Doctors not only demand fair remuneration: they also aspire to more time and recognition. During the congress of the College of General Medicine which was held in Namur on November 15 and 16, the session devoted to “fair price” opened the debate on financing models and the distribution of tasks, emphasizing that the well- Being caregivers is just as essential as being a patient.
“The shortage is raging, general practitioners are overloaded, and the population at risk, made up in particular of elderly patients and chronically ill patients, is expanding,” recalls Dr. Lawrence Cuvellier (GBO) to set the scene for the session entitled “ What is a fair price for general practitioners and specialists? », at the 1st Congress of the College of General Medicine. “Despite this, we are struggling to obtain the application of the growth standard. »
Outdated funding?
On a budgetary level, it must be recognized that health care financing, largely based on fee-for-service and hospital day payment, is showing its limits. The question arises as to whether it really makes it possible to offer the best care at the best cost. “We could apply another funding model,” comments Dr Gilbert Bejjani (ABSyM). He evokes a “value based” model, in which the reference criterion would be the value provided, both to the patient and to the caregiver. But he highlights the complexity of implementing such a system, due to the great variability of care.
Delegate for better care
“However, some improvements could be implemented,” explains Dr. Bejjani. “By allowing caregivers other than the doctor to perform actions for which they are competent, we would free up budgets, because the services of these caregivers are less expensive. » Citing the example of deliveries entrusted to midwives in simple cases, he suggests reserving complex cases for obstetricians. This would free up resources to finance new care or better remunerate existing care, thus making it possible to do more with the same means.
The need for time, not just money
“What we need most is time, not money,” objects one session participant. Dr Bejjani responds that this distribution of tasks would free up time for doctors. The budgets released could also be reallocated to better remuneration, preventing doctors from having to work more to earn more. “We would do more and better with the same budget,” he insists. “There is a notion of subsidiarity in the distribution of tasks,” he adds.
Rationalize medical procedures
We should also question the usefulness of the services provided. Here again, budget and time savings could be made. “The colleague I succeeded very often visited some of his patients to check their blood pressure. I do it much less, which saves a lot of time,” explains another participant. Likewise, it is not always necessary for the doctor to take the blood tests.
A global approach necessary
However, the tools necessary for such a transformation are not all in the hands of doctors. Many determinants of health are not exclusively medical. It would be necessary to also address social factors, strengthen prevention and improve the environment. These changes would only be possible through networking, based on trust between actors, to allow a “reallocation of tasks”. Thus, according to Dr. Bejjani, it would be possible to improve both the well-being of patients… and that of doctors.
Recognition and respect
However, the problem goes beyond budgetary considerations in the experience of doctors. “There are other ways to value the doctor than through money,” exclaims a participant, just before the bell ends the session. He was referring to well-being, recognition and respect.
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