The National Federation of Doctors (FNAM) is calling for the repeal of legislation that changed the metrics for financial incentives for family doctors in health centers and the rules that can increase the number of users per doctor.
In a statement, the FNAM said it had met with the Portuguese Association of General and Family Medicine (APMGF), “to discuss the common concern about the future of the National Health Service (SNS), regarding the functioning of health centers” with the entry into force at the beginning of the year of new legislation on Family Health Units (USF) and Local Health Units (ULS).
FNAM wants to see this legislation repealed, in favor of “maintaining the autonomy of primary health care” and “new solutions that dignify the SNS”.
The union argues that the new methodology for calculating remuneration supplements “makes doctors uncomfortable in their clinical practice, since it jeopardizes the quality of care provided, as well as the technical-scientific independence of professionals, conflicting with ethical principles and social justice”.
The metric for financial incentives, called the Team Performance Index, now takes into account the prescription of medicines and complementary diagnostic tests.
The FNAM also criticizes the new Patient Complexity Index, which could lead to the lists of patients per family doctor, “which are already oversized”, “growing even more”.
“This instrument, which is ethically and socially questionable, considers that there are users who weigh less than one or even ‘zero user’ on the family doctor’s list, using characteristics such as gender, nationality and economic status, whose construction is flawed by humanity. Thus, if the User Complexity Index (UCI) is applied, accessibility to the family doctor will worsen,” warns the federation.
Finally, the union federation believes that the new ULS have come into operation “without any strategic vision” and “compromising the autonomy of the USFs”, as well as a preventive vision of medicine, which is now centered on hospitals and illness.
