The new lever of general medicine: what perspectives?

by Amir Roberti


02 MAY

Dear Director,
on the occasion of the meeting promoted by FNOMCEO on the ‘Medical issue‘was shown a survey (alarming in my opinion) according to which many doctors even at a young age have expressed a desire to leave the profession. In fact, according to this survey, 25% of my colleagues between the ages of 25 and 34 (precisely the age group in which I return) if they had the possibility, would ‘desert’.

I am still attending the Specific Training Course in General Medicine, but I had the great opportunity to already assume the ownership of a Primary Care position. In fact, my position is privileged: if on the one hand I experience the problems of my clinic daily on the field, on the other hand there is a constant confrontation with my young colleagues from which great fears about our future shine through.

In fact, I can only see how delicate it is to carry out the profession of General Practitioner, especially for those who – like me – started working during the period of the pandemic. Stormy times and great changes, of course, but our commitment is always high; after all, the pact of alliance with patients and their right to health is at stake. We have a great responsibility towards our clients and important choices to be made towards them.

Our profession is also slowly undermined by the unprecedented growing bureaucratic load (therapeutic plans, various types of certificates, tampons, non-compliance measures in pandemics) which sometimes prevents us from carrying out our outpatient clinical activity in the best possible way: an activity that constitutes the backbone of our profession and which today is however increasingly sacrificed.

It would be necessary for everyone – without distinction – to have a support staff, aimed at lightening the administrative part of our work; but even here one cannot fail to notice the disparity between who receives reimbursement for these expenses (group medicines) and who has to bear all the burdens (individual GPs).

The service we offer is sometimes poor in the eyes of patients and the articles in some media (which portray our category as millionaire slackers) contribute to increasing discontent in patients to the point of leading to episodes of verbal and physical aggression. In the face of the three hours (minimum and not maximum) of the clinic, in reality a greater number are dedicated to it, so much so that it also affects the private life of each of us. In this regard, I listened to stories of elderly colleagues who ended up in burn out precisely in order to dedicate more and more time to patients.

Load of bureaucracy, denigrating attacks or physical assaults, patient dissatisfaction, disproportionate work-life ratio: all this represents a source of great fear for young doctors who therefore ask themselves whether it is convenient to undertake such a career.

For example, in my Region (Veneto) the tenders for deficient territorial areas (increasingly deficient due to the haemorrhage of retirement that is occurring) are almost deserted: and with a scenario as described above, one wonders why? Solutions such as increased investment in the recruitment of healthcare personnel may not remedy the problem. Let us bear in mind that the real problem is not only the number of future GPs, but above all the quality of the work that is offered to young colleagues, some of whom do not intend to accept the Convention and all that it entails.

Instead, our profession should be made more attractive. But how to do it?

Firstly, I believe that a greater bureaucratic streamlining would allow us to return to privilege clinical activity and secondly by looking at the positive examples of the multi-year activities of older colleagues: their testimonies can help young colleagues to acquire the experience necessary to believe more in themselves and the awareness linked to the mission of their role.

Finally, I would like to make my personal contribution.

Right from the start I began to perceive the great satisfactions that this profession can reserve. In particular, I like to approach my figure to that of the ‘Gubernator‘, that is the helmsman, of the health of my clients. A holistic health concept, which permeates both biological and social aspects. I like to think that I represent the point of reference for my patients and that the relationships with them will be destined to last even decades; it is gratifying to know that I am considered a familiar face to them and often the first point of contact for any type of situation.

The clinical figure who best knows the patient and who accompanies him on his journey. I know that I will succeed: the passion, the good will, the satisfactions, the mutual support among colleagues, the professional comparison will certainly be of great help as well as comfort in the long march that awaits me, because in addition to following the patient I will grow equally I also go through all the contributions of life that they will be able to give me.

Dr. Amir RobertiPrimary Care Doctor at Santa Maria di Sala (VE)
Doctor of the Specific Training Course in General Medicine – Veneto Region

02 May 2022
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