Jesús Diez Manglano, president of SEMI.
The Internal Medicine Spanish, which was still recovering from the effort made during the hardest part of the covid, live again a stage of saturation due to the lack of specialists, the increase in non-covid pathologies and the slight uptick in hospitalizations due to the seventh wave of the coronavirus pandemic.
“Right now, the feeling of the representatives of all the autonomous societies of Internal Medicine is that we are saturated with work. My Service theoretically has 55 beds and we have 85 patients, that is, 70 percent more. This is what is also being experienced in the rest of Spain. We have 160 percent patients, but not 160 percent professionals. In addition, of those of us who are there are many who are on sick leave and they could not be replaced because there are no professionals”claims Jesús Diez Manglano, president of the Spanish Society of Internal Medicine (SEMI).
A shortage of professionals that, according to the internist, is widespread throughout Spain: “Recently, I have spoken with internists from Galicia, Extremadura, Madrid, the Canary Islands, Asturias, Valencia, Murcia and Aragón, and the problem is the same everywhere: places are not filled”.
Some facts that lead Manglano to ensure that the situation of Internal Medicine in Spain “It is very worrying”. “We must bear in mind that it is the basic specialty in hospital care and in the medium-term future we do not see measures being implemented to solve this problem,” claims the president of SEMI.
Given the bad situation, the doctor foresees that there will be closures of “consultations” or that the “most serious patients” will not have to be prioritized, but rules out replicating plant closures like the one that is going to be carried out in the Internal Medicine plant of the Hospital of the capital of La Vall (Valencia Community), something that he considers an “incredible” situation.
The covid flu, an end to media prominence but not to care
The doctor acknowledges that in the hardest moments of the covid pandemic, the specialty was much more recognized. However, he assures that his role in care has not changed at all. “This alleged flu has taken away media prominence, but not at all healthcare protagonism. In fact, the patients who are admitted to the hospital for covid, although they have less serious conditions, are still being treated by internists, ”Manglano details.
In addition, in this new situation are added the usual patients and those who are seeing for the “postpandemic rebufo”. “Add those who they did not receive attention on time and now many complications are arising. Definitely, the role of care has not declined absolutely. The feeling we have is that Internal Medicine is saturated, in addition to the lack of professionals, we must add the covid patients, who have increased a bit lately. We have many different pathologies that have become much worse”, explains the president of the SEMI.
Internal, a ‘replica’ of the situation in Primary
The situation that Internal Medicine is experiencing has many characteristics similar to the one that Primary Care has been suffering from for some time, something that for Manglano should lead the health authorities to reflect on the National Health System.
“There must be a reflection of the health system we want. Undoubtedly, in the public health system that we have in Spain, success depends on everyone’s activity, but the basis is in doctors with a holistic, global and generalist conception, who are primary care doctors in the community environment and internists in the hospital environment”, assures the president of the SEMI.
In this sense, Manglano claims that “if that is well endowed and works, there will be an optimal development of everything else, if this begins to fail no matter how good everything else is, the system will start to fail”.
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