The three main Primary Care medical societies (SEMERGEN, SemFYC and SEMG) point to the poor management that is occurring in the 17 regional health services. As well as the “leaks” that exist in the healthcare system
The general health landscape has generated a complicated situation in the Primary Care and therefore, in the health services of each autonomous community, they indicate the three main associations of this specialty.
“Family doctors are not here to cover holes”, he explains to EFE president of the Primary Care Medical Society (SEMERGEN), José Polowho warns that poor regional management is ruining them, burdening the workforce, bureaucracy and obstacles to prescribe a simple diagnostic test.
And it is that there is no equity in the benefits of the 3,000 health centers and 10,000 offices in Spain. Depending on how autonomous the health center is, a family doctor may or may not prescribe an MRI or an endoscopy which, if done, avoids referring the patient to a specialist and thickening a waiting list for a diagnostic test.
For this family doctor, another “leak” in the system is al low budgetor that the communities allocate to primary care, which is not associated with a political party, but with the own management of each autonomy.
As an example, remember that in Spain Primary Care is assigned the 14% of public health expenditure, from 11% that dedicates the Community of Madridthe lowest, al 18% of Andalusiathe highest, “both governed by the Popular Party”.
From SEMERGEN, they warn that family doctors have been complaining for years that this level of care should be provided 25% of public health expenditure. “And we are eleven points below”, he asserts.
In the opinion of the president of SEMERGEN, Primary Care experienced a “real boost” in the 80s and 90s, but with the transfer of health powers, he says, “everything has gone from bad to worse”.
And a “second hole” of this level of assistance is the lack of resources and of forecastsince it was not taken into account, despite the warnings of the medical societies, the avalanche of retirements of the baby boom generation for which there is no generational replacement.
33% of family doctors are over 60 years old
From the Spanish Society of Family and Community Medicine (SemFYC)her president Remedios Martín, he affirms that there is no replacement even if many MIR places are released, and this happens “because it has not been planned in previous years”.
According to the report of Ministry of Health “Offer-Need for Medical Specialists 2021-2035”, there are seventeen deficit specialties. The list is led by Family Medicine but there is also anesthesiology and resuscitation, geriatrics, psychiatry, radiodiagnosis or paediatrics.
Martín proposes as a solution that the 17 deficit specialties take all the MIR places.
“It is necessary to plan according to the needs”, he says, so that the rest of the places that are not in deficit would be stopped or deserted for a while.
Martín also advocates for universities to recover “the virtues of the family doctor”, which are being lost due to job insecurity, and to insist on rural areas “where there is a lack of doctors, there are closed centers and the infrastructure is outdated” .
This is the case in Castilla y León, Castilla-La Mancha, Extremadura or Aragon, where there are rural centers with poor connections to hospitals and clinical histories that are not digitized, which hinders prescription.
Galicia, with the biggest shortage of doctors between now and 2026
The 60% of the 36,247 family doctors in Spain are over 50 and 33.2% over 60, according to a report from Study Center of the Medical Union of Granada.
By community, the oldest workforce (over 60) is in Castile and Leon, Aragon, Andalusia and Galicia, as well as Ceuta and Melilla.
Precisely and according to this study, Galicia is where a greater deficit of doctors would be detected by 2026 due to the retirements of the ‘baby boom’ generation and the lack of replacement doctors, followed by the Valencian Community, Andalusia and Castile and Leon..
Cut the drain on family doctors who go abroad
The president of the Spanish Society of General and Family Physicians (SEMG), Antonio Fernández-Pro, shares with his colleagues that the main problem is with the regional manager, “there are good ones and bad ones”, but he also focuses on the “bleeding” of doctors who are leaving Spain. “You have to cut it somehow,” he says.
And that’s why he proposes to create suggestive scenarios. “We can train doctors at will, but it takes eleven years to become a doctor and it makes no sense to invest in them if they leave later,” he points out.
Fernández-Pro insists on the need to fix doctors in the system, but especially in rural areas, where there are many coverage problems.
“It is necessary to create scenarios that provide professional stability and encourage family reconciliation” proposes the president of the SEMG to put an end to the flight of talent and close another of the “holes” of this first level of care.