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“I work part-time as a dispatcher,” says the family doctor. This happened after the decision of the Minister of Health when family doctors were forced to register patients with references during quarantine. The ministry says doctors cannot necessarily do this.
The ring wheel rotates
Aurelija Proscevičienė, who works as a family doctor in Kaunas, said she did not calculate how much, on average, her workday receives calls to different medical institutions to register patients with specialist doctors. “However, I once realized that it took me 1 hour and 15 minutes to register two patients with doctors. And these are not the only patients that I registered that day. All of this takes a long time due to the fact that it is impossible to call to medical offices directly. ” – According to the doctor, you must call persistently and for a long time before calling – Finally, when you have registered, call the patient and inform them when they have registered, find out: where, how long will you need to discuss with the patient at the moment Adequate to register in advance is not always free at that time, sometimes the treatment center where you register offers a completely different schedule. Sometimes it turns out that this is not the right time for the patient. Then the ring wheel spins again. “
The family doctor can clean the office himself, but this is not done. The principle that a highly qualified professional must work in a job that matches his qualifications must be upheld.
The interviewee was surprised that, at this time, a referral from a family doctor, which can also be found in the electronic space, is almost useless, since these doctors still have to register patients with the doctors who are being referred . According to A. Proscevičienė, it is extremely difficult to register patients with specialists who provide tertiary level services. Cases in which, under current quarantine requirements, GPs register for a specialized remote consultation, are time consuming. “That constant call is a mockery of our work. As long as I do this kind of job as a dispatcher, I can’t do my direct duties: consulting patients, writing e-prescriptions,” the doctor lamented.
Not by competition
Professor Julius Kalibatas, president of the Lithuanian Association of General Practitioners (LBPGA), admitted that he received a series of complaints from his colleagues about their obligation to register patients with specialists. “Of course, a family doctor should only prescribe referrals to specialist doctors; the patient should register with them. In developed countries, where family medicine has a very deep tradition, all this is done by secretaries. The doctor never calls to register patients, “Kalibat said. if necessary, this work could be done by nurses in Lithuania.
In his words, the current order is incorrect, unnecessary, so the family doctor is burdened with unnecessary work that does not correspond to his competence. “A person without higher medical education can also call and register over the phone. Intelligence must be used rationally, not wasted. Of course, the family doctor can clean the office himself, but this is not done anywhere. The principle is that a highly qualified specialist must do the job. ” Assigning extracurricular activities to a highly qualified specialist, a physician, is a flawed practice, “in the teacher’s words, which prevents general practitioners from performing their actual duties correctly.
According to J. Kalibat, the LBPGA plans to address the Minister of Health, requesting the revocation of the order for family doctors to register patients with specialist doctors. “This term is very evident in conservatism in the decision-making of the Ministry of Health (SAM). If the ministry has already made a decision, they try to defend it to the end. SAM never apologized for making an unconscious decision.” The autocratic methods of governance of Mr. Aurelijus Veryga do not help, they are not for our time “, the President of the LBPGA did not spare the criticism of the Minister of Health.
The conservatism of the Ministry of Health in decision-making is very evident in this term.
Can’t just doctors?
We asked the SAM Press Service why, with a referral from a GP, patients are currently unable to register with a GP. We received a response from Gitana Ratkienė, Advisor to the Division of Primary Health Care and Nursing of the SAM Department of Personal Health. Remember that even during the quarantine period from April 30. Priority is given to remote consultation, which is established by decision of the Minister of Health, who is also the Head of State Operations (OV) at the state level.
“To consult a specialist doctor remotely, the GP must register. The patient cannot do so, since the advice is not given to the patient but to the doctor. (…) If the GP or the specialist decide that the patient needs direct contact with the patient consultation, in which case (…) the patient registers in accordance with the procedure established by the head of the medical institution that provides outpatient and / or tertiary outpatient consultations , writes G. Ratkienė Therefore, there are no restrictions on the VO’s decision on who should register for a specialized consultation.For the services of a specialist physician, the procedure approved by the supervisor may stipulate that the family physician and / or the nurse and / or the assistant nurse and / or the receptionist and / or the patient (or their representative) register for direct consultation. “
G.Ratkienė stated that only the head of the institution providing outpatient personal health care services can decide which of the listed specialties should register the patient during quarantine for a consultation with a medical specialist.
The SAM Press Service did not respond to the question of whether it is estimated how much doctors’ hours will be paid and will be wasted. As with the question of whether to withdraw instruction to family doctors (or other specialists) to register patients with specialist doctors in the near future.
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