This week in our blog we wanted to interview Gary Gambassi who illustrated his vision as a family doctor of the latest generation, on the assistance of the elderly patient, in all its complexity.
What is the average percentage of over 65 patients assisted by a family doctor?
The average percentage of patients over 65 is approximately 25% of patients followed by a general practitioner; this figure does not actually correspond to the workload of a family doctor by population group. In fact, the over-65 age group represents the portion of the assisted population that most comes into contact with their family doctor. A patient over 65 goes to the surgery on average 15 times in a year; if compared with the number of contacts of a patient in the 35-40 age group, which is approximately 4 visits/year, it is evident that the over 65 population determines an important workload for primary care.
How do you live it professionally (workload) and humanly?
From a professional point of view I can consider myself more than satisfied; I have been carrying out this work for about 1 year in a group medicine (8 general practitioners with secretarial staff and nurses) and the emotional return of this profession repays the difficulties that are sometimes encountered. The relationship with patients in the General Medicine setting is particular; you are doctors first of all, sometimes you become friends, and undoubtedly you represent a point of reference for them. It’s a life path as well as a job.
What are the most critical clinical-care problems for the family doctor?
The real challenge for the new family doctors will be to manage patients with more than one chronic pathology appropriately, both from a clinical and organizational point of view. In fact, university training teaches the management of individual pathologies and the guidelines that form the basis of our work are structured vertically on the various pathologies. But the real life of managing a chronic/complex patient is very different; often the family doctor has to manage 2 or more pathologies in the single patient and consequently an extremely complex diagnostic-therapeutic path (for example a patient suffering from post-infarction ischemic heart disease, chronic obstructive pulmonary disease, diabetes mellitus and hypertension can also take 5 or more drugs simultaneously several times a day).
When dealing with palliative care, how has this sector evolved and how does the family doctor play a reference role?
In these months I have been attending the Advanced Training School of the Italian Society of General Medicine for General Practitioners with a Particular Interest in Palliative Care and Pain Therapy. The objective of the training course is to train family doctors with the aim of representing within the future organizational forms of general medicine (AFT Territorial Functional Aggregations) a point of reference for colleagues of the same AFT in terms of Palliative Care. This should not be confused with the role of the Palliative Care Specialist which remains distinct from the GP with particular interest; the latter carries out peer training activities on Palliative Care and has the role of facilitating the colleague of his AFT in the territorial Palliative Care Network.
Author: Giovanni D'Antonio
