Internal outpatient specialist: between cutting-edge technologies and initiative medicine, a reorganization that places the patient at the center

by Luciana Cois

Despite the undisputed potential of Internal Outpatient Specialization, too many gaps prevent its optimal development. Suffice it to say that, after almost a year from the date of operation of the ACN, the process for the RIA was concluded only in very few regions, which could guarantee suitable health objectives, as well as the paths and operational tools to implement them consistently with the needs of each SSR

09 JUNE –

A society like ours, deeply affected by the pandemic still in progress, needs a National Health Service that places the person and their needs at the center and that integrates the moment of treatment with that of health promotion and disease prevention.

An objective that can only be achieved with a reorganization of services in which local medicine, and in particular outpatient specialists, takes on that central role that it does not yet have. A role widely reiterated in Ministerial Decree 71, but which we would not like to remain only on paper.

It is necessary that the Outpatient Specialist can make use, within the nascent community homes, of the latest generation tools, such as to present extremely timely diagnoses and to direct only the patients manageable exclusively in this area to the hospital structure. The adaptation of the instrumentation would also allow to carry out a large part of the diagnostic and therapeutic services provided by the nomenclator in the territory. And the technological innovation of IT equipment would allow a real start of telemedicine.

Only in this way, for CISL Medici, will it be possible to focus on the needs of citizens and not only on the treatment of individual diseases, creating an initiative, proactive medicine, different from the waiting medicine typical of hospital care. Thus creating a stable relationship with the patient, not limited to the treatment of the single episode. To offer an all-encompassing, continuous, person-centered service capable of coordinating care at different times and according to the different and undeniable specialist skills.

In this direction, the key proposal of the CISL Medici consists in:

• strengthen the number of AIDS in outpatient clinics starting from the hourly completion of specialists already in service. In fact, it seems absurd how, with the serious shortage of specialists in Italy, this disconcerting anomaly has not yet been intervened, preventing the activation of many shifts and, consequently, concretely affecting the waiting lists.
• Enhance multidisciplinary and team work and focus on integration and reunification between local and hospital medicine. Indeed, it is necessary to strengthen the relationship between hospitals, territorial specialist outpatient clinics and general medicine, also by implementing the health file.
• Realize a real care of the chronically ill, an effective filter in the hospital, diagnosis, therapy, prevention and support activities for GPs and PLS in alliance with the needs of citizens.
• Encourage, within each territorial unit, the activity of the SAI in team with all the health professionals necessary for a real proximity medicine activity – from doctors to psychologists, from nurses to physiotherapists – in order to create health paths and adequate lifestyles that can affect the well-being of the population.

Despite the undisputed potential of Internal Outpatient Specialization, too many gaps prevent its optimal development. Suffice it to say that, after almost a year from the date of operation of the ACN, the process for the RIA was concluded only in very few regions, which could guarantee suitable health objectives, as well as the paths and operational tools to implement them consistently with the needs of each SSR.

Our trade union association, through its national and regional coordination, is working to organize initiatives aimed at gathering useful observations from all members to improve the ACN in view of the next renewal. In this way, based on the opinions and experiences of those who live the medical function in the field every day, it will be possible to propose really useful changes, so that, step by step, the Internal Outpatient Specialist represents an increasingly avant-garde reality, present and aware, capable of responding to the real needs of patients and always placing the person at the center of his path.

Dr. Luciana Cois

National Secretary of CISL Medici

09 June 2022
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