“With forty or fifty patients a day it is impossible to make good medicine”
Segismundo Blanco wanted to be an engineer but his mastery of mathematics was not up to his plans for the future, so he decided to follow the family tradition and become a doctor. In 1981, the man from Estrada began working in public health. These days, after 42 years, the doctor has made his last shift at the Estrada health center, his last job occupation after closing his dental clinic with the arrival of the pandemic. We talked with him about his career, the situation of medicine in Galicia and his plans for the future once the gown is hung up.
–You have several doctors in the family, did the idea of dedicating yourself to medicine come from there?
–My first option was not to be a doctor but I ended up falling into medicine. My intention was to study telecommunications engineering but my mathematical base was quite short. I had to change my option and since there are many doctors in my family, that option arose. That was how I began to study the degree, and I liked it. In the end it went well. At that time, I also lived with an uncle of mine who was a doctor, and that had a lot to do with the idea of dedicating myself to this. We are talking about the year 1973, when I began to study in Santiago.
–When you finished, did you start working in public health?
-No, then I had to go to the military. It was when I came back that I started working as a general practitioner. The first place I was in was in A Cañiza. I was moving through various places, also with substitutions in A Estrada. It was a difficult time because there were many doctors at that time, so there was little work. We were sharing the vacations of the colleagues who had a place. Later they gave me a contract in Salvaterra do Miño. I was there for a year and then I went unemployed. Shortly after I applied for some oppositions from the Xunta to work in preventive medicine. I spent two years there working in Pontevedra. That’s when the opportunity to become a dentist arose.
-A major change.
Yes, some friends of mine who were going to the Dominican Republic to study dentistry convinced me. It didn’t take much to convince me either, because at that time the work for doctors was rather scarce. It was an opportunity and I took advantage of it. They spent two years there to become a dentist. Later, when I returned to A Estrada, I set up my dental clinic and spent thirty years working as a dentist. When the crisis began, back in 2009, it was when I went back to work in primary care. From there I was alternating between both, until 2020, when I closed the clinic. With COVID, everything had become very complicated and a very large investment had to be made. For three or four years it was not worth it for me to do it, so I closed and dedicated myself only to the clinic, until now. The truth is that I was already tired of working and decided to quit for good.
Those two years in Santo Domingo must have been quite an experience for you.
–Yes, it was very nice and it also gave me the opportunity to study again, something that, secondly, you did with more affection. Today it is difficult to imagine but at that time there were many Spaniards studying dentistry in the Dominican Republic, because there was a very good agreement between the Spanish and Dominican universities and they easily validated the degree. Not now.
–Did you find competition as a dentist in 1990?
– Quite a bit, although the franchises had not yet appeared, which are a ruin for dentists and the patients themselves. They use tiny materials and sometimes leave the treatments half done when they close. You can’t complain to anyone there. Nobody gives hard four pesetas. The prices are more competitive and they offer you implants for 200 euros but you can only do that with horrible materials.
– How do you assess your stage in public health?
–I had to live a very interesting time because I lived through the establishment of the electronic prescription and the electronic medical record. We stop using folders full of papers to use programs that are relatively good. I also had to experience the degradation of primary care. Using schedules with forty to fifty daily patients it is impossible to make good medicine. It’s chaos. In addition, the pandemic had to be dealt with, when the volume of work became gigantic. Now it has gone down a bit but there is still a strong pressure on care. We need more doctors and pay them better. Doctors leave here because they don’t pay well. The bad policies, the policies of cuts, caused a diaspora of doctors. There are Spaniards all over the world. We train them at the price of gold and they leave because they have no future here. Someone needs to slam the table down and stop this, but I don’t see the point of doing it.
“We received awards because things are being done well”
–Does everything depend on the working conditions found at the end of the degree?
–If in other places they pay you more and you have better working conditions, you leave, obviously. Why does Madrid have the problems it does? Why did they fire the doctors? They are close to areas like Valladolid or Burgos, where conditions are better. Something similar happens here. Also, young people are fluent in English, so they can go anywhere.
-At the local level, you also had to experience the change of health center.
–Yes, we left a center that was expired to a new building with all the comforts. The change was gigantic. It was an interesting change. This center receives awards but because things are being done well. We have a magnificent coordinator, who is the one who does much of the work on the awards. The rest of us pitch in but he is the one who does all the work. The merit of all is to agree with him and do things together and in a certain way.
-In these forty years medicine will also have changed a lot.
-Fortunately, yes. Despite the obstacles that put us has changed for the better. Right now we have many more means and the training is getting better. That’s how it works better.
How do you face this new stage in your life?
–Now it’s time to rest, which I need, and then try to do some of the things that I couldn’t do due to lack of time.