Health Ministry extending powers of GPs

THE HEALTH Ministry is gradually extending the powers of general practitioners (GP) in the health care system in hopes of improving overall efficiency and promoting GP as a specialisation.

(Source: Sme)

Changes allow GPs to perform pre-surgery examinations and the regular treatment of patients with high blood pressure patients, and now the ministry wants them to provide regular treatment of patients with light forms of diabetes. Doctors specialised in curing diabetes as well as some diabetes patients protest the plan. 

As of April 1, GPs can take care for patients suffering from high blood pressure without any serious complications within so-called dispensary care.

“The main aim is that by extension of powers of GPs make this specialisation more attractive,” Health Minister Viliam Čislák said as cited by the Sme daily, adding that this should increase the number of GPs and improve services.

The new regulation sets what initial examinations should be done and who should perform them. After examination of a patient by a general practitioner, in case of an uncomplicated patient, the GP will keep them in  regular, dispensary, care. In case it is a complicated case, the GP will consult it with a specialist. If the condition of the patient requires it, the specialist will take over his regular treatment.

Extension of powers of GPs means that health insurers may increase payments to GPs for examinations and treatment as well as extension of the scope of medicines GPs can subscribe.

Specialists agree with this setting and see it as advantageous for them. According to Gabriel Kamenský, senior expert at the Health Ministry for cardiology, it would be very beneficial when light patients will not visit offices of cardiovascular specialists and they will be able to treat more serious cases. He pointed out for that some patients wait three months for an appointment.

“If those lighter patients were not going into our offices, we would have more time for those more serious,” Kamenský told the Pravda daily. He warned that they are 250,000 risky citizens in Slovakia who are not treated at all and that these should be caught in the network of GPs’ offices.

Peter Makara, the head of the Slovak Society of General/Family Practice SLS, recalled that GPs already now provide regular care to high-blood pressure patients, but new powers will enable them to report to health insurers provided care and collect payment for it.     

Diabetes cases

The Health Ministry wants to continue in extending power of GPs and plans to add them a power to take a regular care for diabetes patients as of the beginning of 2016. But this time doctors specialised in treatment of this disease call it an unprofessional experiment. They believe that this change will bring a worsening of medical care for diabetic patients and increase costs of health insurers. GPs respond that they already now provide regular care to patients suffering from lighter forms of diabetes and call for cooperation as there are expected to be increased occurrences of the disease in the future. 

At the question are especially patients suffering from the type 2 diabetes connected with higher age and obesity and patients in a pre-diabetic state -- those suffering from lighter forms of the disease and mostly are treated with diet and pills.  

The Health Ministry is just working on the regulation and claims that it is discussing with GPs and diabetologists about the regulation while the latter only uselessly worry the patients, the Dennik N daily wrote. The ministry points out that in the United States or European countries like the Netherlands, Sweden or United Kingdom specialists treat only complicated diabetes patients or those who already suffer from complications. Others are treated by GPs.

Diabetologists in Slovakia do not want the change.

“This would endanger health of patients, the quality of their life, worsened access to modern medicines,” said Emil Martinka, chairman of the Slovak Diabetic Society that represents the specialists, as cited by Denník N.

The Slovak Society of General/Family Practice SLS points to the increasing number of diabetic patients in Slovakia and that it is beyond capacities of diabetologists to care for all of them. It points out that there are more than 355,000 diabetics in the dispensary care of diabetologists. GPs treat additional 200,000 diabetic patients and other 200,000 pre-diabetic patients.

GPs complain that because of restrictions they cannot prescribe the most modern treatments for patients.

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