Jesús Díez Manglano presides over the Spanish Society of Internal Medicine (SEMI) and reiterates the holistic vision of internists to treat patients who have had a manifesto during COVID-19.
¿La Internal española goza de buena salud?
I believe that the pandemic has manifested itself in the fact that Internal Medicine is a fundamental specialty. We are the doctors who work in the hospital who have a holistic vision of the patients, and they have been demonstrated with the COVID-19. It is applicable to all infectious diseases, and its pathologies in which only the problem is the infection. We have seen many extravagant manifestations of COVID-19. We are the doctors who best treat us with Primary Attenuation through our patient’s holistic vision; they work in the extrahospital medium and ours in the hospital. Have to keep in mind that we are living at a demographic moment in which the people do not have only one nurse, they are multiple. For that matter, there is a rich global vision. If it is a good health, then it is clear that for the sake of the thinking population we need to increase the number of places for residents of Internal Medicine.
Is there not enough Internet number in our country?
We need to cover the need to mention. In addition, in the next 10 years our sanitary system will be undergoing an important renovation of sanitary professionals that will be celebrated. We need a job, and for teners we have to work hard and plan now.
How are you working on this line?
We are working on this re-indication, but also the ministry and universities are concerned about this need.
What are the dangers of Internal Medicine?
Among the most susceptible areas of major is the presence of Internal Medicine in Spanish universities. The accreditation system that ANECA tends to favor more than the accreditation of people who are dedicated to very specific areas and do not have those who have a global vision, as we care about internists. Each has less internal faculty and fundamentals for some faculties, such as Physiopathology, General Pathology or Medical Pathology.
Is management important when it comes to assistance?
The internists are some very vocal medics. On occasion, in our dedication to the clinic olvidamos aspects related to management. The medicine of any specialty should be known only to clinics, including clinical management. For this reason, we are making a major effort from the SEMI to promote knowledge about clinical management.
And the investigation?
We have many good investigators in specific aspects, such as being able to carry autoimmune, lipid, cardiac insufficiency. The investigation in these camps is important for the public opinion that has chronic illnesses. These are very well known to the internists, but to the agencies that finance the research projects the easier results of entending more concrete projects.
How can this situation be improved?
We are making an effort to train well with the investigators internally, to be able to reach out to the company and the regulatory agencies that need it, all through the demographic and sanitary situation that we are living. We also have a very good relationship and we carry out joint projects with patients’ associations, which, on occasion, better understand the situation than regulatory agencies, in order to transfer these needs to regulatory agencies.
Has COVID-19 been described as part of the chronic pathologies that are being treated by Internal Medicine?
As a consequence of the necessities required in hospitals and health centers, consultations are eliminated and other appointments are not made by telephone. It has been sued for some type of patient. También hemos observed patients to those who are the citations, but not acudian for help.
What is the best way to improve chronic care?
We have the global vision. It has failed its organizational efforts on the part of the sanitary authorities. The implementation of the national strategy for the implementation of the chronicle and the application by the autonomous communities has been very different, although it has not been approved. We believe that this decision should be taken by the Inter-Territorial Council or by specific working groups, which should establish a common approach to chronic disease in all autonomous communities. A fundamental aspect is to agree on all autonomous services so that clinical history can be shared throughout the national territory. It is necessary to compare the clinical history programs of all autonomous communities so that they can be accessed in any place and a patient can receive health care assistance in any point.
What are the SEMI’s objective priorities?
Satisfy the needs of our societies, with continuous training, teacher training for residents and with research. We have some aspects that we consider to be important for the situation we are living in during the pandemic. We have been tense to all the sanitation system and we have held that tomar decisions that he raised ethical issues. For this reason, we consider that we should address the bioethics of our society.
What are their questions about the pandemic?
However, the administration of treatment determinations, the mechanical ventilation administration and patient care, propose to patients the use of medicines of which there is no sufficient investigation to establish the use. There are now more data available, in accordance with the principle of pandemic, we use drugs that we think can be used, but there is no evidence of respect. This is an important ethical question. We also have ten patients who, through the sanitary organization, have been admitted to hospitals and have not received visits. If a patient is alone when living a debilitating situation, with an aggravated and debilitating situation, then help and preoccupation are important, there are also many issues.
Fuera de la pandemia, ¿también hay hai aspects ethicos relevant?
There are various surprising aspects related to euthanasia. Now it’s time to dump her. The SEMI, at the end of the year, published a guide to clinical practice regarding care at the end of life, good practice in patient attention.
What are the SEMI accounts for taking part in the training?
The residents have their training program in each hospital. As a society, for resident physicians we have a vernacular school for its training. Además, in European school of verona and invierno participant some recent Spanish. For our societies as well as for our residents, we have an online teaching platform that runs between 30 and 50 courses a year. Since it went on sale, it has had more than 17,000 participants. With the University of Barcelona we have an agreement with the SEMI and Menarini chairmen, where direct and specific courses are being developed for internists, even if they are open to other specialists. We have a master of autoimmune diseases, diabetes, infectious diseases, chronic illness attention, multipathological patients, emergencies, cardiovascular disease, cardiac insufficiency …
Are all courses maintained during the pandemic?
The master of diabetes, since he has been infected and infected with infections, has recovered during the social pandemic he has suffered from overwork, and is struggling with new programs in his time.
How did you get involved in the training?
An online webinar was launched that was followed up late during the second semester of 2020. He conducted 50 meetings in our societies on very varied aspects, including those related to the pandemic and the coronavirus. diabetes, enfermedades autoinmunes, EPOC …
Do you have any specific courses for MIR or youth medicine?
In all our courses you can appoint a doctor in training. But there are some courses that are specific to them, such as those of the Verano school. Consisting of one or three days in which the participant has 50 resident physicians, you can listen to them in the discussion sessions of clinical cases. Este año se ha tenido que hacer online. We also have courses that are open to all societies, but there are many guides to medical residents. As its clinical reasoning courses, it is necessary to analyze complex cases in order for the training physician to understand the reasoning and simplification to be able to clarify what can be done in each case.
Does it have a relationship with other scientific societies in the training courses?
We have our own teaching platform, owned by SEMI. In addition, we have a number of joint programs with other companies, as is the case of the master on cardiac insufficiency that we have done through the IMAS Foundation. It participates in the SEMI and the Spanish Society of Cardiology (SEC). It is joint and conducted as well as internists as cardiologists. We have also conducted another course conducted by resident medical tutors that has been conducted with the foundation and by the SEC, the Spanish Society of Neumology and Thoracic Surgery (SEPAR) and the Spanish Society of Digestive Pathology (SEPD).
With what other cross-country work areas?
We are interested in working with any company with which we have an agreement. In addition to the mentions, we will join forces with the Primaries. For example, now we have a meeting with the Spanish Society of Medical Education, where we have a specific course on our platform in which the Medical Council of Medical Students participates and we will also do a verna course at the University of Alcalá.
How is his relationship with Primaria?
We have a very good relationship with the three companies of Atención Primaria. Hecho, with semFYC hemos organized during 11 years the conference on chronic patient attention. With SEMERGEN and with SEMG we also have joint projects.
What paper does FACME have in relation to other scientific societies?
We have our own specific meetings with distinct scientific societies. FACME is a federation of different societies that can organize multiple events with the participation of different societies, which can be the COVID congress that is organized this year and that is full. The FACME organizes and has the potential to collaborate with the distinguished scientific societies.