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“It just came to our notice then. We are closing the chain of primary health care, which is most important,” wrote on Facebook in a letter sent by SAM, Jurgita Sejonienė, who was elected vice president of the Medical Movement and was elected to the again Seimas with the conservatives, and illustrated what the work of family doctors would be like.
Other patients – remotely only
The letter states that it provides an algorithm for the provision of services by a family doctor and his team members to patients with COVID-19 disease.
It is emphasized that those healthcare professionals who will treat patients at home will only be able to consult other patients remotely.
“We want to inform you that SAM is urgently resolving the issue of paying additional supplements for work in direct contact with patients with COVID-19 disease,” says the letter signed by Kristina Garuolienė, Deputy Minister of Health.
Its annex establishes the behavior that a GP must follow when treating patients with a confirmed diagnosis of coronavirus.
According to him, a person at home or in a social care institution who has been confirmed with a coronavirus will see a family doctor.
The latter doctor is expected to periodically assess the course of contact disease, according to the severity of the COVID-19 disease, of which three are distinguished: mild form, severe form and critically severe form.
In the case of a mild form of the disease, symptomatic treatment is applied at home or in a social care institution; the course is supervised by family doctors.
In the event of severe illness from COVID-19, the family doctor will call an ambulance and contact the district hospital. The patient is treated in the internal medicine service of the hospital located in the municipality.
If the form of the disease is critically severe, an ambulance is called and the patient is treated in a hospital with an infectious disease ward. If necessary, transfer to the intensive care unit.
After reading the letter, not everyone understood when the procedure would take effect, if family doctors could refuse to go to patients with coronavirus; this is not clearly stated in the document.
15 minutes with written questions to SAM representatives on Thursday, but did not receive a response 24 hours a day.
A.Veryga: we have to do the work
In Friday’s press conference, Health Minister A.Veryga said that family doctors are not only planned to be used, but are still working in that position.
We will be angry or not, we will have to do the work, we will have to form teams in the municipalities.
“Of course, when asked if it is true that family doctors are going to be used to combat the coronavirus,” Veryga replied. . I have already said, as I said, that the whole system will have to re-adapt to the rapid spread of the disease, whether we like it or not, we will resent it or not, we will have to do the work, we will have to form teams in the municipalities to help patients at home. We will have to adapt the system to the deterioration of the situation. “
He said it would be necessary to think about how to test for COVID-19 in the future. The minister added that family doctors “are an integral part of the health system, it has always been that way.”
“Family doctors have and will have a role to play, there really is no need to scare or intimidate anything here,” he explained.
According to the minister, this issue has received much attention to no avail.
“Another thing that has been the subject of discussion, and I think there really is an unnecessary fear of it spreading, is that because medical teams are going home to care for patients with milder forms of COVID-19, they really don’t. it should be dramatized in some way. We need to think about how we can ensure that critically ill patients can be treated in inpatient facilities or hospitals. These teams should be formed in the municipalities and should not really be dramatized or written in such a way that “we are shocked” or similar, “said A. Veryga on Friday.
The scheme developed by SAM shows that the family doctor will go not only to patients with a mild form, but also to patients with COVID-19 with all forms in general, and will determine for himself what form it is. It is true that they will send the seriously ill to hospitals and visit the sick at home.
An algorithm for the work of a family doctor was sent to the municipalities of SAM
The minister said on Friday that we must be focused and united, and that all patients must get the help they need.
I would like to ask you before the shock, if there is any uncertainty, we will be happy to explain to all professional and medical groups, let’s explain that there would be no shock, especially since every morning the representatives of the municipalities join the ministry headquarters. they’re talking, ”he explained.
Family doctor: tests are needed to evaluate the condition.
Head of the Primary Health Care Center of Aukštadvaris, Jurga Dūdienė family doctor on Friday 15 minutes He said that he had not received any explanation from SAM so far as to what the order in the letter meant.
“Yesterday I tried to contact the union organization of family doctors throughout the day, they are only verbal explanations that were only recommended, here for the municipalities. On the other hand, the attitude is that he received no answer, and the doctor from the Trakai district municipality tried to call me, so far there is no official answer. ” 15 minutes she said.
According to J. Dūdienė, now that there is a mild form of the disease, family doctors consult coronavirus patients remotely, their condition is monitored by phone. If the situation worsens, the patient discusses the situation with the family doctor during the working day, who can send him to the admissions department for a more detailed examination.
Photo by Valdas Kopūstas / 15min / Jurga Dūdienė, Head of the Trakai District Aukštadvaris Primary Health Care Center, family doctor
“It should be understood that a family doctor returning home needs a blood test and a lung X-ray in order to be able to competently tell him that he has a severe form of coronavirus. “We definitely won’t be able to do that with one person,” he said.
The doctor assured that in case of a change in condition (cough, persistent fever, shortness of breath), the family doctor who examined the patient would still send him for an examination by ambulance.
“Exactly the same person, after evaluating his state of deterioration, can do so by calling 112 and going directly to the designated hospital,” he emphasized.
J.Dūdienė agreed that sending family doctors to coronavirus patients would pose a threat to the doctors themselves.
“The algorithm defines that if a family doctor goes to a patient’s home, he can only see all the other patients by phone that day. Which means all scheduled patients scheduled for that day can only see their doctor remotely. If we are talking about the extraordinary patients who did not have COVID-19 that day, we could not see them either. This procedure would destroy accessibility and reduce accessibility for all other patients ”, emphasized the interlocutor.
P. Poderskis: not fully discussed
Povilas Poderskis, director of the municipal administration of the city of Vilnius 15 minutes he said a letter from SAM was discussed at a meeting of the Vilnius health team on Thursday.
“We see this commandment as one that may not have been fully debated and would need more precision there. If GPs now start walking home with coronavirus patients, they will no longer be able to provide contact services. This is also provided in the description, in this case collapse the entire institute of family doctors and diseases would be removed, “said the director of administration.
Luke April / 15min photo / Povilas Poderskis
According to P. Podersky, if there is an opportunity to call a doctor home with COVID-19, this opportunity would be actively used, and therefore doctors will review all cases where it does not make much sense to go.
He is convinced that it will be safer for everyone if patients with mild forms are treated at home and consulted remotely.
“In this way, we will keep our doctors safe and sound and the system working,” emphasized the interlocutor.
According to the director of administration, larger medical institutions are more resilient, employ more doctors, and this procedure would cause more problems for small general practitioner surgeries.
“They would experience this problem very acutely and quickly,” he said.
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