Elvira Bisbe: "Catalonia will reach its peak of doctor retirements this year"

BarcelonaThe doctor Elvira Bisbe (Barcelona, ​​​​1961) is the new president of the Barcelona College of Physicians (CoMB) and the first woman to hold the position since the institution was founded 131 years ago. Obispo was vice president in the last legislature led by Jaume Padrós, but has been linked to the college since 2010, when she joined as a member of the governing board then chaired by Miquel Vilardell. Hers was the only candidacy that stood for election last February and is of a continuing nature, although she highlights the style of the new governing board. She gives ARA her first interview since she took office.

How has the change of board been?

— Well, I am very happy to be the first female doctor to break the glass ceiling and become president of the College after 130 years. However, I have been on the board for a long time alongside Dr. Padrós, who has been an excellent president, from whom I have learned a lot. We have different leadership styles. I think that until now the College has been very presidential and I would like to give more prominence to the team. We are a group that is very committed to the values of the profession and we represent different areas of medicine. This gives us the possibility of analyzing problems in a much broader way and, thus, giving better answers.

How do you see the profession today?

— I would like doctors to feel proud of their work again.I get the impression that the hangover from the pandemic and the lack of doctors have created much more pressure on healthcare. I also think that autonomy has been lost, that there is an excess of bureaucracy and that professionals cannot do what they really like to do, which is precisely being a doctor.

The lack of professionals is a problem that we have been dealing with for years.

— Yes, it is one of the great challenges and we have been warning for a long time that proper planning has not been carried out. To this we must add that the population has increased a lot and also the complexity of the patients, which increases the pressure on healthcare. We have a growing shortage of doctors and, in addition, we are retiring more than we train. Between this year and the next we will reach the peak of retirements, so far more than a thousand professionals from the generation of baby boom They have already done so every year for the last five years, and, on the other hand, we only recruit between 800 and 900 specialist doctors, because not all of them stay in Catalonia once they finish their residency, some go to other autonomous communities. Currently, more than 50% of the new members of the COMB are doctors with non-EU training.

And how is this situation resolved?

— We need to eliminate bureaucracy. For example, we are short of doctors in primary care and 30% of their time is spent doing paperwork. This means that they spend 540 hours a year doing bureaucratic tasks and we cannot afford that: if there is a shortage of doctors, doctors should be doing the work of doctors. If we free them from this work, we could bring more than a thousand professionals back into the system and citizens would not have to wait two weeks for a medical visit. As we saw with the pandemic, short-term absences could be optimized so that they are not the responsibility of doctors and they could thus dedicate more time to care.

What is the current ratio of specialists?

— We have 2.6 specialists per 1,000 inhabitants, which is well below the European recommendation. We see that there are more and more non-EU members, and we need them because there is a shortage of doctors, but there is a problem: they can easily obtain recognition of their qualifications, but, on the other hand, they have many difficulties in obtaining recognition of their specialty with the Ministry of Health, which makes them a vulnerable group. If we see that it is impossible for them to obtain recognition of their qualifications, we advise them to do the MIR so that they can join the system with guarantees.

Which sector group are you particularly concerned about?

— The doctor who works with insurance companies. The number of junk insurance policies has increased, offering patients coverage that is far below that of the public system, and they pay very poorly: it is common for professionals to charge 8 euros for a medical visit. There are around 10,000 of them in Catalonia and 90% do not have the option of negotiating their fees and must accept the remuneration imposed by the companies.

The Committee for Evaluation, Innovation and Operational Reform of the Health System (CAIROS), which is tasked with designing a new health system, also wants to do away with bureaucracy.

— Yes, CAIROS has been inspired by documents that have been drawn up over the last 30 years and is a diagnosis shared by many agents in the sector. The problem we have is that the system is very rigid and it is very difficult to make changes. I think they are very pragmatic and will start with those actions that are most feasible. We have to go step by step, but I hope they can do their job and implement the necessary changes. My hope is that this works, it is urgent. If not, the quality of care and the sustainability of the system will be compromised.

Do you think that the Statute of Autonomy will be reformed as the Ministry of Health wants to do?

— It is a law that should be approved with a broad political consensus and at the moment we believe that there are not enough majorities for this to be possible. In addition, the powers in health are in the hands of the autonomous communities and not all of them are governed by the same party. All of this makes the changes that the Spanish government wants to promote very difficult. In addition, it has generated alarm among the professional community due to measures such as, for example, requiring exclusivity for those in positions of responsibility, who cannot work in the private sector. If one of the biggest challenges is the lack of doctors, we are not putting more spokes in the wheels. It is a proposal that goes against the public system, because it will make it more difficult to retain talent.

Trade unions are calling for a single statute for doctors and have called for professional associations to join in.

— For years, we have been asking for an exclusive agreement for doctors in Catalonia. When the conditions of the sector are negotiated, we are in the minority, because there are many other professional roles and many of the measures we demand cannot be implemented if the others vote against. It is an unfair situation and we find it logical that we have our own agreement. Regarding the single statute that the unions want, it is too early to make a statement. We have a meeting with Doctors of Catalonia in the near future in which we will address these issues.