Iria Miguéns Blanco, member of the Board of Directors of the Spanish Society of Emergency Medicine (Semes).
The hospital emergency of the National Health System (SNS) live a structural excess of patients that goes beyond those related to the Covid-19 pandemic. In the last two years, these specialists have seen a continuous increase in people who, due to their own characteristics and those of their pathologies, should go to Primary Care, however, given the bad situation experienced by the first level of care, they choose to go to the Emergency Room to be treated as soon as possible.
“Since the end of the first confinement and in relation to the lack of efficiency of Primary Care for various reasons, there are a number of patients who are going to the ER”, points out Iria Miguéns Blanco, member of the Board of Directors of the Spanish Society of Emergency and Emergency Medicine (Semes).
The time-dependent pathology, which is the one traditionally treated by specialists in the Emergency Department, is still the predominantbut in relation to patient profile ‘extra‘ that fills the Emergencies, Miguéns Blanco points out that they find “everything” and each of these patients has “a reason for consultation that the population prioritizes”.
“There are since administrative doubtswhich are the least, to a increase in more banal pathologiesspecially in under 60 years. This can be attributed to the fact that some of them are patients who could benefit from outpatient devices or first aid from a Primary Care doctor”, explains the specialist.
In this sense, Miguéns Blanco, assures that many patients go to the ER because Primary Care “is suffering and we notice it”: “We also get patients with chronic diseases what could there be prevented breakdowns with a previous intervention in Primary Care”.
Difficulties in caring for ‘extra’ patients
As highlighted by the emergency physician, the care work of Primary Care and Emergency is “completely different”. “We are specialists in time-dependent pathologies, although we lend ourselves to everything as a network of the National Health System that we are, but the work with Primary Care is very differentiated and we need that everything works so that we can each dedicate ourselves to what we control”, claims Miguéns Blanco.
The specialist does not want to address the Quality of care offered, although he does acknowledge that he looks affectedand denounces that there are tasks that require a “continuity of care” that they cannot offer. “Of course we will pay attention to all kinds of patients, but beyond that there are processes that, due to the shape of the system itself, do not correspond to us,” claims the specialist.
According to Miguéns, the situation they are currently experiencing is “criticism” with a demand that is higher than the services they can provide, in addition, remember that the staff is tired after the overexertion made during the hardest part of the pandemic. For this reason, the specialist considers that it is necessary to take solutions to facilitate access to health centers and also think about how to care for the Emergency Department and its professionals.
“We have had a few years of brutal wear and tear and with emotional consequences that are talked about a lot, but the measures we expected have not yet been taken. we need to be taken care ofwe want to continue working, but in optimal conditions”, he claims.
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