The Federal Constitution was amended on May 18, 2014 as follows:
“Art. 117a (new) Basic medical care
- Within the scope of their responsibilities, the Confederation and the cantons shall ensure adequate, high-quality primary health care that is accessible to all. They recognize and promote family medicine as an essential component of this primary care.
- The federal government shall issue regulations on:
a. education and training for primary health care professions and on the requirements to practice these professions;
b. the appropriate payment for family medicine services.”
In the recent past, it has become a tradition in Switzerland to look at the practical consequences of a voting proposal after a battle has been won or lost. Thus, there is great joy about the won vote “Yes to family medicine”. The family doctors were actively supported from all sides. Only a few voters seem to have noticed that the position of the family doctor has been strongly relativized, even devalued, with the counter-proposal that was accepted. Here are some excerpts from the Federal Council’s message on the popular initiative “Yes to family doctor medicine” of September 16, 2011:
“… What is needed, on the other hand, is flexibility in the sustainable further development of the current range of services towards better coordinated primary health care that is needs-based, of high quality and at the same time cost-efficient. This can only be ensured with the involvement of all professionals working in primary health care for the benefit of patients.”
“… Therefore, in the future, more work should be done towards integrated care, in which other specialists in primary health care are also involved in the consultation, triage and treatment of patients. Pharmacists, chiropractors, other medical specialists (e.g. in telemedical consultation), nursing specialists or persons from other therapeutic professions should be considered. Likewise, the important role of medical practice assistants (MPAs), which is repeatedly emphasized in the initiative documents, is undisputed. At the same time, not all tasks can be assigned to them, especially in the case of patients with complex multiple diseases. For this, other, specifically trained specialists (e.g. nursing) must be involved.”
“… Within the framework of primary health care, family medicine is explicitly mentioned as an essential component. This is against the background that family medicine – even if not in an exclusive manner – represents the backbone of primary medical care and assumes or can assume an important task for the comprehensive care of patients. Conversely, it is clearly stated that primary care is not monopolized by family physicians or by other medical or non-physician professional groups. In view of the increasingly interdisciplinary nature of primary care, this would not be very forward-looking and could even jeopardize supply if there were a corresponding shortage of primary care physicians. …” [1]
In the world of highly fragmented medicine (one to two specialist titles per organ and disease) and the expected flood of independently working non-physician primary care physicians, a broad, well-founded knowledge of general medicine is of very great importance for future family physicians for the benefit of our patients. Let’s stand up for it!
Literature:
HAUSARZT PRAXIS 2014; 9(6): 1
