The MIR, used to cover rural areas: "Attempts against the quality of care"

The areas of difficult health coverage, the "medical deserts", are and will be an increasing problem in the next decade, according to the General Council of Official Medical Associations (Cgcom).

Oliver Thansan
Oliver Thansan
06 July 2023 Thursday 22:22
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The MIR, used to cover rural areas: "Attempts against the quality of care"

The areas of difficult health coverage, the "medical deserts", are and will be an increasing problem in the next decade, according to the General Council of Official Medical Associations (Cgcom). Hence, through the national youth committee, it has denounced that resident doctors are being "used unjustifiably to alleviate this situation."

A study carried out by the Cgcom on the perception of young doctors regarding areas of difficult coverage (carried out with 52 members representing the 50 provinces and the two autonomous cities) reveals that 91% perceive the "medical deserts" as a problem in their province and 44.4% affirm that last-year residents are being used to cover said areas.

This, according to the study, not only undermines the figure of the professional in training, but also threatens the safety and quality of care with which the population in areas with difficult coverage must be treated.

"We want to warn that we are facing an emerging problem throughout Europe and that it can get complicated if we do not put remedies now," María Isabel Moya, vice president of Cgcom, explains to La Vanguardia.

Moya understands that the problem has a multifactorial genesis, "either because of the working conditions offered in Spain, the competition between autonomous communities, the difficulty of hiring in certain areas, the mobility that professionals now have throughout Europe or the conditions of life and infrastructures in certain geographical areas”. All this, he adds, "is complicating a basic principle of our health system, which is accessibility."

71% of those surveyed also confess that there are no initiatives in their province to assign resident doctors to areas with difficult coverage, and maintain that offering economic incentives in terms of travel or housing and improvements in working conditions would be a point of " attraction".

For Moya, not only would economic incentives be necessary so that residents who have been trained in a place with difficult coverage to remain in it, but other types of stimuli are also needed: "Scoring, for example, more in oppositions, also in the professional career... That is, benefiting the professional in some way”.

Family and community medicine, psychiatry, immunology and occupational medicine stand out as the specialties with the greatest deficit between now and 2035, and more likely to be affected by this problem.

According to the study, the "medical desert" implies the "continuous and permanent" inability of a population to access health services. Although this situation occurs mostly in rural areas, Moya recalled, during the presentation of the report that took place this Friday, that it also affects cities with high density and regional hospitals that find it very difficult to retain talent and hire medical specialists.

The difficult-to-fill positions, according to the report, are those that meet up to three of the 13 requirements that have been listed. Among these, that the distance or travel time from the health center to the reference hospital center is greater than 70 km or 40 minutes or that the average weekly distance traveled from the health center to the clinics that comprise it is greater than 100 km or five hours a week time-wise.

Also that the population density is less than the average density of populations under 5,000 inhabitants, that the number of patients is greater than 35 per day or that continuous care is required with more than four guards per month.

In the words of Dr. Domingo A. Sánchez, coordinator of the study, "the success of the report lies in the fact that it is the first step to address a problem that is in full swing."