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The idea that every senior with a positive coronavirus test result should be examined by a general practitioner within 48 hours met with a cold reaction from doctors. Adding an additional obligation in the face of constant staffing problems in the health care system is just one of the reasons. Because there are more of them. – In fact, this regulation reduces the availability of doctors in clinics. Because not all clinics have the option of separating a room where it will be possible to examine a patient with coronavirus – says Dr. Małgorzata Stokowska-Wojda, an internist and family doctor from Łaszczów in the province of Łaszczów in an interview with Medonet. Lublin.
- We want every positively tested citizen who is at least 60 years old to be examined by a general practitioner within 48 hours, said Prime Minister Mateusz Morawiecki on Friday.
- In this group, the risk of death or severe disease is the highest, so medical assistance must be provided relatively earlier, explained Minister of Health Adam Niedzielski.
- This regulation has nothing to do with medical indications – comments the idea of the Ministry of Health Dr. Małgorzata Stokowska-Wojda
- We are so burdened that retired doctors who work in the POZ by the hour will give it up. The staff is crumbling, and the minister adds the work – adds the doctor
- More information can be found on the Onet homepage
Examine the infected person within 48 hours
The Ministry of Health published an ordinance on Monday stating that a primary care physician is to examine patients over 60 years old who have been referred for isolation because of COVID-19 detection. The examination should take place within 48 hours, it can be performed at a primary health care clinic or during a home visit at the patient’s place of stay.
– This medical help must be provided relatively earlier and hence the examination is obligatory – said Minister of Health Adam Niedzielski at the Monday press conference. – This obligation results, inter alia, from on the one hand, there were many complaints both with the Patient Ombudsman and the National Health Fund about the limited availability of a physical examination, and on the other hand, I have examples of doctors who saved patients in such a professional way from going to hospital – said the head of the Ministry of Health.
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Last week, we asked the drug for a comment on this regulation. Jacek Gleba, a family doctor from Warsaw. This is nonsense – he said shortly.
Regulation inconsistent with medical indications
We also talked to Dr. Małgorzata Stokowska-Wojda, a family doctor from Łaszczów in the province Lublin.
– This ordinance has nothing to do with medical indications. Many infectious agents have said it misses the procedure, because not all positive seniors require careful monitoring, and on the other hand, there are younger patients with a severe course of COVID-19, he says.
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– It is difficult for us to understand why this regulation was created and what it is supposed to mean. There is talk about the patient’s well-being, but besides those 60 plus patients who have a mild course of COVID-19 because they have been vaccinated with three doses, we also have many who are much younger but have chronic diseases, such as severe asthma and having hard time coronavirus. I test patients at my clinic and examine them immediately after the test. And I see that there are far more people who have not been vaccinated and are at risk of severe COVID-19, regardless of age – explains the doctor.
There is a shortage of doctors and appropriate clinics
According to the doctor, the new regulation may cause logistical problems in many institutions. – How to organize it? A more reasonable question would be how to disorganize this. We are to examine these patients ourselves. We go home visits or invite you to the clinic. And in the latter case, in order not to endanger other people, it is necessary to make a time split. Many patients who are under 60 and tested positive also need consultation. And they will have to be examined later, they will have to wait longer for the visit – he says.
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Another thing doctors have been talking about for a long time is staffing problems. There are fewer and fewer medics in Poland, our country is in one of the last places in OECD countries when it comes to the number of doctors per population. In addition, the situation was complicated by procedures related to the pandemic, namely the transfer of some doctors to covid hospitals from other facilities.
– After new covid wards were established, doctors from places where there were more of them, also from primary care clinics, were delegated to work in these hospitals. The burden of the fight against COVID-19 has been shifted to these hospitals. And at the moment, the only possibility for us to be able to organize it within the framework of the criteria ordered by the Minister of Health – because the Ministry of Health is responsible for the organization of the system – there is a transfer back – he says.
Doctors do not lack good will
The words of Minister Niedzielski from the Monday conference that “goodwill and work organization are needed” for the implementation of the ordinance attracted the attention of not only medics.
