Jesús Díez Manglano, Antonio Fernández-Pro, José Polo García, Ricard Ferrer, Ángel Cequier and Salvador Tranche.
Six of the most important medical scientific societies (SEMI, Semfyc, SEMG, Semergen, Semicyuc and SEC), which represent a group of 50,000 medical specialists -more than 40 percent of the doctors who are part of the National Health Service- have signed a statement in which they show their rejection of the creation of an emergency specialty.
However, they support “unreservedly the need for recognition of professionals who work in emergency services and the importance of structuring the future training of these professionals”, and are committed to developing a proposal for a specialized training area (ACE) in the ER.
In their opinion, taking into account that the health system “is in continuous transformation”, they consider that “The SNS will have to adapt” in the short term to the new healthcare needs marked by these changes in the epidemiological (chronicity, multipathology) and demographic (aging) pattern.
“We consider that establishing a more fragmented healthcare system with the creation of new specialties goes against the construction of a system focused on the needs of the patient, aimed at giving each one of them the personalized, integrative and longitudinal care that this may require” , they point out.
Comprehensive and continuous care in Primary Care
The second argument against is that urgent care is understood as comprehensive and continuous care that is provided by Primary and Hospital Care, and for services and devices specifically dedicated to urgent care. And any of these areas, ranging from the patient’s home to the hospital, passing through the extra-hospital emergency, “are part of the natural scope of work of the family doctor.”
Third, they point out that “the pathology treated in the Emergency Department, as well as all urgent pathology, is enormously varied. It is not only acute but also chronic.” Therefore, they believe emergency services professionals must have a “generalist” profile in order to provide an adequate response to the general problems of patients.
On the other hand, it maintains that “it is not true that there are deficiencies in the quality of care provided in the emergency services and that the lack of an emergency specialty compromises such assistance.” In his opinion, “there is a high degree of training for the professionals who currently provide these services, which are practically all of them specialist doctors via MIR, mostly Family and Community Medicine and Internal Medicine but also Intensive Care and other specialties that have extensive training to deal with any urgent pathology “.
Fifth, they consider that the fact that physicians-in-training (MIR) have to assume a significant part of the care burden is not a particular scenario of emergency services, but rather is a common situation in any hospital service. On the other hand, they affirm that “there is no problem of legal recognition of professionals working in the emergency room“, and they see that” it is the health administration who must give legal support and define the degree to carry out the activity in this area. “
The Emergency specialty “does not solve any problem”
Likewise, in seventh place they argue that the appearance of a new specialty of Urgencies and Emergencies would not solve any of the current problems of the emergency services that are of an organizational and non-competence nature. “In fact, we estimate that the creation of this specialty will reinforce a fragmented healthcare model that it is unsustainable in time “, they affirm.
Furthermore, taking into account that urgent pathology is the responsibility of all medical and surgical specialties, they point out that “it is not possible to establish a boundary between competencies of professionals who work in emergency units, points of continuous care and hospital emergency services “.
“We believe that the proposal for a specialized training area (ACE) in the Emergency Department gives a much more coherent response to current social needs, as well as to the organizational requirements of health services, and even to the professionals’ own personal needs, they affirm in the penultimate place.
Finally, they recall that work in the ER is carried out under a high level of pressure that entails considerable professional burnout. “The ACE in the Emergency Department represents a more flexible model that facilitates the mobility of physicians in different healthcare settings (emergencies, primary care, or hospital services such as internal medicine), with the consequent advantages both for professionals and for the healthcare organization itself” , they conclude.
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