Can’t find a doctor? Go to a vet – Health (otherwise)

In some regions of French-speaking Switzerland it is increasingly difficult to find a general practitioner, I receive requests daily in my office. In the absence of doctors, will it be necessary, as provocatively proposed by a resident of the canton of Neuchâtel, to be treated early by a veterinarian?

Finding a new doctor, a nightmare

The situation in French-speaking Switzerland varies from region to region, but the problem is clearly getting worse. It is increasingly difficult to find a doctor who accepts new patients, especially for so-called general practitioners, i.e. general internists. It is painful for me, when asked to follow a new patient, to respond negatively, particularly when the request comes from an elder. However, I have to do this, to save time for my patients and avoid burnout.

A shortage of doctors?

Switzerland certainly does not train enough doctors, it imports a large number of them from other countries. Among the trained doctors there are certainly too many who are moving towards specializations, in our country the balance between general practitioners and specialists must certainly be reviewed. This shortage situation would be even more serious if our politicians had not invented a health system with high deductibles that cause many patients not to consult when they are sick.

In the face of these patients who cannot find doctors, in the face of emergencies overwhelmed by the influx of patients, in the face of ever-increasing insurance premiums, are there no other solutions than veterinarians? In other words, should we stick to the equation “patient request = office consultation”?

The patient

What does a sick person do in 2022? To heal herself, she can use different pathways. First, if her health problem is not serious and she has knowledge, she can cure herself. Second option, you can consult Dr. Google, a source of information of varying quality. Third option, again for the simplest health problems, you can contact your pharmacist. Fourth option, a doctor.

Apart from the vet, any other ideas?

Shouldn’t we offer the population a more modern and efficient healthcare system in 2022? The first step would be to increase what are called “health skills” of the inhabitants of this country. This means that citizens should have more knowledge, both to take care of their health, nothing replaces prevention, but also to know how to cure themselves when they suffer from minor health problems. It could also be imagined that it is part of basic school education.

The second step is to go beyond the current equation “one health problem = one visit to the doctor”. Although the British health system is very different from ours, I was struck by this study conducted in a study where the waiting list to see a doctor was often several weeks long. By implementing a triage solution, i.e. asking patients to say why they wanted to see their doctor, the waiting list disappeared: a third of patients were redirected directly elsewhere, a third were treated remotely, so more quickly, only the last third came to see their doctor eventually.

Telemedicine must therefore be developed, both to treat more easily at a distance what can be treated, but also for its triage function, a widely underutilized tool in our healthcare system. A good example of what should be used and developed is the site, which allows for just this triage and, when possible, to remotely solve your health problem. This solution is used by several hospitals, such as that of La Tour in Meyrin, Bienne and soon the hospital network of Neuchâtel, to better sort patients and discharge their emergencies. At, the professionals who take care of you are all doctors who also work in private practice. This system is not sufficiently known to patients, it is also, I believe, not sufficiently supported by healthcare professionals. There are few doctors who, in their absence, offer their patients the use of the services of in parallel with the solution of the doctor on call.

And apart from the doctor?

The last consideration to be made in the face of the shortage of doctors is whether, in addition to the doctor, other professionals should not be involved. Personally I think that when faced with a sick person, even if the doctor will often remain the privileged interlocutor, one must imagine a medical team. In a sense, this team already exists as medical assistants effectively answer many of patients’ questions. However, it must be developed with the integration of nurses and nurses, ideally with advanced practical training, i.e. the acquisition of knowledge that allows them to be autonomous in solving health problems, the simplest ones, for alternate follow-up. with the doctor of people with chronic diseases but also for health promotion.

Otherwise, the last option, the vet.

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