Via layoffs to employees studies? One way to destroy general practice
In Turin there are 680 family doctors, high average age, if we assume the farewell at 65 within 10 years 465 will have left and a few dozen will be added to the 215 remaining colleagues. But in the rest of Piedmont things are no better. «Colleagues are trained in Turin and mostly come from Turin, the replacement is here, while already today in Bra there are five unfilled shortages and in areas of Verbano and Biellese it is not possible to replace those who retire. What's more: our prospective study according to which by 2020 more than one million Piedmontese may no longer have a trusted doctor, and almost 2 million by 2024, illustrates a trend that can be reproduced in all regions of the Po Valley, where the balance exoduses-inputs of MMGs became negative before the 
peak of retirements due to the high age of the category». Alexander Dabbene, secretary of Fimmg Continuity of Care Piedmont, confirms the disturbing data of the statistical survey of the Training and Continuity of Care sectors of Fimmg Piedmont. On a regional scale, between now and 2024, 2278 mmg will go away, 68% of the total, replaced by only 748 new doctors, a negative balance of 1530 doctors, about 2 million patients. But why so few entrances? «The projections come from three statistical calculations whose results overlap. Meanwhile, of the 900 doctors now in the ranking to participate in calls for assignment of deficiencies in Piedmont, only one 9% is both a resident in the region and holds a diploma in general medicine; of the others in the running, one 50% does not have the title of specific training, others have it but are not in Piedmont and to these must be added various doctors from 118, from other sectors, etc. who reside elsewhere but have held a place in this ranking. In the end – Dabbene reiterates – only 150 are ready to take over. The same number, 150, is obtained by adding together the doctors who in the rankings have the adequate score to assume deficiencies, and the doctors who participate in the calls for competition. We can say: “they are always the same…”, and if we add the next graduates, about 80 per year, we arrive at the “famous” 748 who are not enough to replace the exoduses». Remedies? In the long term, more course participants should be increased. In the short term, Fimmg asks that a hundred doctors begin to be recovered, allowing entry into the ranking a year earlier. How you do it? «If a colleague graduates by December of this year, he can apply for the ranking in January 2015 and enter the list by the end of that year, ready for the 2016 calls, and in the meantime can only assume provisional positions. If one could apply before entering the third and final year of the course, one year would be recovered». This is what Fimmg Piemonte asks for.
Mauro Miserendino
Saturday, September 13, 2014 – Doctor33
Via layoffs to employees studies? One way to destroy general practice
«Removing social safety nets from employees of professional offices is a government decision that causes enormous concern among family doctors and in particular in Fimmg. It's a way of preventing the development of general practice." Thus Fiorenzo Corti, communication manager of the Fimmg union, joins Andi and the dentists in stigmatizing the outgoing decree of the Ministry of Labor which denies layoffs by way of derogation for this year to employees of professional studios. The decree had a troubled process: it was created to restrict the types of redundancy payments that could be granted to small companies (the CIGS by way of derogation is a conquest of the last few years of "well-being", in 2004), and it removes the wage integration also from apprenticeship and job administration, but here the regions are opposed. Now, access to the benefit was growing and providing relief for professionals: in 2012 - reports Dentistry 33 - 106 dental assistants had benefited from layoffs, and the following year they had more than doubled, reaching 244 (data from Confprofessioni ). General medicine is not affected by the crisis data on dentistry turnover, but in recent years it has acted as a driving force for employment with 1200 more hires in 2013 alone and of these 500 regarding study assistants, figures who are about to be hired with a contract ad hoc equal to the IV super level of employees of professional firms. Corti explains: «The idea of thinking that 16,000 studio collaborators are “fireable” is not just a theory. The question concerns us deeply. We maintain that our collaborators should be employed by the family doctor or by the general practice service companies. If someone thinks that these figures for whom a contractual framework is envisaged, indirectly or otherwise, even to be more relaxed at work, have to go to work for the local health authorities or other structures, they put a wall in the relationship of trust that over years of hard work has it is established between study collaborators and clients of the general practitioner. Fimmg will defend the contractual achievements of these years with tooth and claw».
Mauro Miserendino
