Florence, 25 October 2024 – Remember the ‘old’ doctor, awaited by your mother like an indisputable oracle, who rang the bell, came up with the brown bag and after the visit issued the sentence and wrote down the medicine he administered on paper in black and white to the case? Prehistory, alas, and not so much because who knows how much time has passed since that little ancient (and analogue) world but because the dizzying – and apparently fallacious – acceleration of digital has overturned habits and customs of doctor/patient dialects with results that on paper could – and maybe they will be able to be winners that currently hinder everyday life a lot.
The Florentine doctor confirms this Fabio Mazzerellia life in a white coat, and recently retired. With a premise: “I would not like to be seen with the classic obstructionist who says no regardless of IT systems in the healthcare world, in fact I was one of the first supporters”. So what’s wrong? “The fact that the way they are currently designed just creates bureaucracy upon bureaucracy, complicating the work of doctors rather than simplifying it.”
The things, already not easy, according to Mazzerelli they have become further complicated with the pandemic. The professional, who began his career in 1983 and ten years later he became a general practitioner, in addition to home services, he was able to calmly visit his patients in clinics or divert them, with experience, to hospitals.
“Once upon a time, everything was much simpler because there were what we can define as ‘self-filters’: we took the patients’ names, surnames, health cards and noted some exemptions. By working on paper one created a huge dam to computer systems, of which I repeat I was a supporter but which in practice today, due to a series of distortions, which are not only those linked to the tilts that follow one another like the one in recent days, erode the doctors’ spaces to the detriment of patient care” he adds Mazzarelli which then goes into more detail by listing some examples.
“The bureaucracy in the new systems has first of all led to a boom in restrictive notes that arrive as if fired from a machine gun with everything that comes with it. – he explains – Then there is the sore point of therapeutic plans with the use of specialist drugs which we monitor but in a context where the doctor is practically a spectator”.
Then there is the question of Nao, the new oral anticoagulants that family doctors can now prescribe for atrial fibrillation. Here too due to a cumbersome mechanism of transcription Mazzerelli explains that “I make the diagnosis, the therapeutic plan, I sign the prescription and in the end it is as if I were writing to myself”.
“I am of the old school, when I sign a prescription I assume all responsibility – he then concludes – today instead with the so-called respect of notes there is a process that in fact serves to keep pharmaceutical expenses under control which involves an enormous waste of time”. In short, what is missing today? Empathy with the patient, the calm and time required for an accurate examination, the possibility of delving into every aspect of a pathology.
There is another problem then, a child of the times. The explosion of the internet and social media have led many people to trust the web almost more than their family doctor. I asked my patients: “And who diagnosed this, Doctor Google?”.
