Family Doctors: We are not heroes in white, but hostages of a dysfunctional health system!

(Patria) – FBiH Doctor’s Association of Family Medicine Doctors Sarajevo has sent a letter to multiple addresses in Sarajevo Canton.

“Doctors working in family medicine are by definition” gatekeepers “in the healthcare system. We are like soldiers on the front line of defense. We are the first contact in the healthcare system for our patients, but also the last to make decisions about their health with them. We are here to prevent, to heal, to facilitate the patient’s journey in the healthcare system, and to support our patients and their families.

Even before the COVID 19 epidemic, family medics were scarce staff. During the COVID19 epidemic, and according to Crisis Staff orders, we reorganized according to the instructions given.
We first formed H teams to go home and take swabs from the pediatric to the geriatric population. At the same time, we formed and organized triage checkpoints, centers for telephone support to citizens in which doctors arrive 24 hours, dispensaries for the admission of patients with febrile conditions and suspected COVID19. According to the orders, we complete epidemiological questionnaires, take sick leave, self-isolation, check the arrival of microbiological swab findings and report the results to patients. We make reports and record everything separately in patient records, transport patients according to indications, etc.

We are in constant communication with other health care institutions regarding the COVID 19 epidemic (epidemiologists, sanitary inspection, HMP and hospitals at all levels) to care for patients because capacity is limited at primary care level. Because of all this, but also attacking us as a profession, we are on the verge of strength.
In addition to the above we treat all other diseases and conditions that are not COVID19, organize outpatient clinics, go home visits and arrange transportation, supervise other health services.
Primary health care will not be destroyed by COVID 19 but by a closed and disorganized health system. For illustration purposes, in one of nine health centers, we received 444 phone calls in one working day and answered a number of questions from objectively frightened citizens.

Through mass media, they accuse us of not answering our fellow citizens, and the reason is that our telephone exchanges are unable to receive such a large number of calls.
At the time of the COVID 19 epidemic, family physicians simultaneously provide services and care for patients in social institutions such as the Public Institution for the Care of Mentally Disabled Children and Youth Pazarić with all employees, the Nedzarići Gerontology Center, the KJC Center for Children without Parental Care, the Student Home. Bjelave ”, which currently houses 127 quarantined people (2/3 of whom are from other FBiH cantons).

Family medicine doctors are also coroners who go to the center to take swabs for Sars Cov 2 from the bodies of the deceased. We would also like to point out that we have been providing daily health care at the Usivak and Blažuj Migration Centers for over a year, and yet our patients remain cared for. All this is done by only about 140 doctors of family medicine in the entire Canton of Sarajevo, of which one is in self-isolation and with confirmed disease COVID 19. The number of doctors is free to say “on paper” about 200.

One part is on maternity leave and maternity leave, one part uses the legal right to be with children up to 10 years of age, and one part unfortunately has a serious chronic illness, including malignancy. The average age of doctors in family medicine is over 50 years.

We would like to emphasize that family medical and JUDZKS are now transferring work related to COVID 19 patients from private polyclinics, institutes for student medical and occupational medicine, traffic workers, etc. Please note that our working hours are from 08:00 to 22:00 and at the call center 24h.

And now that we have organized, we have formed COVID outpatient clinics in all 9 municipalities consisting of call centers, triage checkpoints, outpatient clinics for the examination of febrile conditions and patients with respiratory problems (consisting of an RTG, a pulmonologist, a laboratory, swabs, home visits for these patients) and when we finally determined the patient’s path, for each municipality, we were informed that a reorganization at the PHC level was being made again, ie that 4 ambulances were planned for COVID 19.

In this way, we limit the health care of the citizens of individual municipalities to expand the service in terms of the formation of wiping points as planned. We find out about this reorganization indirectly, without any involvement and the right to give our opinion and to be consulted on this. The fact is that such a non-transparent process will directly jeopardize the provision of health care to the population of Sarajevo Canton.

To our knowledge, the FSF has awarded 90,000 tests for the CCC and 1,200 ZZJKS. For the residents of Sarajevo Canton, 1,200 swabs have been forwarded to JUDZKS and most of them have already been done. A strategy for testing health professionals is still not defined, although we are at high risk. Needless to say, we also have our families, grandparents and children we have to worry about. We are doctors, we chose this because we love this business and our patients. We give and we will do our best as we give it every day, but I ask that all those pursuing health policy and this crisis do not make unreasonable, illogical moves and do not do so in a completely non-transparent manner. Please include us in the processes that affect us, our work and our service delivery.

Your assistance is needed in the procurement of personal protective equipment, disinfectants, containers, sufficient number of vehicles, recruitment of medical and non-medical staff and mobilization of existing staff from other primary level institutions

We are not heroes in white, but hostages to a dysfunctional health care system, and obviously inadequate and non-transparent moves in which individuals perceive us as figures in the chess field, not as professionals and people who perform demanding and humane work. A large number of family physicians believe that it is high time to replace our workplace policy with the profession, “said in the letter.

Patria / Balkantimes.press

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