Family doctors in Alicante see twice as many patients in September

What is a typical timetable in primary care? Many family doctors in the province of Alicante, and in the Valencian Community in general, see 40 to 50 patients per day. “That’s a huge number, it’s outrageous,” says Elche-based doctor Mari Ángeles Medina, head of the Valencian Society of Family and Community Medicine.

In this month of September, which is still a holiday in the healthcare sector, doctors who return to work are swamped with up to fifty consultations every day.

Scientific societies and the World Health Organisation (WHO) advocate treating no more than 20 to 25 patients per day, or fewer depending on the complexity, in order to give safe care and a more accurate diagnosis.

According to the doctors who talked with themselves, 30 patients, which is currently rather usual on any given day, is an overwhelming workload if the goal is to provide higher-quality care. The recommended consultation times are 10 to 20 minutes each patient, or 3 to 6 per hour, with a limit of 25 persons per day per primary care physician.

A third of the staff remains absent because September is a holiday month for healthcare professionals

In September, approximately one-third of doctors are on holiday. In addition, there have been conferences and training courses, doctors on call, sick leave, and days off. All of these instances are never covered, and patients are distributed among those present. We do everything and more than we can; we sincerely regret if patients do not receive the attention they deserve,” Medina adds.

This month is very busy, with numerous cardiovascular follow-up cases for patients who suffered from heat exhaustion and neglected their preventive measures and therapies over the holidays.

Medina argues that health centre physicians disagree with the Ministry of Health’s assertion that there is a delay in Primary Care. “It’s a hospital-centric concept. In Primary Care, we always see any patient who needs or wishes to be seen on the same day. “President Mazón said so,” he recalls.

Two weeks for a planned appointment

In terms of wait times, scheduled appointments currently take between 10 days and two weeks, although Medina maintains that urgent/emergent appointments are not delayed. During some times of the year, up to 65 patients are seen. “We are quite eager to defend this approach since we are judged by hospital metrics. Despite our reduced staffing, we always see every patient who asks it. It is only fair that we be recognised for this, as it involves a significant hardship and effort that is not reflected in the delay indicator.”

“Despite our reduced staffing, we always treat every patient who asks it. It is only right that we be recognised for this, as it represents a significant hardship and effort that is not reflected in the backlog indicator.”
He defends it “as a way of doing justice to our community, which, in addition to being dented every day, is measured by an unattainable goal and is kept in the public eye.” It appears that we are to blame for things not going as planned. “Enough talking about delays; we can’t fix them,” he says.

Closed agendas and patients with no designated doctor

September is a holiday month for doctors, so their calendars are hectic. Many of the remaining positions are empty, thus patients whose doctors are missing are split among those working. For example, at the Plaza de América health centre in Alicante, some doctors have retired. Patients must contact or come to the counter to plan an appointment with the doctor with the least amount of waiting time, unless the issue is urgent.

Radiodiagnosis

Medina notes that steps to streamline demand management in Primary Care are presently being implemented as pilot projects, while attempts to support diagnosis, such as the radiodiagnostic viewer, are in the works.

Doctor Rafael Pérez Trullás also confirms the patient load. On Monday, Sptember 22nd, he treated 36 patients at the Cabo de las Huertas health centre in Alicante, which is considered a “privileged area” with reduced demand. Doctors say that 40 to 50 patients per day constitute a “daily routine” at health centres like Pla Provincial Hospital, Campello, and Mutxamel.