A hot summer is coming for kids Italian hospitals, especially for internal medicine departments. These departments, which mainly accommodate elderly and chronic patients, have to deal with a chronic staff shortage which worsens further during the summer months. But what is the scenario? And what should patients expect who will need to use the services provided within healthcare facilities in the coming months? The panorama, according to data released by Federation of hospital internal medicine doctors, is one of those that does not reassure at all: from June to September, for example, beyond 91% of doctors takes advantage of summer holidays, leaving departments with staff reduced by up to 50% in many cases. This phenomenon, combined with the already known lack of personnel, would consequently lead to a emergency situation which puts the healthcare system to the test.
In short, the data are merciless and reveal a situation with dramatic contours: this is why Fadoi has already asked for aparliamentary investigation knowledge on Internal Medicine departments.
There is a shortage of staff and an increasing workload for those on duty
According to Fadoi, the staff reduction varies between 21% and 30% in 48% of the departments, between 30% and 50% in 19,4% of the departments, and between 11% and 20% in 21,8% of the cases. So? The translation is quickly done: these percentages translate into a increased workload for doctors who remain on duty, who must manage a high volume of patients with limited resources. In internal medicine departments, where patients require complex and continuous care, this situation can lead to a serious risk of operational crisis.
Faced with this critical situation, Fadoi asked for a parliamentary inquiry to evaluate it state of internal medicine departments and propose appropriate solutions. The federation underlines that one million hospitalized patients are admitted every year and that it is essential to strengthen these departments to guarantee adequate assistance. “Internal medicine must be strengthened” is Fadoi's clear message, which highlights the need for structural interventions to meet the growing demand for care.
Personal emergency: critical situation in clinics and emergency rooms
La summer crisis it is not limited to internal medicine departments but also affects other departments. The hospital outpatient clinics they reduce their activities in 52,7% of cases and close completely in 15,1% of hospitals. Only 14,1% of clinics manage to keep the number and times of activities unchanged. This scenario puts further pressure on doctors, forced to cover extra shifts and manage a volume of work that exceeds normal operational capacities. In the first aid, the situation is equally critical, with internal medicine doctors often co-opted to cover staff shortages.
Doctors in summer: no weekly and daily rest
During the summer months, 56,8% of doctors see frequently skip weekly rests which should be guaranteed by law, while 26,7% fails to get 11 hours of daily rest necessary for recovery. Furthermore, 44,7% of doctors are forced to cover additional night shifts, and 28% have to also guarantee shifts in the emergency room.
In some hospitals, doctors work between 12 and 60 hours per week, while in 10,5% of cases the weekly working hours exceed 90, putting their health and the quality of care provided at serious risk.
Francesco Dentali, president of the Federation, complaint that the assignment of internal medicine doctors "is to the detriment of the activity of Internal Medicine, which is already understaffed, thus ending up losing further quotas of staff, who instead of being present in the department are given 'on loan' to the emergency rooms". These departments, already understaffed, they lose additional human resources, worsening the situation. The classification of internal medicine departments as "low care intensity" does not reflect the medium-high complexity of the patients treated, making it necessary to rethink staff assignment policies to ensure adequate assistance.
There is a lack of new generations of specialized doctors
A further problem that aggravates the lack of personnel is the lack of new generations of specialized doctors. According to the National Agency for the Evaluation of the University System (Anvur), in the academic year 2022/23, approximately half of the scholarships in Internal Medicine have remained discoveries. This data greatly worries Fadoi, since without an adequate generational turnover, the shortage of doctors and nurses is destined to worsen in the coming years.
To address this crisis, it is essential take immediate measures and plan strategies long-term. There Fadoi proposes an expansion of internal medicine departments, an increase in scholarships to attract new doctors, and a review of personnel management policies to prevent internal medicine doctors from being distracted from their main functions. There is also a need for greater investment in technologies and resources that can lighten the workload of doctors, thus improving the quality of care.
