Francisco Goiri Madrid

Madrid

Updated Tuesday, February 13, 2024-01:34

  • Health The Ministry of García willing to create more MIR training places in Family Medicine after pressure from the PP communities

Addressing the shortage of family doctors requires multifactorial measures, say professionals who practice at this level of care. Last Friday, the monographic meeting of the Interterritorial Council once again established a roadmap (at least of intentions) to tackle the problem. Mónica García, Minister of Health, showed her willingness to create more MIR training places in Family Medicine after pressure from the PP communities.

The Ministry of Health and the 17 Health Ministers sat down to outline an intervention plan due to the lack of doctors. García listed the

three major agreements reached

: reviewing the teaching accreditation criteria of Family Medicine units "without reducing quality"; that communities fill out the registry of professionals “to know where they are; now there is 30% left to incorporate”; and that communities "improve the working conditions of primary care doctors and their daily lives."

Because, regardless of the conditions and attractions for this specialty, the deficit of professionals exists, the numbers say so and the mathematics is stubborn:

if fewer enter than leave, there is a lack of people

. Pure mathematics. And fewer enter than leave.

To know more

MIR 2024.

Record number of MIR family doctor positions despite lack of interest in the specialty

  • Editor: PILAR PÉREZ Madrid

  • Editor: NURIA MONSÓ

Record number of MIR family doctor positions despite lack of interest in the specialty

MIR.

The lack of family doctors becomes endemic: "Serving 50 people a day is crazy"

  • Editor: CANDELA HORNERO

  • Editor: TOBÍAS BROWNE

The lack of family doctors becomes endemic: "Serving 50 people a day is crazy"

The

Spanish Society of Family and Community Medicine (Semfyc)

has taken the trouble to compile the accounts and make them available to those who met at the IC today. In 2021, four years ago, there were exactly 12,613 Family Doctors in the National Health System (SNS) aged 65 or over (31.8% of the total, according to official figures from the Ministry of Health itself), the same that next year they will have turned 70 (or older) and will have retired.

The question that Semfyc asks is: with those who have entered the system in that same period, is there room to replace those who leave? And the answer is no". "No", if we stick strictly to Familia residents who have graduated (and who will graduate) in the period 2021-2025. Semfyc's accounts (including estimates of graduates in 2024 and 2025) put the total number of new specialists who have entered the labor market in that period at exactly 9,940.

Ergo

, new qualified residents minus retired doctors, is equal to -2,673 physicians.

Pure mathematics. Stubborn math.

In 2021, more than 12,600 family doctors were 65 years old or older. Does the SNS have relief for them in 2025?

And we do not take into account the percentage of those 9,940

new

specialists , from the last five years, who, for one reason or another (mainly, working conditions), are not working in the system, do not practice as a family doctor in any of the 17 health services of the SNS. The same health services that today, by the way, told the Ministry of Health that what needed to be talked about was the lack of professionals.

THE LACK OF PLANNING BEFORE 2018

Sticking exclusively to the entry/exit flow, the report that Semfyc makes available to any health official who wants to read it states that the fundamental cause of the current deficit of Family doctors lies in

the low number of positions in the specialty that were announced before 2018

, "along with the high number of retirements recorded" in those years.

The data speak again: while the total number of MIR places has grown gradually until the last call (from 5,023 in 1995/96 to 8,875 in 2023/24), those in Family Medicine were always below 2,000, until in the 2019/20 call (the one prior to the declaration of the pandemic)

they exceeded that figure and began to grow steadily

, until reaching 2,489 in the last call.

In fact, from the MIR 2018/19 call to the current one, the percentage increase in the total number of MIR places that were announced in the public system is practically identical to the percentage increase in Family Medicine training positions in that period ( 31% and 30%, respectively).

Correction factor

.

A little late, according to Semfyc, but correction factor.

So yes: looking only at the

entry

versus

exit

binomial , the figures show that the SNS has been slow and short-sighted (to put it mildly) in realizing that the system was going to need more family doctors in the medium term. Once this fact has been confirmed, says Semfyc, this is where the term

"multifactorial"

comes in , the one that - let's cross our fingers again - health officials must know how to place behind the noun

"solutions"

.

WHY IS THERE NO REGISTRATION OF PROFESSIONALS BY SPECIALTIES IN THE HEALTH SYSTEM?

According to the report of the primary scientific society, the management of the replacement rate of specialists in the SNS

should not be done specialty by specialty, but rather should be global

, "including both specialties with a surplus and those [read Family] with rates of replacement less than 1, which indicates a deficit in its supply".

Then what do we do?

Easy, Semfyc responds: use "instruments for analyzing the supply and needs of medical specialists in Spain that are continually updated." We were done.

This is called the registry of health professionals

, it had to be (by law) in operation in 2018, and almost 6 years later it is not "continuously updated" - as Semfyc says - nor are all the health professionals who should be included registered in it.

According to the Ministry of Health itself, approximately 30% are missing

.

Addressing the crisis requires "something more than simply reducing the cut-off grade or increasing Family places"

Apart from doing merely instrumental duties, the same politicians who meet today in the IC (and also those who preceded them and who will succeed them) should engrave in themselves a principle that Semfyc repeats again (as the Forum of Medical Doctors has been doing for years). Primary Care): The deficit of primary doctors and the improvement of the level require "

more profound and structural measures than simply reducing the MIR cut-off mark or increasing the number of Family places

, without assessing the total calculation of the supply of places for all specialties".

And that translates, among other things, into "a comprehensive approach that values ​​the quality of care,

enhances other professional profiles in primary care

, and also recognizes the crucial importance of Family and Community Medicine in the National Health System." ". To whom it may concern.