From Oska to Oka, why is regional medicine collapsing?

Coordination of medical personnel Usca toscane

July 04

Dear Director,
The Tuscany region provides health, but it is the citizens who pay for it. These days what we’ve been condemning for days is happening: Usca offices are still barebones in many areas of the area. What caused this situation?

The region of Tuscany has proposed to physicians who have so far worked in Osca, a new assignment (in the new Occa) which, however, increases the tasks and reduces, at the same time, both staff and salary (by about half), making it a fact inferior to the fact of continuity of assistance ( The so-called medical guard). However, the proposed framework is exactly that of a day care continuity framework, with a contract that does not include biohazard exposure from Sars-Cov2, global patient and patient care, daily telephone monitoring of people receiving care, and automated diagnosis using ultrasound and blood gas analyzers. All tasks required, however, of doctors at the new Oka.

Moreover, this decision was made unilaterally by the regional government and Usl, without involving those who had worked for years at Usca, often compensating for systemic deficiencies in regional medicine and the entire NHS.

Faced with such working conditions and the inappropriate attitude of the district and local health authorities, most colleagues refused the new job.

Thus the Tuscany gives up the thousands of months of accumulated professional experience in this field, a service that has succeeded and the possibility of truly protecting the health of the population. All this for a supposed economic saving that may never happen.

We believe, in fact, that at the moment of the re-emergence of infections, the decision to save on the main regional service for the management of positive cases is a sign of lack of foresight and lack of attention to the needs of the population. Primary care will not be able to make up for the lack of service in Oska where we have worked so far, not because of a lack of will or less skills, but because of a lack of time to devote this additional task. All of this would predictably translate into an increase in access to the emergency room, and therefore hospitalization.

An example is what happened in the northwestern United States where a model system of intermediate care facilities, a national unit that includes semi-intensive treatment, palliative care, and hospice services, was dismantled. A fully discovered service that led to the transfer of patients to Ps.

All this could have been avoided if the established service had been confirmed with the same personnel, equipment, offices, duties and rewards, as was done in other regions, for example, in Emilia-Romagna. On our part, as has also always been emphasized on Usl and the Region, there is availability at any time to resume service, as long as our professionalism is recognized, those who have worked at Usca in recent years participate in decisions regarding our work and patients’ health.

Coordination of medical staff Tuscan Osca

July 04, 2022
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