The Primary Doctors Forum urges the Administration to enable the means before January so that temporary disability can be managed at all levels, and not only in primary
They have been warning for years and nobody pays attention to them, neither the Ministry of Health nor the autonomous communities. And the pandemic has shown – they say – that their demands are logical, feasible and quickly applied. In the absence of an institutional response, they set a deadline: the Primary Doctors Forum gives a period of two months to the Administration (all of them) to guarantee that temporary disability reports (TI) are issued at all care levels. on paper, from January 1, 2023primary would only assume the parts that derive from its clinical activity.
“Essentially, we want the first level to stop being the scribe of other care levels. If we continue to give sick leave to patients that we are not seeing, and who come to us from the emergency room or specialized, we will be clearly breaking the law, and we can get into trouble,” he warns. Ana Gimnez, CESM’s Primary Technical Secretary. The union representative admits that this is still a recommendation -and adds that the Family doctors “finally will do what they can”-, but she clarifies that “we have been warning for years and we are getting more and more fed up“.
The Forum that brings together all the organizations that represent first-level doctors staged yesterday at the headquarters of the Collegiate Medical Organization (OMC) a malaise that the successive waves of covid have increased: “Because they have shown the precariousness of primary, but also because they have shown that, if they want, the administrations can introduce changes that lighten the bureaucracy, and do it quickly”, he said Paulino Cubero, Semfyc spokesperson. An example: during the pandemic, the days on which it was possible to issue the sick leave and discharge reports in the same process increased from 3 to 7. “The communities took 3 days to enable the tool to make it possible. We now give them two months,” says Cubero.
The law to which Gimnez refers -and which, according to the Forum, would be violated by primary school doctors-, is the Royal Decree 624/2014which specifies in its article 2 that the sick leave will be “issued by the doctor of the public health service who has carried out the examination of the affected worker”. Anna Mara WhiteVice President 3 of SEMG-Madrid, recalled that “although primary care physicians have historically assumed this task, This decree establishes the obligation of all physicians to issue these reports in the same clinical act.regardless of the job, including consultations, hospitalization and emergencies”.
The Primary Forum estimates that the efforts resulting from this referral represent around 15% of the bureaucracy that the family doctor attends to on a daily basis. Although the total volume is difficult to quantify, Aurora Garca LernSemergen’s secretary, graphically points out that “Mondays are bad; we practically spend the day doing bureaucracy“. In tune with Cubero, García Lern adds that “the Administration has plenty of time to do what we ask of it; It is something much simpler than what was done with the recipes and, in fact, there are several communities, such as Catalonia and Aragon, that have already arbitrated specific measures in this regard, and others, such as Madrid and the Basque Country, which, in theory, They have a pilot going.”
But in addition to generalizing the model of temporary incapacity at all levels of care, primary care physicians demand that the Administration simplify the procedures, so that “unnecessary or useless bureaucratic aspects are eliminated, electronic procedures are generalizedthe models are unified and the possibility of self-justification of dismissal in very short processes is valued”, lists Garca Lern. In short, the Semergen secretary points out, “we only want to fill in what is really important for the follow-up of a casualty”.
There are, they say, countless examples of inane tasks throughout that process, and Gimnez has noticed the subsidy they are entitled to receive pregnant women who are low due to risk. The law says that, for the recognition of this subsidy, the interested party must ask the family doctor for a report that supports the situation of the pregnancy and the probable date of delivery. The CESM representative considers it more logical and effective that the obstetric history -which all pregnant women have- is “valid and sufficient” as a report to start the procedure.
In the same line, Hermenegildo Marcosrepresentative of Rural Doctors of the WTO, has requested that all non-clinical data be eliminated from the discharge forms, such as the national occupation code, “that the doctor ignores, the patient generally does too and that does not contribute anything”and that, in the case of the management of the temporary incapacity of patients assigned to mutual societies, “the same electronic procedure is followed as for patients of the general regime”.
‘Zero paper’ indeed
The Primary Forum also asks the National Social Security Institute to modify the Royal Decree on Temporary Incapacity to simplify the 4 currently existing groups based on the duration of the low “and adapt the deadlines to the estimated durations depending on the processes, eliminating unnecessary confirmation parts in long processes”.
In addition, in tune with the zero paper philosophy that, in theory, is sponsored by the Administration, the representative of Semfyc has demanded the publication, “as soon as possible”, of the decree “that regulatesguide the electronic model as an exclusive doctor-patient-company communication channel in everything related to IT”.