This conclusion can be drawn from the data presented in the information report of the Ministry of Health: only 5% of the population are satisfied with the level of medical services in the Republic of Latvia.
Pandemic mortality
Another sad indicator is that the mortality rate in Latvia exceeds the EU average. The main causes of mortality are cardiovascular diseases and cancer. There is also such a criterion for the quality of medical care as medically preventable mortality. That is, we are talking about the effective treatment of certain serious diseases.
Alas, Latvia has nothing to boast about here either: medically preventable mortality in Latvia is more than twice the average in the European Union! Where to next?!
Five major problems in primary medicine
Not the least, and perhaps even the key role in these tragic statistics is played by… primary medicine or, in simple terms, family doctors. The information report of the Ministry of Health lists all the main problems and “sores” of the Institute of Family Doctors.
First of allthis is a shortage of personnel (shortage of family doctors and staff working in the practices of family doctors – physician assistants and nurses) and aging personnel (more than 30% of family doctors have already reached retirement age).
Many family physician practices have only one nurse, which results in significant workload for both the doctor and the nurse.
Second problem – if some doctors even have a shortage of patients (up to 1,500 and 1,500 people), then other family doctors are clearly working hard – 14.7% of family doctors have more than 2 thousand patients. There are also record holders – those with about 3,000 patients registered.
Third problem – family doctor practices often face a lack of space in rented premises. This problem is especially relevant in large cities – the rented premises are clearly not enough to conduct medical procedures and examinations.
Fourth problem – a very complex model for financing the practices of family doctors. Financing is provided for 18 different positions!
Aesculapians constantly “fight” with excessive bureaucracy – they need to fill out mountains of paperwork. The level of digitalization among family doctors also varies – some doctors already fill out medical documents exclusively in an electronic environment – most often in a local system. But there are also those doctors who continue to keep paper medical records.
Considering the amount of paperwork that doctors must fill out, the question arises: how do they even have time and energy for the patient?
Fifth problem – young doctors are not eager to become family doctors. Although the state has been constantly increasing the number of places in residency in recent years – that is, for graduates of medical faculties to undergo residency paid by the state. So, if back in 2007 there were only 14 such places for resident doctors, then this year there are already 55. However, only… 37 are filled!
The reasons for the reluctance of young doctors to become family doctors are clear: a huge burden, including psychological, given that the lion’s share of patients are elderly people with chronic illnesses, excessive bureaucracy and lack of career prospects.
What should be the “ideal” practice of a family doctor?
What is proposed in the information report of the Ministry of Health? Medical officials have drawn up a concept of optimal practice for a family doctor.
What is he like? One family doctor must have 1,500 patients registered. Among them are both adults and children. The practice must be open 40 hours per week and every weekday, and patients must be able to reach the practice by telephone during these hours. The practice must consist of a family physician, two physician assistants or nurses, a receptionist and an additional employee.
The premises should be 80–100 square meters in size. meters, with accessibility for people with functional impairments, each employee of the practice should have his own workplace, as well as a treatment room, a staff rest room, etc.
The state plans to finance one more full-time position – an employee – in the doctorate in order to reduce the burden on doctors. The employee will be able to call patients and perform other auxiliary work not directly related to the provision of medical care.
It is also planned to motivate family doctors to engage in prevention and provide quality treatment. Funds will be allocated for the purchase of equipment both for emergency medical care and for various manipulations. In other words, a trained doctor and nurses can perform some manipulations – ECG, checking sugar levels, systems – at the doctor’s office, without sending the patient to a day hospital or hospital for this.
To rejuvenate the workforce, the Ministry of Health plans to attract funds from European funds; it is also planned to simplify the process of taking over the practices of family doctors by young specialists – instead of retiring colleagues.
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2024-04-21 02:35:35