As a GP, I work at the community centre by choice, not because I have to. Here’s why

I want to go to the Community Home by choice, not out of obligation. Why? Because my job is to care for people. To care for patients I have known for years and with whom I have a relationship of trust – which is at the heart of my profession. That is why I chose this job: to be close to those who are ill. And this obligation takes away my time, my physical presence, my closeness. I believe the healthcare system is collapsing because we have given up on connecting with people, on really getting to know them. But if I do not know a patient, when they fall ill I will find it harder to treat them and will need to use more resources. They will feel frightened and lost, constantly seeking reassurance through tests – tests that are often unnecessary and difficult to carry out due to waiting lists.

Being obliged to spend part of our working hours at the Community Centre takes us away from our role; it forces us to do ‘other’ things rather than looking after our patients. We’re already short of time; taking any more away would, for me personally, mean reducing telephone contact with my patients, cutting back on home visits that aren’t strictly necessary, closing some of my six mountain clinics, and having to limit myself to the minimum clinic hours required. All this just to cross the valley and go to another area within the Community Care Centre to look after patients I don’t know – patients who already have a doctor, in the same situation as me, who hasn’t had the time to look after them! Anyone should realise that this is a paradox! Removing doctors from their local area also means forcing patients to relocate and depriving them of their sole trusted point of contact within a healthcare maelstrom that creates confusion and disorientation.

The other major problem is our future colleagues: our work no longer appeals to them. The relationship of trust and taking responsibility for patients, in all their complexity, have always been the main motivation for entering this profession. Forcing them to work gruelling shifts in community care homes, taking time away from getting to know and caring for new patients (because this is what the new ‘Single Role’ agreement requires), is driving them away. There are few applicants for the new vacancies, and a great many resignations after just a few months on the job. This is a dead-end path! Someone must absolutely step in to give us back our job, which is to be in our own clinics, in our own local area, close to the people we care for.

There are now a great many colleagues who do not want to compromise or have to give up their work, and who are organising themselves into spontaneous movements to make their voices heard, as demonstrated by the recent open letter from 700 doctors in Lombardy (now numbering 1,000) to the one million patients they care for, in which we professionals appeal for the support of our patients and the attention of the authorities.

I believe that community centres offer a great opportunity to develop local services and coordinate local resources, and that they can become a tool for gaining a comprehensive overview of the community. However, the idea of staffing them by taking hours away from GPs is not the right approach. This requirement runs counter to the patients’ own interests!
*General Practitioner in Val Brembana (Bergamo)