2023-12-05 08:32:00
Tiago Villanueva, President of the European Union of Primary Care Physicians (UEMO), explains in this interview for EL MÉDICO INTERACTIVO the main objectives during his mandate (2023-2026). According to this Portuguese doctor from the Portuguese National Health Service, the UEMO calls for “the recognition of Family Medicine as a medical specialty at the European level.”
How do you evaluate your career during these months as president of the UEMO?
2023 has been a year with several challenges, because we are faced with the need to resolve internal issues that were pending, such as the revision of the statutes, for example, and which we happily managed to resolve at the last meeting held in Murcia. We hope to have more serenity to carry out our projects from now on.
What are the main projects you want to launch?
First of all, we want to represent family doctors in European medical institutions and organizations. In the UEMO we integrate the European Medicines Agency (EMA), the Health Emergency Preparedness and Response Authority (HERA), the Health Technology Assessment Agency or the AMR One Health Network. This participation requires enormous availability of human resources, so that we can ensure attendance at the numerous meetings that are promoted.
And the projects related to the specialty?
We publish many ‘institutional statements’ that aim to denounce irregular situations or support a specific country. Our main aim is to obtain recognition of Family Medicine as a medical specialty at the European level. This makes a lot of sense, since it is already considered a specialty in most European countries. Unfortunately, the European Directive on the recognition of professional qualifications includes Family Medicine in a separate annex from the rest of the specialties. The UEMO simply requests to consider our specialty in the same annex as all the others.
Do you think that the European Union of Primary Care Physicians is sufficiently known among PC doctors? And among the rest of the healthcare community?
Probably not, and it is one of our objectives, that is, to work to increase the visibility of the organization and the vital role of the family doctor in European healthcare systems.
What are the main problems of Primary Care doctors in Europe?
Firstly, the difficulty in recruiting and retaining family doctors in the health system, even in countries that offer good salaries and good working conditions. In most European countries, salary, working and professional development conditions are not attractive enough. There is also a widespread problem of work overload and excessive bureaucracy.
Are there many differences between countries?
Yeah; According to a survey we conducted, patient quotas can vary between 500 and 3,500 patients between countries. Furthermore, the number of consultations ranges between 10 and 50 per day, while the consultation time can vary between 15 and 25 minutes.
You have mentioned the problems of work overload, bureaucracy or professional instability. Are they common factors in all EU countries?
The problems are similar throughout Europe, but the differences that exist in terms of the organization of the health system, working conditions and remuneration mean that the degree of satisfaction varies greatly. In general, a family doctor in Denmark, Sweden or Norway has a higher degree of professional satisfaction than a Spanish doctor. I have attended consultations with family doctors in Denmark, and there really is a big difference compared to my country, Portugal. The problems we encounter in practice are the same, but the way of working and working conditions are very different.
How can these problems be solved?
We must learn from countries where doctors feel most satisfied. In general, this involves, first of all, valuing them and offering them good contracts and good working conditions. The Spanish Medical Association has prepared a document in which it analyzes positive and negative policies in terms of retention of doctors in health systems. Unfortunately, decision makers tend to focus more on negative policies than positive ones.
What is your perception of the Spanish public health system? One of its big problems is maintaining its sustainability.
I have done internships and training in Spain, and the Spanish health system is probably the one I know best, after the Portuguese one. I am aware that each autonomous community has its own system, and I believe that Family Doctors in Spain have excellent training at the internship level (residency), as well as continuous training, and have great resolution capacity. Health centers, in general, are very well equipped. The remuneration of Spanish family doctors is slightly higher than that of Portuguese doctors. On the negative side, I think there is great pressure on care and job stability problems that generate a lot of dissatisfaction among professionals.
From the UEMO, what is the relationship with public administrations like? And with other entities such as the European Union of Medical Specialists? Do you think there are common problems?
Normally, the organizations from each country that are represented in UEMO are the ones that interact with national authorities; However, during the Portuguese presidency we want to get closer to other European medical organizations. Therefore, we always try to send UEMO representatives to meetings of other organizations and participate in the quarterly meetings of the presidents of European medical organizations. In this way, we agree on positions and explore ways to work together, because when we act in synergy or partnership we are always stronger and have more impact. This work is allowing us to develop excellent relationships with other organizations.
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