Doctors practising “disaster medicine” as patient numbers skyrocket

Not enough doctors for number of patients 

Portugal’s doctors are practising “disaster medicine” in several health units where the volume of patients is excessive in the last week of the year, the national doctors’ federation (FNAM) announced today.

“The closure and restrictions of almost half of the accident and emergency departments (A+E) from north to south of the country is something that has become trivial in this ministry of health led by Manuel Pizarro, who has not had the competence to attract and retain doctors in the National Health Service, in a year when the number of doctors retiring has peaked at 822,” the union said in a statement.

According to FNAM, doctors are overworked and “without adequate conditions to carry out their duties”.

“The shortages multiplied over Christmas, and the worst is feared for the last few days of the year, where the periods after the celebrations are traditionally more demanding for the A+E departments,” warned the federation, highlighting situations in which medical teams “usually operate below the minimum staffing levels” and that put doctors and patients at risk, such as the A+E department at the Santo António University Hospital Centre in Porto.

According to the FNAM report, intern doctors “have been forced” to make up for the shortage of specialists and there are days when “a single intern doctor is working in an internal medicine emergency department, and at the same time there are at least 140 patients admitted under the care of this speciality, with no specialist doctor on the internal emergency roster”, a situation that is expected to continue from January onwards.

 “In addition, doctors have been the victims of illegal deregulation of their working hours, with a six-day working week, without being granted compensatory rest after working on Sundays and public holidays,” said the same source, stressing that the payment of overtime to interns has yet to be settled.

FNAM also said that at Leiria Hospital, the situation has become particularly serious, with services dependent on just two specialised doctors and two general interns, who “don’t have the necessary experience to perform medical acts autonomously with the necessary safety for patients”.

“During the night of Christmas Eve, the entire hospital was left to one specialist, two general practitioners and two 1st and 2nd year interns. All the other accident and emergency speciality departments were closed: Cardiology, Gynaecology, Surgery, Paediatrics. Internal Medicine has been closed since the night of the 24th and even so, patients have continued to arrive by their own means and by ambulance without contact with the CODU (Urgent Patient Guidance Centre),” it said.

In the Algarve, there are some A+E departments that alternate between Faro and Portimão hospitals, without the capacity to operate at the same time. This is the case with Paediatrics, Gynaecology-Obstetrics, Gastroenterology and, more recently, Urology,” said the doctors’ representative body.

In the same document, Fnam also said that it is making available to doctors a declaration of declining functional responsibility, with the aim of “rejecting any and all responsibility arising from the practice of medical acts”, whenever they are faced with inadequate conditions for the exercise of their functions, and challenged the next government to negotiations.

Source: LUSA