – explains Brausi – The first is the rationalization of resources in surgery. This topic was explored in depth during the Arezzo forum a few months ago. The CIC proposes that the management of the resources available to surgical specialties should pass from the general directorates, but also from the surgeons themselves who, on a daily basis, frequent the operating rooms and use the technologies”. Precisely for “the purchase of the latter – he continues – it is proposed to take regional needs into account with super prudent purchases. An example is the purchase of robots, which cost a lot and which are sometimes in excess in the various regions. This “approach” could lead to very substantial savings and new resources that could be used in other sectors. The second question is the medico-legal one. “Surgery” is the specialty that “receives the most complaints of all and that 95% of these complaints will result in nothing being done – underlines the president of the College – The CIC has been dealing with this problem for many years with the Gelli law and with long and in-depth discussions also in Parliament. On June 12th we organized a conference on this topic in Rome.
The Minister of Health, Orazio Schillacci, was invited together with representatives of various trade unions, presidents of medical-surgical societies, medical examiners and lawyers. The various aspects of the problem will be debated from both a surgical and medico-legal point of view. The objective is to reduce royal medical disputes, i.e. complaints”. To this end, “we believe it is useful, in this context, to establish”, first of all, “an impartial committee with the task of evaluating the complaints and establishing whether the fundamental criteria exist for the complaints to continue the process”.
Secondly, “change the rules” and that is to ensure that “the choice of consultants – explains Brausi – must be super selective, drawing from rankings proposed by the various surgical companies. Therefore, act on the legal profession, i.e. on the bar association, to eliminate those centers still in existence that are offered on the web, in hospitals, etc., offering free legal assistance to patients, in exchange for a percentage of any plea bargaining with the structures and surgeons”. With this practice “the impact on the insurance system is evident and it is useless to underline that, by implementing these proposals, the costs borne by the State will also decrease significantly”.
The fourth question concerns hospital-territory interaction. “Careful management of general practitioners, especially of health homes and specialist clinics in the area – concludes the surgeons’ resident – would select hospital accesses and, in particular, access to emergency rooms which, at the moment, are the structures that are suffering the most in the healthcare sector”.
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