“Too many recipes, criminal shield and artificial intelligence to cut them”

In the first five months of this year, Italians have booked over 23 million medical visits and tests such as ultrasounds, CT scans or MRIs with the National Health Service. At the end of the year, at this rate, almost every Italian will have received at least one prescription (excluding drugs). A mountain of services counted by the new National Platform on waiting lists that after a long wait has just started working and should represent one of the driving forces of the Government's plan to combat the number one emergency in Italian healthcare: the hated queues that convince four million Italians to give up on treatment and that the Court of Auditors defines as a "shameful phenomenon for a civilized country". An emergency, that of waiting lists, which like a coin has two sides: on one hand, the too narrow funnel against which citizens collide when they call the CUPs, which is particularly hateful when it comes to seriously ill patients who cannot wait, but on the other hand there is also the so-called "inappropriateness", the useless prescriptions prescribed by doctors driven by defensive medicine and that is, the fear of protests from patients or even of finding a lawsuit. This phenomenon clogs up the system and lengthens the lists: "Today we have a problem of inappropriateness that we have not addressed immediately so as not to give citizens the feeling of wanting to cut services, but this phenomenon concerns at least 20% of prescriptions. Citizens sometimes demand to receive treatments that are not needed, as a doctor I say that if you have back pain before having an MRI scan a visit to the orthopedist is enough", explains to the Sole 24 Ore the Minister of Health Orazio Schillaci who yesterday participated in the Forum Logos & Téchne in Syracuse organized by Fiaso, the federation that brings together hospital and ASL managers where the spotlight was turned on artificial intelligence in hospitals. "Artificial intelligence will be able to give a hand to doctors, but then we need to intervene on defensive medicine", adds Schillaci who announces the very short arrival of the criminal shield for white coats. "We experienced it during Covid and now it will become structural within the year, already in the next few days this measure could be included in the bill for the reorganization of professions that we will present to the Council of Ministers. Doctors will no longer have to fear criminal cases, serious negligence and the possibility of civil compensation will remain".

Confirmation of over-prescription comes from the National Platform that collects all ASL bookings by ASL: the first overall numbers with the national medians - the local differences where the most sensational cases of delay are hidden are still missing - show how the NHS is better at responding in cases of an urgent nature (urgent and short services with times ranging from 72 hours to 10 days), but much less so for non-urgent services - deferrable (30-60 days) and programmable (120 days) - where inappropriateness risks nesting more easily with waits that even far exceed a year. On this front, the filter of family doctors will be crucial, on which a reform has been under study for months that could see the light in a bill to reform the hospital and territorial network: "Guidelines and artificial intelligence can be fundamental tools for the role of the family doctor, because without appropriateness the system can no longer hold up", insists Schillaci. Who sees in the new Community Houses an opportunity in this sense: "There will be teams of doctors there who can help make the right prescription choice". Also for the president of Fiaso Giovanni Migliore there is a problem of governing the demand: "There are some patients who receive ten times more services than they need and there are others who do not receive one and would need more. Inequality of access must be fought and artificial intelligence can give us a hand".

Of course, the number one problem remains the offer of services, which is burdened by the shortage of doctors and nurses, as the Court of Auditors recalled yesterday: "It is necessary to put the health professional (the doctor and the nurse) back at the center of the "health village" so that, adequately remunerated, they can be decisive in the decision-making and management processes of the structures responsible for care. The revaluation of human capital would also be functional to the reduction of the shameful, for a civilized country, phenomenon of waiting lists".