A whole scheme of abandonment of the health sector and contempt for labor rights, causes Mexico today to have a dependency on clinics adjacent to pharmacies. Medical personnel are also subjected to them; It’s not that they don’t want government jobs, it’s that you have to think about salary and working hours. That set of problems creates a million dollar business for a few.
Mexico City, October 1 (However).- In May of this year, the Mexican Institute of Social Security (IMSS) announced the call for 13 thousand vacancies in the health sector. Given the lack of staff in public clinics, the response was expected to be overwhelming but it was not, and two months later only 521 people had applied.
The data shows that although there are doctors, government positions are not the primary option for professionals. According to different testimonies, the problem goes through working conditions and adequate economic compensation for this work.
All doctors, at the end of their academic training, start compulsory practices that are strenuous: 24-hour guards, sometimes symbolic salary and marathon work days.
The different health units offer monthly, quarterly or semi-annual contracts with salaries ranging from 2,500 to 5,000 pesos per fortnight, and it is the same in rural areas, which is why the permanent requirement of medical personnel to obtain the vacancies that They raise the salary between 7 thousand and 9 thousand pesos fortnightly.
The drop in doctors’ salaries is proportional to the boom private medical services and clinics adjacent to pharmacies. These two options, although they are aimed at different sectors of the population due to the cost of the services, have in common the speed of consultation.
And this for doctors meant submission to private.
Faced with the arrival of some illness or physical discomfort, Mexicans have three main options for medical attention: make an appointment or go to the emergency service of a public institution, pay between 800 and a thousand pesos for a medical consultation in a private clinic, plus the cost of the drugs prescribed, and the third option, a generic pharmacy that provides a consultation service for 50 or 70 pesos.
In the context of the economic crisis, the third option continues to be the most recurrent, since it involves low-cost medical attention and medicines.
According to data from 2021, the Federal Commission for Prevention and Health Risks (Cofepris) had a record of 45,794 offices adjacent to pharmacies. In that year, the second of the COVID-19 pandemic, permits were issued to 8,220. Thus, throughout Mexico, 45 percent of the pharmacies that exist have an office, according to data from the National Association of Pharmacies in Mexico (Anafarmex).
The pandemic came to give this business more power, since only in the first four months of the COVID emergency, 36,000 patients with symptoms first attended these services, more data from the Association shows.
Faced with hundreds of clinics, it could be said that there is no lack of work for doctors, but according to testimonies collected by Neverthelessthe proliferation of these services that also come to relieve a large part of the demand for medical attention to public units, has meant a demerit to their profession but economically it is also the most profitable.
“The dynamic in these offices is the flow of people. The offices are attended in three schedules: morning, evening and weekends. The shift is from 6 to 8 hours depending on the doctor’s availability and each office per shift serves an average of 15 to 35 patients. Currently consultations are charged at 50 pesos and procedures range from 20 pesos to 100 pesos. In one turn, a minimum of 700 pesos is generated. In good shifts, from one thousand to one thousand 700 pesos. A doctor could then ask for more than one shift, ”said a doctor who asked not to make his name public.
The procedures offered are such as taking blood pressure, applying injections, taking glucose or minor cures.
“General practitioners are very upset and we are not fifís. The vast majority of us come from a humble background with a desire to excel, we really expected more support from the public system in terms of work and fair wages. But if not even the unions of these organizations fight for a better treatment for their doctors, a better salary, a better institutional support, what can we expect?”, expressed another of the doctors interviewed.
THE PERFECT BUSINESS
With a health system in the process of being rebuilt and with poor working and salary conditions for medical personnel, these clinics, which are a small dark room with a desk, a stretcher and a toilet, are a strong source of money, which is multiplied by also offer remedies for diseases, that is, medicines.
It is a double gain for the companies because it covers both needs also at the cost of the doctors. Specifically, the consultation model that is offered in exchange for a voluntary payment, that is, where there is no established fee and a “free consultation” is promoted, is the one that is on the rise the most.
As the payment is at the “will” of the patient, a company-doctor employment relationship is not created and frees the company from granting employment benefits, social security, vacations and the right to fire the doctor for any reason and in any circumstance.
And although the deaths in these offices are minimal, the pharmaceutical company will never take responsibility for these events, only the doctor even if he is offering a voluntary service.
This market also has among its main victims recently graduated doctors who have fewer opportunities to enter a public body.
A doctor who currently works for Fundación Best, from which Farmacias Similares spun off, explains that there is no interest in doctors but in the sale of medicines.
“In a very good shift in this foundation you get, as a doctor, 1,500 pesos or even more. However, drug sales amount to 100 thousand pesos and perhaps I fall short in that calculation, ”he commented.
In other words, he added, it is the profit against labor exploitation, since the doctor can earn 15 or 700 pesos and the profits from the sale of medicines are guaranteed.
“It is very unfair that medical issues are only touched on to revile the staff to make a scandal due to an adverse circumstance, to discredit the doctor, that is, only for negative issues when it is not the wish of any doctor to harm others,” he concluded. the fountain.
Daniela Barragan
She is a journalist from UNAM, specializing in politics from Carlos Septién. She has dedicated the last few years to data journalism, with an emphasis on issues of poverty, inequality, transparency, and gender.