Doctors join against the prescription nurse with this offensive

This Thursday is fulfilled a month since the approval in the Council of Ministers of the Draft Law on Medicines and Health Products. Although it is not a definitive text, there have been numerous disagreements transmitted by the different agents of Spanish health. Among them, Medical unionsthat from the first moment their positioning made public before such regulations.

The project, which is part of the recovery, transformation and resilience plan prepared by the Government and funded by the European Unionhas re -brought to light one of the most ‘hot’ debates currently the health field: the nurse prescription. And not only that, since he has also got medical unions to leave their differences behind and go hand in hand against her. A union union headed by the two ‘bastions’ of the defenders of the rights of the current doctors: the State Confederation of Medical Unions (CESM) and the group of professionals for a medical and optional statute (Apemyf).

The new document designed by the Ministry of Health has made both align to ensure that the prescription nurse and physiotherapist contemplating the draft law is eliminated or, at least, modified. This happens a month after doctors went out to demand a new Marco Statuteor even an own medical statute. A revindication that Apemyf and Cesm have decided to defend on separate roads, although the two groups came to the concentration. Some claim that by internal discrepancies, others than by differences in the objectives.

Union to eradicate the prescription nurse

But, even so, the preliminary draft of the Drug Law has returned to Open ‘Ray of Light’ Between both organizations. And, so far, only pharmaceutical products could prescribe medical professionals, dentistry or podiatry. Well, this new standard, which is expected to pass through the Congress of Deputies for approval before summer, has ‘forced’ organizations such as the Medical Union of Navarra (SMN), Methys of Catalonia, the Association of Physicians and Higher Titles of Madrid (Amyts), the Euskadi Medical Union (SME), the Professional Medical Union of Asturias (Simpa) Galicia (Simega) a join in the presentation of allegationsas has been confirmed Medical writing.

The contributions presented by the autonomic unions of doctors to the norm They follow the same linefocused on the eradication of said ‘indicator’ nuance of the text. Of course, the deadline ends on May 8.

To Amytsthere are two articles of the standard that should be written, modify or even eliminate. The first of them is 4, which addresses guarantees of independence, transparency and conflict of interest. Within the section it is affirmed that “without prejudice to established incompatibilities For the exercise of public activities, the clinical exercise of medicine, dentistry, veterinary, nursing, physiotherapy or podiatry, as well as any other health profession that could have The power to prescribe or indicate the dispensation of medicines and ‘products’, it will be incompatible with any kind of economic interests Directs derived from the manufacture, elaboration, distribution, intermediation, and marketing of medicines and “products”, as well as with the performance of professional activity or with the ownership of the pharmacy office or retail commercial establishments. “

A ‘faculty to prescribe’ that is much clearer in the Article 86where he deepens Recipe and hospital prescription. And it is that the text ensures that “the recipe, public or private, and the order of hospital dispensation are the documents that ensure the establishment or continuity of a treatment with medications by instruction of a doctor, a dentist, A nurse, a physiotherapist or a podiatrist, within the scope of their respective competences, only professionals with faculty to prescribe medications subject to prescription. “

Towards an alleged ‘competency invasion’

It is in the latter where the ‘main problem’ is for the union organization with representation in the Spanish capital. Specifically, request that the prescription option to health professions that “have no competence for medical prescription”. As indicated, “the medical prescription is not an isolated process, but the result of the global patient evaluation.” That is why they consider that prescribing professional profiles “must have extensive training in pharmacology, physiology, diagnosis, prognosis, adverse effects and pharmacological interactions.” A formation that, according to his words, Nurses do not have.

In fact, they raise “a Competency invasion Among professions according to the distribution of the professional competences established in Law 44/2003, of November 21, on the ordination of health professions. They defend that doctors, dentists and podologists, within the scope of their respective competences, are the only prescribing professionals.

“The doctor is a central figure in the strategies of impulse quality in the pharmaceutical benefit given the role attributed to him in the health care of the patient and, therefore, in the prevention and diagnosis of the disease, as well as in the prescription, where appropriate, of the treatment with medications” justify from the organization. But Amyts has not only confirmed the existence of an alleged ‘competence invasion’, since he has also claimed that The validation of protocols and clinical practice guides and welfare for the indication, use and authorization of dispensing medicines subject to medical prescription by nurses are appealed in court by competence invasion, which manifests the discomfort of the doctors.

Lack of concretion in the text

From the point of view of Metges, in the same sense as Amyts, “the text suffers from a Absolute lack of concretion in relation to the limits in the prescription. “” The prescription by other healthcare groups must occur in the strict scope of their powers. The draft does not define them clearly and that could lead to situations of professional intrusion, “they point out from the Catalan organization.

They have also spoken regarding the Physiotherapist prescription: “The Law of Ordination of Health Professions (LOPS) is clear and says that the only possible treatment for physiotherapists is one that derives from Physical media and agentsnon -pharmacological “.” Patient safety and health service quality They are not duly guaranteed in these regulationsbut seriously compromised, “they sentence.

For its part, Simpa recalls that, in terms of medications subject to medical prescription, the performance of nurses “is conditioned to the terms established by each protocol and guide of clinical and welfare practice approved and validated.” “With the draft that has been transferred to us, everything seems to indicate that These control needs are minimized and the need for specific formations or the existence of specific orders/protocols to be able to make such prescription is blurred, “they say.

Patient safety, “committed”

Outside the Apemyf fan is CESM, which goes hand in hand with the medical profession forum, which also brings together, among other entities, to the Collegiate Medical Organization (WTO) or the Conference of Deans of Medicine Faculties. All will march in block against the law of the medicine. As Fuentes del del
organism, its resources will also point to the chapters related to the prescription nurse.

“We will do what is necessary to make it very clear that the act of diagnosis and prescription are exclusive acts of medical personnel, and we will act At the forum level of the medical profession“, summarize the representatives of the doctors, who emphasize the danger of this type of work being carried out by” professionals who are not trained for it. “” Security is put at risk, “they say.

In less than a day the period of allegations ends. At that time, Health will decide what his next steps will be. Even so, the most complicated is, the Congress of Deputies.