A family physician, that is, who?

Dr. Google or Dr. Sutkowski? Who are patients betting on?

Dr. Sutkowski, let's bet on Dr. Sutkowski (laughs).

How about going to a search engine for a diagnosis, and to a doctor for medication?

For a diagnosis undoubtedly to the search engine. Later, a moment of wondering if I can handle it. And then to us doctors. Fortunately, patients have respect for me, for which I can only thank them, and enough attentiveness and culture that they usually don't make their own diagnoses right away. Of course, they have their own vision of what is going on. Sometimes it happens that they try to pull up and impose a diagnosis. Sometimes they are right. Then you have to admit it to the patient, that this time the Internet and the patient were not wrong. But more often the opposite is true. It is difficult for the patient to find himself in all this , because he needs to know the context, and sometimes he searches in the dark. As a result, the patient's thoughts diverge into things that are not there.

But ultimately patients go to a family doctor. A family doctor is one with a specialty. This is also often said of PCPs. Collectively, this is a large professional group.

The total is more than thirty-some thousand doctors. With this, family medicine specialists are 12.5 thousand. Who is a family medicine doctor? This specialty was established quite a long time ago in Polish conditions, on August 19, 1984. Today, if someone does a four-year specialization, he becomes a specialist in family medicine. POZ, or primary health care, is not a doctor just a place where doctors work. This needs to be distinguished. The doctors who work there are PCPs, and they are not necessarily family medicine specialists. Often it's not, because we're about a third of the lineup. Doctors of very different specialties work with us We counted more than 60 of them, but most often they are fellow internists or pediatricians.

If we consider that doctors working with patients, there are about 130,000 in Poland, and with the right to practice almost 160,000, we are dealing with a very large professional group. Does this professional group enjoy the respect you mentioned earlier?

Not really. This respect could come from a variety of reasons. Whether we have earned the respect or lack thereof depends primarily on us. For many years this specialty was somewhat depreciated. There were times when politicians had family on their lips during elections, and therefore had family physicians on their banners, but we were really considered doctors who knew little and did this specialty perhaps out of necessity, in fact we were not even considered specialists.

At the same time, we were said to be "first conflict" doctors, because we are on the front line. At the same time, it seems that this specialty, contrary to what most of the public thinks, is very difficult. She combines elements of pediatrics, internal medicine, surgery, ENT, gynecology or ophthalmology. In fact, a little bit of everything from medicine. And if you're into everything, you're supposedly into nothing. But this is not true in this case. Acutely in family medicine it works. There is scientific evidence for it, which I preach, that if a family doctor is close to you, you live longer, better and in better health. It is the family doctor who is a certain guarantee of health, because he is close to us, he is a friend of the family and knows its context. He is close to the local community and understands it. He is obviously a specialist and can do many things. Fortunately, the perception is changing that the family doctor is a bit of a, excuse the expression, a horse doctor for everything. But there is a downside. Namely, that the system does not notice us. Family medicine specialists, but also PCPs are badly needed. We need, like the whole world, to bet on outpatient health care, rather than starting with hospitalization. This involves the money that goes to POZ, the organization of the system, the training of staff. We have a lot to do in this matter. And the environment must be worthy and ready to change, to resist all sorts of political impulses, not necessarily substantive, when it comes to the system's puzzle. The system in Poland is going through all sorts of fluctuations, taking three steps forward and one sideways and one backwards. And that's the way it's been going throughout history. Family medicine, on the other hand, will undoubtedly defend itself, because it is the most total specialty, the most broad in terms of non-surgical specialties. Although, as I said, we are a little bit surgical too. The system doesn't notice us, it treats us equally. So you can sit in a clinic, hand out "cards" and be a bit of a family doctor, simplifying of course. On the other hand, we should undoubtedly be very active and take advantage of our opportunities. The system, the Ministry of Health, the National Health Service should promote and use the capabilities of the family doctor, the specialist in our family health.

You used the term "doctor of the first conflict", moribund. What else can you listen to while sitting in the office?

Everything. We primarily explain ourselves for the system. We get it because we are on the front line. The patient has grievances with us, although they could be with others. With other doctors the patient is not able to talk, because access to other specialists is difficult. We are for all possible illnesses. Patients come to us with multi-disease and multi-symptoms. They complain in many areas because the system is unclear to the patient. It should definitely change. And we family medicine specialists, family physicians, have ideas on how this system should change. We would like to have definitely more influence on it. Unfortunately, this is not always the case. And what we can listen to depends primarily on the patient, his culture and the context. In the public perception, as it turns out, when confronted directly, the family doctor comes off well. This is a doctor the patient can choose for himself, so it matters a bit. Of course, it varies. Patients discharge from the clinic for absurd reasons, thus manifesting some kind of dislike, not always dislike of the doctor, but, for example, dislike of the clinic, registration, the system. These manifestations are numerous and very often result from frustration that is not directly related to the family doctor, to the treatment of this doctor. And so we are very close to people, we try to understand them. And patients understand more and more who the family doctor is. I hope this will pay off in the future.