A new stage in primary care?

Antonio Fernandez-Pro Ledesma.

The XXVIII National Congress of the Spanish Society of General and Family Medicine (SEMG) provided a place to reflect on the future of the first level of care. A future in which professionals claim to be involved in decisions to put an end to a model they describe as exhausted.

In an interview with Medical writingPresident of SEMG, Antonio Fernandez-Pro Ledesma, reviews the main ideas derived from the annual event such as decentralization, implementation of new models of care, priority of chronic patients or diagnostic tests in the health center.

Antonio Fernandez-Pro: “The main tool we need is time.”

What is your assessment of the XXVIII National Congress of SEMG?

It’s very good. He met the expectations we had and had a very important level of interaction with many young people. People really wanted to be personal and this was noticed in the rooms, everything is practically complete and the level of interaction with the speakers was extremely important.

The number of streaming connections that were made when the nine rooms were live was also very important, and the truth is that there were thousands of questions about whether the presentations would be immortalized like last year and we will obviously be able to hold an open congress by mid-August. .

Did the hybrid format remain?

Yes, definitely. This is an excellent format, although it still needs to be polished a bit to complete the knowledge and accreditation of the online sessions. Removing these things to refine it a little more, the result is spectacular, I mean it’s a successful format without a doubt.

Were they able to adapt to family values?

We seriously believe that a new stage is beginning. Primary care in this country really needs to take another course. Occupational instability and professional malaise are noise. The politician and the manager must realize once and for all that they must rely on the professionals to perform this exercise. And this change will start sooner or later, since then the values ​​will remain the same.


“The politician and the manager must realize once and for all that they must have a professional”



What is the roadmap for changing the Basic?

The road map to follow is very easy. Stop doing what we do wrong. If we continue to do the same things, we will continue to achieve the same results. We saw that it was not a question of money, in Catalonia it was promoted with 9,000 euros and yet 20% of the vacancies remained vacant. Something more is needed.

It was clear at Rafael Bengoa’s conference, he said it without hesitation, and I completely agree with him. We need to start a clear and obvious decentralization, leaving the initiative to the professionals. This does not mean chaos or saving whoever can, nor does everyone do what they think is good, but you really need to have managerial autonomy. We have to apply other models because we are not going anywhere this way

Antonio Fernandez-Pro Ledesma, President of the Spanish Society of General Practitioners and Family Physicians (SEMG).

How is the gap between politics and the family doctor?

This is a void that takes many years, the non-experience of everyday reality makes you not see things the way you see them. There was a great distance between the manager and the ordinary doctor. So there was a lack of understanding and a lack of communication. Another atavistic evil that is our profession is the lack of connection or understanding between levels of care. We must be interconnected, this must be cross-cutting and there can be no order and control without professionals.

How can this difference be reduced?

Like everything in life, increase communication. That is, just consider the professionals. When you have to make a decision with a certain depth, to agree … It’s not complicated at all, it’s like a big family and it’s about looking for the common good, not about quick and quick solutions to complex problems, they are not so easy . The paper supports everything, but it really goes into the reality of the trenches later, and it’s not so easy to combine these protocols.


“Other models must be applied, we are not going anywhere this way”



How do you think healthcare has left Primary out of technological innovation?

It is reckless, thinking in this way, in my opinion, is due to ignorance and ignorance of what reality is. When the technological systems we have are absolutely outdated, when there has been no update for years, saying that technological repairs will be done and that the main thing is not needed, because if we do it in the hospital, we reduce waiting lists for Primary … Indeed, the only thing I think is that whoever did it does not know very well what the system is, because the problem is the difficulty of reaching the second level.

“We need to start a clear and obvious decentralization, leaving the professionals to take the initiative”

Should diagnostic devices be given to health centers?

Yes, family medicine has been saying this for a long time. One of the intentions of this society has always been to remove as much technology as possible from the hospital and to bring all technology closer to the general practitioner. Not because we have a desire for protagonism, but because what we do is bring the diagnosis closer to the patient. This reduces waiting time and uncertainty, thus increasing patient safety by being more accurate in diagnosis.


“The main tool we need is time”



Attention to chronic patients is another major topic of Congress. Can you make up for lost time?

I believe that there is a time that is irreversible. Cancers occur in later situations that we have diagnosed before. You need to insert your batteries and mark some priority criteria from the application. We need to have time to talk and look for that patient who has not had control for two years. The main tool we need is time.

How do you get more time?

The last major crisis we suffered in Primary Care in the sixth wave was due to bureaucratic problems, due to sick leave, something that could have been solved in another way. We need time for patients, if up to 35% or 40% of my time is spent on bureaucratic issues, then it doesn’t make sense. We also spend a lot of time from medical transport to solving second-level interconsults or requests for additional second-level tests. This is a situation that we need to put an end to, and we also need to improve the flow of patients in the system, with one-on-one consultations, decisive consultations and a little more.

What hopeful message for the future can you convey to your family doctor?

There are many. I always say the same thing, we are in a difficult profession and the situation is complicated, but we are also in the most beautiful profession in the world. This is the only specialty that has an ideology, not politics, but contact, brotherhood, there is a concomitant ideology. And this intimate moment of being with the patient face to face, just the two of you, is so intense and so passionate that I personally wouldn’t change it for anything.

Antonio Fernandez-Pro Ledesma during the interview at the XXVIII National Congress of General and Family Medicine.

Although it may contain statements, data or notes from healthcare institutions or specialists, the information contained in Medical Writing is edited and prepared by journalists. We recommend that the reader consult all health issues with a health professional.

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