Hospital emergency: 91% of doctors on leave and more than half of departments in crisis

Hot summer in the internal medicine wards of the country's hospitals where mainly elderly and chronically ill patients are admitted: between June and September, more than 91% of doctors take their 15 days of holiday in the summer. This leads to a reduction in staffing levels in the wards - already struggling with chronic staff shortages - of between 21 and 30 per cent in 48 per cent of cases, between 30 and 50 per cent in 19.4 per cent of wards, while the shortage is between 11 and 20 per cent in another 21.8 per cent of cases. In practice, more than half the wards are short of from one doctor in five to one doctor in two, with the risk of crisis.

The figures were released by the Federation of Hospital Internist Physicians, which is calling for a parliamentary enquiry into the wards of Internal Medicine. "We receive one million in-patients a year in our wards. Internal Medicine must be strengthened,' is the Fadoi demand. The summer problem does not stop with the wards; outpatient clinics, in fact, decrease their activities in 52.7 per cent of cases and close altogether in another 15.1 per cent of hospitals. On the other hand, 14.1% guarantee unchanged number and timing of outpatient activities. "The sacrifices made by doctors to cover the already chronic staff shortage are enormous," says Fadoi.

According to Fadoi's data, 56.8% of doctors between June and September very often see their weekly rest periods, which should always be guaranteed, skipped, while the 11-hour daily rest period is not always guaranteed for 26.7% of professionals. In the same period, 44.7% are obliged to cover night shifts with additional activities, while 28% are also called upon to guarantee emergency room shifts (4.4% only in the summer period), with between 12 and 60 hours per week in 56.1% of hospitals, while in 10.5% of cases the hours spent in emergency rooms is even more than 90, according to the survey.

"This,' denounces Francesco Dentali, president of Fadoi, 'is to the detriment of the activity of internal medicine, which is already understaffed and thus ends up losing further staff quotas, which instead of being present in the wards are given 'on loan' to emergency rooms. Internal medicine wards, Dentali continues, cope with the greater number of admissions with less available staff than other hospital operating units, due to a 'low intensity of care' classification that in no way corresponds to the medium-high complexity of the patients treated. And doctors and internist nurses are often co-opted into the emergency rooms to cover gaps in the staffing plan, thus shortening a blanket that is already too short and that is increasingly struggling to cover the care needs of patients admitted to internal medicine.

The survey will also be crucial to investigate regional differences and compliance with standards in the various territories. In addition, emphasises the president of the Fadoi Foundation, Dario Manfellotto, to be considered "the obstacle race to prescribe innovative drugs and for many chronic diseases". And the future does not look rosy either, in fact, according to the latest Anvur (the Agency for the Evaluation of the University System) data, in the academic year 2022/23 about half of the scholarships put out to tender in Internal Medicine will remain unfulfilled, with the risk of worsening the shortage of doctors and nurses, Dentali points out.