Family doctors concerned about chronically ill patients

in News · 04-07-2020 14:00:00 · 3 Comments

General and Family doctors are “very concerned” about the impact that the three-month stoppage of consultations and treatments due to the covid-19 pandemic have had on chronically ill patients who lack “permanent and careful monitoring”.

"We are still discovering what will happen with three months of almost total abstention" from the non-urgent care activity in the health of the population, said the president of the Portuguese Association of General and Family Medicine (APMGF), Rui Nogueira, in an interview with Lusa agency.

But chronic patients are the main concern: "We still do not know what are the cardiovascular consequences of heart attacks that are happening or have happened, how are patients with heart failure, kidney failure, diabetics, hypertension progressing", he stressed.

"We had up to 20 thousand patients with active covid (...) but we have a million other patients", warned the doctor, expressing a particular concern with oncological diseases that "do not give much room for manoeuvre".

"We have already obtained good responses for these patients, but we must have early diagnoses, which we may not be able to achieve", lamented Rui Nogueira, noting that cardiovascular and oncological diseases represent more than two thirds of the causes of death.

According to the doctor, confinement also brought other complications to the population, such as weight gain and mental illness.

"People have gained weight, we are already seeing this in the consultations, with gains of six, seven, ten kilos", he said,stressing that "confinement is the opposite of everything" what doctors advise users, how to get out of home and do physical activity.

As for mental health, he stated that "it is a reality that has not yet been properly studied, evaluated", and that, although it is not "a vital situation such as cardiovascular and oncological diseases, it is a very vast area".

"We have many patients with mental health problems, but now the problem that needs to be evaluated has increased even more," he defended.

Regarding what needs to be improved after the pandemic, the doctor defended that “it is necessary to invest in the IT area and in the administrative technicians” so that it is “easier for doctors to access patients and vice versa”.

“There are things that are still not perfect. Let's say 80 percent is, but the other 20 percent is missing. For example, one in five patients is still not well computerised” in terms of exam requests.

On the other hand, it is necessary that the users' phone numbers and e-mails are updated in the system. "There has to be a technical effort by the computer technicians to make the updating of these data more friendly, the doctor cannot do this work".

During the pandemic, doctors used teleconsultations to accompany patients, a practice that the doctor says “facilitates in many ways”. However, he affirmed, it is not possible to "do without the presence of the patient in most situations, but that does not mean that there are not many situations that are easily solved by phone or e-mail".

A situation that "is not yet resolved", and that Rui Nogueira says he does not even know "how and when it will be resolved", is that patients lose their fear and return to health services.

"There was an initial phase in which we called the patient to say not to come to the consultation, we evaluated it by phone, and only if it was really necessary to go, but most of the consultations were postponed," he said.

Now, the consultations are being rescheduled: "We have to run after them and they after us", he described, venting that "it is a disorganisation still to be resolved".

"It will take us four to six months to resolve this," he said, also warning of the increase in waiting times, especially in the region of Lisbon and Vale do Tejo, where there are 700 thousand users without a family doctor.

In this region, “there are 20 or 30 health units where half or a third of the population does not have a family doctor. And this is terrible”, he concluded.


Comments:

After reading Steve's and John's comments, I agree....mental health is being overlooked.

By William from Other on 06-07-2020 05:06

When will the governments finally recognise that the whole anti-Corona program was a disaster and should under no circumstances be repeated.

By John Dough from Lisbon on 06-07-2020 08:23

Question for Rui,
Why does everyone have to be registered to your Association?
Hippocratic Oath - let food be thy medicine and medicine be thy food"
Question Rui. Why don't you preach this?

50% non registered. Rural people work hard, live close to nature, grow plants & eat them, family orientated, live to old age and die.......... Is this to be outlawed under your expansion??.?
No Love Steve.

By Love Steve from Alentejo on 05-07-2020 11:06
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