Keywords: primary care, rural areas, shortage of physicians
Background:
The development of the ASAP (Advanced Solutions for Primary care shortages) program stems from a serious shortage of primary care physicians in the Friuli Venezia Giulia region of Northern Italy.
Aim of the case report:
This project report describes the ASAP program aimed at addressing primary care workforce shortages and ensuring the provision of health services and continuity of care in rural areas.
Case report:
The ASAP project provides the involvement of 3 young doctors, with approximately 1500 patients assigned to each of them. These patients are those who no longer have a traditional GP.
The clinic is organised in 6-hour shifts, further subdivided into 3 hours of clinical activity such as medical visits, and 3 hours dedicated to back-office activities or home visits.
The Local Health Authority provides the premises, secretarial staff and IT support. Payment is made on an hourly basis.
Personally, I have been working in one of these ASAPs since October 2023, along with two colleagues, responsible for 1350 patients, for 18 hours per week.
This experience highlighted several strengths: direct experience in the field for young doctors training as family doctors; work experience in a pre-existing district facility with nursing support and financial benefits. Some of the weaknesses are: inadequate computerized medical record system not even used by regular GPs; difficulty working in a team environment (i.e. not everyone logs visits consistently); high workload because the patient's medical history is not available to the team; lack of time needed to build a relationship with patients; assigned support staff not versed in new system; no technical support in case of need or doubt.
Conclusions:
The ASAP strategy has shown several strengths but also weaknesses. A possible solution to address these weaknesses could be to pair a young doctor with a senior GP who is near retirement to ensure continuity of care during transition.
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