In Milan, many struggle to find one and often those who have it are unhappy. But Dr. Andrea Mangiagalli, who even visited at home during the lockdown, is not in it. And he explains why it is (also) the clients' faultAndrea Mangiagalli, general practitioner with practice in Pioltello (Milan)
He, and he spells it to be clear, is a general practitioner. Andrea Mangiagalli explains it as he opens the door of his studio in Pioltello (Milan): he, like his colleagues, is neither a health care doctor like Alberto Sordi nor a general practitioner ('as if we were basics').
Having said that, Mangiagalli, who in his life also had the task of saving a patient who ended up in cardiac arrest in his office ('even general practitioners can find themselves doing exceptional things'), talks about his work.
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What led you to do this “profession”? «I chose it, I think, when I was five years old. Dad and mom were, let's say, 'family' doctors ».
Why are you few? “Because it's no longer a paying job. And it doesn't even have social appeal: you're the one who writes the recipes, the one who transcribes the specialist's exams. A specialist, then, can make a career. We do not'.
Was the relationship with patients once different? «The patient had a respect for the doctor, I don't say sacred, because it is excessive, but great. The doctor had your health information in hand. Now that's not the case: people come with the list, they've read it on Google, they've talked to their friend.'
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There are people who can't even talk to their doctor, let alone go to the office. It is one of the most frequent complaints. «Believe me, there are many general practitioners who work very hard. Of course, when the goods become rare, the service can become confused and hasty and the patient feels a lot per kilo».
How many hours does she work? «On average eight, this morning I saw 15 patients, I received 25 emails and 26 WhatsApps, the first at 9.02; I have 1,800 patients, I collect 6,300 euros, which becomes 3,000 net. I recommend you write the net».
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What do your patients ask you? 'I'll give you an example: today, out of 15, only seven came here because they had a real need'.
And the others? 'A patient came because his wife had seen a TV program and was convinced that her husband was losing his memory.'
Why all this insecurity today? “Diseases are overemphasized. If one has a very trivial vertigo that resolves itself in two days, immediately think of serious illness. If his neck hurts, he thinks his carotids are closed because he heard the day before that he was having a stroke. All of this means that no one has the ability to wait for a symptom to clear up on its own. So more requests to the general practitioner who is in short supply. In short, a short circuit ».
Don't you believe in prevention? «Prevention is the patient's active behavior towards a situation: I don't smoke, I eat well... It doesn't go through the medical sphere: the only noteworthy medical services are the search for occult blood in the faeces, mammographic screening and PAP test. End'.
So what do you recommend? «Health education: in the subways there are advertisements warning how climbing the stairs on foot saves lives. And, secondly, to equip general practitioners with instruments or throat swabs to understand whether or not a patient should take an antibiotic ».
In short, you feel like a sandwich. «Let's say between a rock and a hard place, between patients and the Region due to the continuous increase in bureaucratic tasks. And then there is another problem: many doctors try to please patients even with things that are not sustainable so as not to lose them. The doctor is paid per patient, so losing a patient means losing income.
And the work increases. «It has also increased because diseases have increased since the 1990s. Let me give you an example: while previously the parameters considered risky for blood pressure or diabetes were at a higher level, now they are lower. This means that there are many more patients who turn to the general practitioner, while there are many fewer doctors».
His job now seems devoid of satisfaction. «I have always liked making diagnoses and accompanying patients on their journey. Follow their medical history. Be there».
In reality, many patients feel abandoned. «It's not like that, but if they need to be pampered… yes, it's always more difficult. Moreover, it also happens that patients skip specialists and general practitioners and go to the emergency room: it is exactly like the shopping center, it is always open and has everything ».
And in all this she? 'I'm 62 and if the situation gets even worse I'll leave as soon as I'm 68. I don't feel like being a bureaucrat'.Source: oggi.it