Modena 24/05/2014
Modena 24/05/2014
"What is the message to the
next generation?"
Giorgio Visentin
Modena 24/05/2014
Summmary
• Once upon a time• Which methodology• Which patients• Which organization• New needs/new rights• Which answers• Why we have to be optimistic
Modena 24/05/2014
Once upon a time
• Prescription on white paper
Modena 24/05/2014
Once upon a time
• Prescription on white paper• No telephone
Modena 24/05/2014
Once upon a time
• Prescription on white paper• No telephone• First floor solo practice
Modena 24/05/2014
Once upon a time
• Prescription on white paper• No telephone• First floor solo practice• Cheap forniture (compared to private
doctors
Modena 24/05/2014
Modena 24/05/2014
Once upon a time
• Prescription on white paper• No telephone• First floor solo practice• Cheap forniture (compared to private
doctors)• No appointment
Modena 24/05/2014
Once upon a time
• Prescription on white paper• No telephone• First floor solo practice• Cheap forniture (compared to private
doctors)• No appointment• Patients were asking free useless
drugs
Modena 24/05/2014
Once upon a time
• Prescription on white paper• No telephone• First floor solo practice• Cheap forniture (compared to private
doctors)• No appointment• Patients were asking free useless
drugs• Frequent home visits
Modena 24/05/2014
Which methodology?
• EBM??
Modena 24/05/2014
Which methodology
• EBM??• Personal relationship with hospital
specialists
Modena 24/05/2014
Which methodology
• EBM??• Personal relationship with hospital
specialists• More theraphy less diagnosis
Modena 24/05/2014
Which methodology
• EBM??
• Personal relationship with hospital
specialists
• More theraphy less diagnosis
• Unknown prevention
Modena 24/05/2014
Which patients?
• Age
Modena 24/05/2014
Which patients?
• Age
• Chronic diseases
Modena 24/05/2014
Modena 24/05/2014
Which patients?
• Age
• Chronic diseases
• Multimorbidity
Modena 24/05/2014
Which patients?
• Age
• Chronic diseases
• Multimorbiity
• Frequent attenders
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Which health?
• Nutritive vs hypocaloric
Modena 24/05/2014
Which health?
• Nutritive vs hypocaloric
• Sport and supplements
Modena 24/05/2014
Modena 24/05/2014
Which health?
• Nutritive vs hypocaloric
• Sport and supplements
Modena 24/05/2014
Which health?
• Nutritive vs hypocaloric
• Sport and supplements
• Smoke and sexy
Modena 24/05/2014
Modena 24/05/2014
Which health?
• Nutritive vs hypocaloric
• Sport and supplements
• Smoke and sexy
• Which diet?
Modena 24/05/2014
Which health?
• Nutritive vs hypocaloric
• Sport and supplements
• Smoke and sexy
• Which diet?
• Hairs
Modena 24/05/2014
Which health?
• Nutritive vs hypocaloric
• Sport and supplements
• Smoke and sexy
• Which diet?
• Hairs
• Health as marketing
Modena 24/05/2014
Which organization?
• Solo practice (Poland)
• Free drugs (any!)
• Appointment
• Fee for service
• Fee for performance
• Home visits
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New needs/new rights
• Health definition
• Diagnosis vs problems
• Information on prognosis
• The concept of death
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Modena 24/05/2014
Communication to the health system
• Control of service
• Control of expenses
• Control of quality
• Accountability
• Excessive control
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Information to the patient/FSE
• Diseases known by relatives or
neighbour
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Information to the patient/FSE
• Diseases known by relatives or
neighbour
• Information from television
Modena 24/05/2014
Information to the patient/FSE
• Diseases known by relatives or
neighbour
• Information from television
• Web pages
• Blogs
Modena 24/05/2014
Information to the patient/FSE
• Diseases known by relatives or
neighbour
• Information from television
• Web pages
• Blogs
• Social network
Modena 24/05/2014
Which answers?
Modena 24/05/2014
Which answers?
• Multiprofessional approach
Modena 24/05/2014
Which answers?
• Multiprofessional approach
• Disease mongering
Modena 24/05/2014
Which answers?
• Multiprofessional approach
• Disease mongering
• Telemedicine
Modena 24/05/2014
Which answers?
• Multiprofessional approach
• Disease mongering
• Telemedicine
• Doctor patient vs team-community
Modena 24/05/2014
Modena 24/05/2014
Modena 24/05/2014
Which answers?
• Multiprofessional approach
• Disease mongering
• Telemedicine
• Doctor patient vs team-community
• Social network
Modena 24/05/2014
Why we have to be optimistic
Modena 24/05/2014