9 clock – It’s a quiet morning. At least that’s what all the employees say here. A family with two small children, a teenager with oversized, fashionable glasses and a man in a bright yellow jacket that is too warm for spring are sitting in the waiting room. That Phone rings continuously, the reception staff can’t keep up. At some point the ringing is just background noise.
On the third floor, Diana Garau is also on the phone as if on an assembly line. The doctor is working since 8 o’clock, has already had a video conference and sees exactly one of her patients this morning – but she hears 33. The telephone appointments came with the lockdown, after that they stayed. Garau calls the patients almost every minute. Her schedule calls for one patient at 9:28 am and two at 9:36 am. A colleague is ill, so some of his appointments ended up with her. At 9.40 a.m. we continue straight away.
Corona was the ultimate stress test for the health centers in Mallorca
The 49-year-old is a general practitioner at the Porto Cristo health center. Health centers are the umbilical cord of Spanish health system, the first port of call for all non-dangerous emergencies. There are a total of 46 of them in Mallorca. Every insured person has an assigned family doctor there, who will refer his patients to specialists if necessary.
Doctors are already working at full capacity in normal times, during which Corona-pandemic Even in quiet Porto Cristo, people were queuing up to the next street corner. It was the ultimate stress test. The employees had to work overtime and were only able to take care of Covid patients.
Even now that the worst seems to be over, it stays load high. Health centers, in Spanish health centers, are often overcrowded buildings with long waiting times and hectic doctors or nurses from the patient’s point of view. It is for the employees everyday with limited time in which they should have an answer to every health problem.
10 O `clock – “The special thing about general practitioners is that we constantly have to adapt to something new,” says Garau. She just got the sore shoulder of a patient, the only face-to-face appointment this morning, next is a telephone appointment with a man over 90 years old whom she does not know. He is one of the patients of her sick colleague. She picks up the phone. busy signal. This happens all the time, the health center doesn’t have enough lines for the many phone calls.
The doctor pulls out her cell phone and calls. Instead of an old man, a hysterical young woman takes off close to tears. She says that the elderly gentleman she is caring for hasn’t slept in days and won’t let her sleep either. “Please, you must help me‘ she says again and again. Garau calms the woman down, makes an appointment with the actual doctor in the coming week and changes the medication slightly if one of the pills doesn’t let the man sleep.
The woman calms down and thanks her just as effusively as she had complained before. Sometimes general practitioners are too psychologists. “Quite often,” says Garau, who smiles a lot and exudes a warm calm. Her patients quickly build trust in her, you can tell that immediately.
Diana Garau looks after many German pensioners in Cala Millor on Mallorca in winter
In the health center of Porto Cristo the doctor is only one day a week, the other days she works in the Außenstelle in Cala Millor. She has to get her appointments through by 12 o’clock today, from then on she’s free lung patients assigned. If you need a Covid test or have corona symptoms, you have to go to a separate floor. Every day a doctor and a nurse are assigned to take care of these sick people. Until then, Garau will be on the phone. When she hangs up after the next call, two more appointments have appeared on her computer screen.
Depending on who she is dealing with, Garau speaks up Catalan, Spanish or even German. The doctor’s second surname is Metzinger, her mother is German. That’s helpful because there are many Germans among her patients in Cala Millor. Some of them don’t speak Spanish well even after years in Mallorca. Garau calls the German pensioners who spend the winter on the island theirs „Winter patients“.
But she also has “Summer patient”. Seasonal workers working in the hotels in the east of the island. In total, Garau cares for around 1,100 patients in Cala Millor and 400 in Porto Cristo. She has looked after some of them since she started in Porto Cristo 20 years ago. “With such patients, I can already tell what’s going on when they come through the door,” says Garau. she knows the whole family, the children, the spouses, the parents. “That’s the best thing about my job. Knowing the people and having their trust.” The worst thing is the little time she has per patient. On some days, between 8 a.m. and 3 p.m., she looks after 50 people.
The Porto Cristo Health Center is one with large windows, cheerful rooms with orange walls, modern decor, and relatively few patients. In Palma, the spaces are common crowdedthe waiting times longerThe people more annoyed. But it is precisely in Porto Cristo that errors in the system become apparent. If time is short even here, it is certainly not enough elsewhere. Garau is a big advocate of the public health system, which, as she says, puts everyone on an equal footing. But she also had suggestions for improvement. Aside from more time, there’s also a lack of preventive dentistry and gynecology to make health centers complete, she says.
10.30 a.m. – While Garau is on the phone every minute, the nurse Aina Piña in the next patient room. She checks the blood sugar level of diabetics, checks the blood pressure of others or takes blood samples. Chronically ill visit Piña about every two or three months. If all goes well, patients see their nurse much more often than their doctor. “In the beginning, patients often want to see a doctor, but then they realize that we nurses can help them with most problems,” says Piña.
11.30 a.m. – Garau and Piña take care of patients who have appointments. But also come to health centers emergencies big and small. Maret Seibt is sitting on the ground floor waiting. The German nurse has emergency service. Today she sewed up the wound of a carpenter who cut his hand with a flex and a woman who was bleeding profusely to the hospital forwarded. Here she treats people who are sick or dizzy. She checks blood sugar levels, blood pressure, connects the patient to the ECG. “Sometimes we have so much to do that we can’t even go to the toilet,” she says.
Seibt was born in Dresden, did her training in Hamburg, and has been living and working in Mallorca for 19 years. The 49-year-old appreciates the Spanish health system. “You’re in good hands,” she says. She says nurses have more jobs here in Spain. they do a lot what the doctors in Germany do. “This also gives nurses a completely different appreciation here,” she says.
The corona pandemic remains an issue at the Porto Cristo health center in Mallorca
12.30 p.m – The Corona-pandemic may no longer paralyze the health center, but remains an issue. Seibt and Garau meet on the first floor, the lung department. They help each other into the protective clothing. Then the doctor examines a man who is already over 90 is and has tested positive for Covid. Meanwhile, Seibt is testing other patients.
If you ask the doctor for an anecdote that describes her work, she thinks for a long time. “There are so many…” she says, remembering a home visit. The little old lady lay in a huge bed. To get to her, Garau had to climb onto the mattress and spent half an hour half sitting, half lying down. She remembers one too homemade stollenwhich she received from a German patient.
The work in the health center does not consist of great adventures or exploits. There are many patients with minor and major ailments. It’s more everyday than emergency, more common cold than heart surgery. The elderly gentleman with Corona has a slight fever, but is otherwise quite fit. Garau receives the next patient who is in front of the door. It is now 13 o’clock. There are still two hours to go.
Public health system in Mallorca
Health centers replace the German family doctor in the public health system in Spain. Depending on where they live, the insured will be clinic assigned and there referred to a general practitioner. There is no free choice of doctor.
The health center with its doctors is the first point of contact, except in emergencies. If a specialist is needed, the general practitioners refer the patients to them. Normally, an appointment must be made before the visit. The health centers also treat minor emergencies.
The larger health centers are called PACs (Puntos de Atención Continuada) and are open 24 hours a day.
In the event of a serious emergency, you should go to the emergency room at the hospital. There are four public hospitals in Mallorca: Inca, Manacor, Son Llàtzer (Palma) and the University Hospital of Son Espases (also in Palma).
Foreign vacationers are treated in the public health system in emergencies using the European Health Insurance Card. Employees in Mallorca are insured via the Seguridad Social, foreign pensioners can be transferred to the Spanish system.
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