The well-known doctor Antonio Linares, an expert in the digestive system, did not stop working even at the beginning of the pandemic, despite the fact that he recognized that he went to his Gijón office with fear embedded in his body. Born in 1956 and linked throughout his life to Asturian health –first in the public network and since 2007 in private care–, he does not see a notable increase in insurance policies due to the increase in waiting lists and trusts that The pandemic leaves as a lesson the possible and necessary collaboration of public and private health in a region in which the shortage of doctors, he anticipates, will not be resolved in the coming years.
-It is well known how the pandemic put the health network of the entire country to the test. What was your experience from private medicine?
-Fortunately, now the pandemic is about to be overcome, unless there are unexpected eventualities such as mutations with which vaccines are not worth it, but we are almost there. It is especially noticeable here, in Asturias. Cabueñes no longer enters new positives and the HUCA plants, as far as I know, have fewer and fewer cases. Everything is better now, despite the recent permissiveness with nightlife and others. It’s good. As you say, I have my clinic and I dedicate myself to private activity. Personally, I never stopped working. I know of some colleagues who did stop providing face-to-face care for a while, but many others continued to see patients. We had to go to the clinic because, among other reasons, we serve the sector of the population that does not use the public network: civil servants and the armed forces. It is also true that last year I had the privilege of anticipating what could come and I got protection material even before the institutions. It was expensive but I got it so I didn’t have to stop working or seeing patients. For two months, like everyone else, we did postpone what was not understood as urgent. On a personal level, I was very overwhelmed at first. I was very afraid of getting infected. The first two months for me were terrible.
-And the telematic consultations? It seems they have come to stay.
-Well I do not know. I also started the online consultation thing, among other things because I am a friend of the Izertis group, which has an application for just this. For me it was a bad experience. They called me patients from Madrid and Barcelona because their usual specialist had not disappeared and I spent 40 talking to people. In the end, I think that this remote consultation thing will have a future, but we have to learn to use it. I ended up exhausted because I kept seeing patients in person, and some came with symptoms that ended up being covid.
-They were a lot?
No, but there was one. Covid-19 manifests itself mainly with pneumonia, it is its main problem. But many patients also have digestive symptoms, especially diarrhea. They came to see us for consultation without thinking that it could be about that. Luckily, none of the staff were infected.
-When the non-urgent activity was postponed, the waiting lists in the public network increased in part of the specialties. How was it in your case?
-In my case, not much, really. It depends on the specialty and the person. I always have a waiting list of patients who prefer to see me, for example. In general, I think that in my specialty, digestive, this increase has hardly been noticed. As a colleague of the Medical-Surgical Igualatorio, I also know that the activity of private medicine in Asturias accounts for 9 or 10 percent compared to cities like Madrid or Bilbao, where it accounts for more than 30.
-For what is this?
“I know that family doctors are working a lot, it hurts me to see patients who regret not getting an appointment”
-Well, I think that the low proportion that we have here is because public medicine, to everyone’s pride, has always worked well. Now I see that there are colleagues who criticize her, and patients, and it’s not my position to talk about it, but perhaps some of that criticism is too gratuitous. We have gone from those months in which doctors and nurses were heroes, which was true, to what you hear now. I know they work a lot. In private they also criticize us, in any case. And, well, I understand that many people, especially older people, want their usual face-to-face consultations. That is why I said before that online medicine will advance, but little by little. Here it has not been generalized.
Has the demand changed?
-Yes, there were people who, due to the crisis and not being able to work, had to unsubscribe from their private policies, but it is also true that there were others who, sensing that public assistance was going to enter the waiting list, decided to take out insurance for the first time. time. In the end, I think, the situation has remained quite similar, the losses have been compensated with the increases, more or less. There was a sector that is not so vulnerable to the economic crisis of recent months that now saw the advantages of taking out private insurance.
– Is a transfer of patients estimated?
-Most of the patients we attended and attend already had their private insurance. The rest were anecdotal cases, such as some patients we received because they had or sensed delays in public medicine or they were not completely calm with their online consultation and preferred to go to the private one to do some test and get rid of the fear. At the Begoña Hospital, both I and a colleague were seeing patients throughout the entire year, also in March and April.
-Are diagnostic delays feared?
“I believe that private medicine also has its raison d’etre and that it can complement public medicine”
-The assessment that I can give, which is my specialty, is that the pandemic has not had as much of an impact as is believed. Also, of course, there were anecdotal cases, I don’t know, such as late colonoscopies that found a lesion that came to the clinic in a more advanced state than normal. What I noticed the most was that we see a lot of pathology in the digestive system because of all this. There is a functional condition called irritable bowel that is greatly aggravated by stressful situations, and on these dates we have seen very overwhelmed patients because they did not understand what was happening to them and feared that it could be something serious, when in reality it was a reaction to all the stressful situation they had experienced.
-What ordinary people call nerves in the stomach.
-Yes, this has already been discussed publicly, even from the political environment. The need to make a special psychological service and provide the system with more means to provide a broader psychological care transcended. On the subject of public delays, I cannot say that I have seen cases in a general way. I work in the private sector, but I spent many years in the public sector and I have immense appreciation for my colleagues and the authorities, who have always treated me well. It pains me to see a patient who tells me that he can’t get in touch with a doctor whom he surely knows, because I don’t know what to say. I know that the colleagues are working hard and that at this point it is very difficult to please everyone. Despite this, I also defend that private medicine has its reason for being.
-In what sense?
-It is that private medicine sometimes seems to be sold from some sectors as something corrupt, and it is not like that either. I think, in general, our community benefits from having private medicine. I can’t say what a bed costs at HUCA, but complex transplants are treated there, patients with metastasized colon cancer are treated, a tremendous amount of resources are used. The cost of means and personnel is brutal. And if there we normalize that there are also patients with trivial problems, which cost the same to the public treasury… Patients with less serious problems can be cared for much faster and just as well in private, simply. Not all of us need special care and a nurse at our disposal 24 hours a day.
-Go on.