‘Nurses will be substitutes for family doctors’, storm over Moratti

“Nurses will also have a role in primary care, offering support and replacement to address the shortage of general practitioners. A trial” is “underway at some ASSTs” and “will be evaluated”. These are the words contained exactly in a passage of the speech that the Vice-President and Councilor for Welfare of the Lombardy Region, Letizia Moratti, pronounced yesterday speaking at a conference of Sidmi (Italian Society for the direction and management of the nursing professions). Words used to underline the “key role” of these figures “also in strengthening territorial medicine”. But they have aroused various negative reactions in the world of doctors and general medicine. Starting with the trade unions. “Alternate nurses for family doctors?”, Asks the Italian Federation of General Practitioners (Fimmg) in a note, labeling Letizia Moratti’s statements as “disrespectful, if confirmed.” , the Fimmg enters into the merits, and “disrespectful towards nurses, as if the latter were ‘little doctors’ and did not have a distinct and autonomous professionalism. Above all, however, these are disconcerting words for the Lombard citizens, many of them without a family doctor, who are offered a nurse as ‘substitute’. Here it is no longer a question of task shifting, but of war policies or from a developing country – the union raises the bar – Of course, in a context of this type, it seems superfluous to discuss professional liability or insurance problems “.” At this point we close the specialization schools “, thunders Guido Quici, president of the Cimo-Fesmed Federation medical union (to which Anpo-Ascoti, Cimo, Cimop and Fesmed adhere).” What do we doctors study to do for 11 years, if then the non-specialists of the cooperatives are allowed to work in hospitals and now the Lombard nurses are even allowed to be alternate doctors for general practitioners? But what do we want them to do in 6-year degree courses and 4-5-year graduate schools if what we learn there is not deemed necessary for our work? If the answer to the shortage of doctors is to hire anyone who can keep the patient company, without considering his or her training, we transform the degree course in Medicine into a three-year course and abolish specializations – this is Quici’s provocation – We would solve the staffing problems in the blink of an eye. So obviously the safety of treatments and the protection of the health of citizens are no longer of interest to anyone “. Finally, a rain of questions:” Councilor Moratti – continues Quici – has perhaps forgotten that the diagnosis and prescription of the therapies belong to the doctor? What should alternate nurses do? And does he really think that there are nurses willing to give up their fundamental role of patient care to take on responsibilities they are not prepared for? Would you be ready to be examined and treated by those who do not have the appropriate skills, and explain to citizens that anyone is better than anyone? And to honestly say that the situation in which Lombardy finds itself today is the result of years of incorrect planning, and not of some kind of unforeseeable disaster “?” People are not joking about their health. The Cimo-Fesmed Federation – concludes Quici in the note – will continue to defend the role of doctors from any attack of this type and in every area, even if the global plan appears increasingly clear: brazenly lowering the level of public health to reach its privatization. But we are not willing to remain helpless and watch “. The presidents of the provincial orders of doctors in the region also rise up.” arouse astonishment, even if they are inserted in a context of previous utterances that denote the lack of knowledge of the real problems and the concrete daily life of local health, but also of the foundations of the various professional systems in force in our country, certainly not derogable by a councilor who, indeed, it should be the guarantor “, they write in a note, recalling that” the current legislation entrusts the diagnosis and prescription of therapy to the doctor, alternatively being a criminal offense. It is singular that a councilor does not realize the difference between the professional profile of the doctor and that of the nurse, who has not understood how the two figures cannot replace each other “, point out the presidents of the Lombard white coats, highlighting” how for years it has been said and how it is envisaged both in the so-called Dm71 and in the PNRR “that these two figures” should be integrated into a team work, to be carried out side by side and not kilometers away, as it seems instead to appear in some projects ” , and “that a better definition of the current functions of the two professional figures is useful precisely to avoid overlapping and inappropriate confusions”. A scenario “like the one envisaged by Councilor Moratti – continue the exponents of the regional federation of medical orders (Gianluigi Spata, president of the Order of Como and of Fromceo; Pierfranco Ravizza, Lecco; Guido Marinoni, Bergamo; Ottavio Di Stefano, Brescia; Gianfranco L ima, Cremona; Massimo Vajani, Lodi; Stefano Bernardelli, Mantua; Roberto Carlo Rossi, Milan; Carlo Maria Teruzzi, Monza Brianza; Claudio Lisi, Pavia; Alessandro Innocenti, Sondrio; and Giovanna Beretta, Varese) – would open up to infinite problems of professional responsibility, on the merits of which it seems useless to express oneself, also in consideration of the ‘summer’ characteristics of these externalizations “.” Perhaps – they continue – it is better to consider them a communicative misunderstanding, however disturbing , when it comes from a leading exponent of a Region who insists on proposing itself as capable of producing advanced assistance models. We leave the judgment to the subjects most directly concerned, the Lombard citizens and their representatives to the mayors, who are demonstrating that they understand very well the substance of the problems “. Problems” including the shortage of nurses “, who” we therefore believe they do not have the time to propose themselves as substitutes and second choices for others. For our part, we reiterate the willingness of the Lombard Orders to collaborate in the hypothesis of reform of our Health Service, certain of being able to provide a report of competence which, in any case, is expressly provided for by law, even if, in fact, from our Region to date. completely neglected “.