– The minister allowed himself to say that we can do it after 18. And that a little more goodwill is needed. I think that we have a lot of good will, it is difficult to accuse us of its lack. I felt as if I needed a ministerial decree for me to examine these patients. It sounded like that – the doctor does not hide her bitterness.
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– We test patients in our clinic, we have a separate entrance and the tested person does not come into contact with other patients, does not go to the waiting room. And if it’s positive, I change my clothes, go over there and test it. And it was done before the regulation appeared. And I’m not just speaking on my behalf. We diagnose these patients, make them as part of the clinic’s work or send them for a test, so we see and diagnose this patient. We have been doing for a long time what the minister says at press conferences. It looks as if the Minister of Health has no idea how clinics work, what we are doing there. This is a serious undermining of confidence in us. I do not know what it is for – adds Dr. Stokowska-Wojda.
– If there are a lot of unvaccinated people, if there are so many people in hospitals because of COVID-19, if there is a problem with getting to the hospital because there are limited scheduled admissions, then it is not undermining trust in those who are closest to the patient. it is reasonable – he emphasizes.
More and more responsibilities for doctors
A doctor from Łaszczów makes no secret that doctors working in primary health care centers have a lot to do. The regulation of the Ministry of Health imposes further obligations. This will increase the physical and mental strain on the medics. – First, we’ll have even more work to do. After all, we also admit patients who did not fit into hospitals because there was not enough space. The second thing is mental fatigue. We are so burdened that retired doctors who work hourly in primary health care centers will resign from it. They have a livelihood, they don’t have to. The cadres from POZs are crumbling, and the minister is putting in place work – says Dr. Stokowska-Wojda.
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– At the moment, in my clinic, I vaccinate, test, monitor people with COVID-19 and see all other patients. Even before the new idea of the minister, I had a lot of responsibilities. It was recently counted and it turned out that we currently have 20 percent. more visits than before. I have a one-person clinic. Two doctors help me, one two hours twice a week, the other four hours twice a week. Thanks to this, working on the tab, I can carry out vaccinations. But these people do not have to work, they have a retirement pension. And there are many such institutions. If those doctors who help crumble, the results will be dire. Human resources are decreasing and must be managed wisely – he adds.
The idea of the minister of health is a scam
Małgorzata Stokowska-Wojda is straightforward. In her opinion, the regulation of the minister of health is a fraud. – This is saying: patient, see how much the minister provides you. In fact, this regulation reduces the availability of doctors in clinics. Because not all clinics have the option of separating a room where it will be possible to examine a patient with coronavirus. In our clinic, when healthy children are vaccinated, they are invited in so-called time separation, when there are no sick children at the clinic, so that they do not mix. If it is necessary to implement the ministerial regulation, then such a time separation will have to be introduced, and then a patient who is not pointed by the finger, that has COVID-19 and is over 60 years old, will not be able to be examined – he explains.
Do you want to test your COVID-19 immunity after vaccination? Have you been infected and want to check your antibody levels? See the COVID-19 immunity test package, which you will perform at Diagnostics network points.
– And we know that after three doses of the vaccine, the symptoms after infection are mild, a person with a positive result usually has a slight runny nose, but such a patient should be isolated, not because he is seriously ill, but because he does not spread the disease further and infect others. So when we deal with them, we won’t be taking care of sick people for reasons other than COVID-19. Something for something, he says.
Dr. Stokoska-Wojda points out one more aspect of the new regulation that appeared quite unexpectedly. – I have just received information from my friend that there was a statement from the minister who spoke about why the visits must take place within the first 48 hours. Because it was strange for us, because usually the condition of a patient with COVID-19 deteriorates on the fifth or sixth day after the virus is detected, and not in the first two – says the doctor.
– And now it turns out that we are also supposed to distribute a drug against COVID-19 to these patients. Because if I am supposed to be a courier in all this, it is a misunderstanding. I really offer my patients a lot and I would like to say immodestly that they are well cared for. And carrying medicines to patients is no longer a task for health care, but for social care – concludes Dr. Stokowska-Wojda.
Also read:
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