Family doctors ‘refuse to sign framework contract’

Most family doctors seem determined not to sign new framework contract with the National House of Health Insurance (CNAS), two weeks before the expiry of the ongoing one.
On Thursday alone, more than 20 doctors from Vâlcea filed at the Public Health Department requests for the release of the necessary documents in order to complete their files so that they could practice abroad, as they had been dissatisfied with the new funding requisites.

The occupational associations said that there are some counties where no doctor would sign the contract and estimated that nationally, almost 70 percent of family physicians would deny the provisions imposed by the authorities.

These provisions also included the blockage of issuing the free and compensated prescriptions, performing additional activities in permanency centers and fulfilling some bureaucratic tasks as a consequence of the introduction of new computer systems.
The secretary of the National Society of Family Medicine, Dr. Sandra Alexiu, estimated that 68 percent of the doctors would not sign the new framework contract.

This situation would determine two out of three policyholders to change their family doctor or may need to pay almost all the primary health care, which were normally free for the policyholders and their families.

Doctor Sandra Alexiu opined that besides the fact that it would be hard to find a family doctor with a contract with the CNAS without having any maximum number of patients admitted - 2,200 people - and the policyholder to be in the record of a doctor for at least six months, the mechanism itself is slow.

‘It’s not so simple, because the patient must be validated in the computer system. I have patients who haven’t been validated for months. We entered the new-borns, the system validated them after three to four months. I consulted them, I vaccinated them, I gave them medical prescriptions and my consultations are not validated until three to four months after.’

‘I had patients whom I could not provide any medical care, because they had registered in the computer as no policyholders, although they were policy payers, with certificates of employment, often even payers directly to the House and, yet had no updated records’, Sandra Alexiu said.

Doctors announced they will work as volunteers for a few weeks

If, however, the circumstance makes us pay anything including the relationship with our family doctor, the doctors assured us that they would offer free consultations for two weeks, which in a private medical office, as most of them will become, cost around 50 lei.
There is no law concerning the private family medicine, Sandra Alexiu said, which drew the attention to some gaps in the legislation regarding health services.

Although the amounts related to the health fund contribution are not returned, a policyholder would have to pay each time for a visit to a patient’s home, for the medical tests or the granted medical vacations and for the entire prescribed medication which used to be compensated or even free.
‘They will have the treatment, but not compensated, in case they haven’t managed to make their own stocks.’

‘I can’t speak at a general level, but in my experience, I talked to patients and I managed to convince them to buy some drugs, to have a stock for two or three weeks in that period, to see how we can solve it’, the secretary of the National Society of Family Medicine, Dr. Sandra Alexiu, said.

The patients’ associations said they supported doctors even though that meant extra costs for them to cover and announced that they started an information campaign in clinics and hospitals.

Translated by: Iulia Florescu

MA Student, MTTLC, Bucharest University