GPs do not make references to children to specialist doctors
A young boy who was injured on a bike last year and subsequently got a scar in the face now has to get a laser surgery to fix it. The GP, on the other hand, refuses to write a prescription for the boy, for the purpose of pushing the Minister of Health into the dispute of GPs and the health authorities.
This mimics sources mbl.is.
In a response to the health of the boy, it is stated that the Association of Icelandic GPs has directed recommendations to members not to make references to children for pediatric and specialty doctors if the GP has not been involved in the problem. The aim is to push the Minister of Health to repeal a requirement for a referral from a GP for children to pediatric and specialty physicians.
The mother is then advised that it is possible to book time with pediatric and specialty doctors without the involvement of GPs. Although the entry fee will not be subsidized « until the Ministry of Health changes its regulation ». This prevents the boy, such as. not getting into the operation but the process will probably cost the family more.
Margrét Ólafía Tómasdóttir, chairman of the Association of Icelandic GPs, reviewed the dispute of GPs and health authorities with mbl.is.
mbl.is/rax
Says unnecessary paperwork comes down to waiting time for GPs
What is this dispute about?
« This referral system for pediatricians was unilaterally placed by the health authorities in 2018. Since it was announced, GPs have strongly objected to it.
She says it is clear that GPs in the current staffing position cannot handle unnecessary paperwork when the waiting list to them is as long as it is. She adds that it is a pity to ask for meaningless paper, the paper because of.
« Of course, we want to provide professional services and work that we have been educating for twelve years, to provide health care. To write some paper just because of the paper, as in such cases – although this is certainly an unfortunate case – we have spoken for empty ears for many years. »
Does the paperwork come down over time that GPs have to care for those in need of the service?
« Yes. It takes five full -time GPs to fill out references to pediatricians. There is a lot of unnecessary paper we are doing, which we are trying to reduce due to a lack of staffing.
This conversation has been very slow in the ministry and it did not happen until we formed this action group of the Association of Icelandic GPs. He has been trying to resist that GPs do not have to do unnecessary paperwork that is not related to the professional assessment of the doctor but is only made to meet the requirements of the system. «
In a response to the health of the boy, it is stated that the Association of Icelandic GPs has directed recommendations to members not to make references to children for pediatric and specialty doctors if the GP has not been involved in the problem.
Photo/Coloubox
There is a need for professional assumptions, not just monetary
What change do you see?
« There will be no need for these references, which it is not really. There are only children who need references in the system, adults can order time with specialist physicians in town without the need for a reference.
This was set up by the Ministry of Health and the Icelandic Health Insurance as some kind of attempt to reduce costs in the health care system. «
How do you deduct references from GPs from costs in the system?
« The idea, on the paper, is that people are not going to pediatricians unless it is necessary. If the GP can handle the case, he does so because he is the cheapest part of the service. Thus, the number of those who go up to the second -stage service, which is more expensive service, would be reduced and thus the savings would be in the system.
There is such a system in the Nordic countries, but there is no habit for such a system here in Iceland. It is wrong to just put such a system on children, trying to create some threshold in the system so that they cannot look for a specialist as adults can do. There must be some professional assumptions behind, not just monetary assumptions. «
Do the children then not come to experts they need without these references?
« Sure they come, but they pay more if they don’t have a reference. »
« This was set up by the Ministry of Health and the Icelandic Health Insurance as some kind of attempt to reduce costs in the health care system, » says Margrét.
Photo/Coloubox
« Very strange » that a GPs need to « write some paper » for the operation to be
When asked, Margrét says a conversation between service levels is another matter. A GP who has a child and sees the need for a specialist in pediatrics to write a joyous reference, it is part of a conversation between service levels and is « a little different from the paper’s paper because ».
« This is part of another bigger, for example, we also want to stop writing physiotherapy references. We think people should be able to choose ourselves whether they want to go to a physiotherapist or not, » says Margrét. GPs write many other certificates just the certificate and not to improve any services. Many of them do not even require any medical knowledge.
She takes the boy in question and his operation as an example:
« If it is quite clear that it has to do an operation on the boy then it is very strange that the GP you have to write some paper for it to happen, it’s just really crazy.
The doctor never had to speak in a cross with the specialist’s assessment, it never exists, so some reference he writes has no professional value, but is just some management in the system.
If this is after an accident, it would have been natural for the doctors who met the boy after the accident to have made the reference. «
« If it is quite clear that it has to be done on the boy then it is very strange that the GP you have to write some paper for it to happen, it’s just quite crazy, » says Margrét.
Photo/Coloubox
Always stop the actions of a certain person
How do you respond to parents’ concerns that children and their health problems are being used in the dispute of GPs and health authorities?
« That’s not the intention at all. It is always the case that if you are going to make something known then there is a risk that it can be bitten by certain parties. It also affects people that waiting time for a GP is long and if it is possible to reduce the bureaucracy so that we can reduce the waiting time, then it would be great.
Regarding just this case, the GP refused to write a reference because he has not been involved in the case, which means he has no professional to add to what has already been decided elsewhere in the system.
Similarly, it would have been natural if the mother had had time with the doctor and discussed the matter there, rather than sending a message to someone who does not know the child. But it is always sorry if it turns out that the actions we are doing will come down to those who accept our service. «
Election promise to promote health care and home medicine
An inquiry says Margrét GPs have refused to write references to pediatricians since last spring. They have won « half victory » while Willum Þór Þórsson was Minister of Health, then part of the references has been canceled and pediatricians were able to refer to each other.
« We can’t understand why this has not been completely canceled. In fact, we have been promised twice, once while Willum was still and then again after Alma took over.
Is there a meeting on the agenda?
« We have been waiting to have an approved meeting since the beginning of April and have not yet received a date.
