Isabel del Barrio, 34 years as a rural doctor in Madrid: “This is a priesthood, I worked 58-hour weekly shifts”

Isabel del Barrio This is the voice of experience. About to turn 61, she has been practicing as a doctor in small towns in Madrid for 34 years. “It’s a priesthood,” he explains. The Socialist parliamentary group has debated the current state of rural health in the Assembly this week, after finding shortcomings in several localities since the October 2022 restructuring of the out-of-hospital emergencies by the Community of Madrid, which operate On nights and weekends, when health centers are already closed.

A restructuring that, obviously, has disproportionately affected municipalities with fewer inhabitants and, therefore, with fewer resources. Of the 179 urban centers in the region, 78 have less than 2,500 neighbors, “Each person is guaranteed basic health care by a primary care team,” explained the regional executive, headed by Isabel Díaz Ayuso. But with the data in hand, today there are 29 local clinics (formerly known as Primary Care Emergency Services (SUAP) in cities and Rural Care Services (SAR) in towns) that do not have doctors, only nurses.

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They have dehumanized healthcare, they have turned healthcare into a business. Especially in small towns, where the family doctor is the primary person who builds the community. But he is lost because there are no resources. There is no time to treat patients. This is a war consultation,” says Isabelle. Who started his career with Raskafriya, in the mountains north of Madrid. “I lived with my parents in Madrid and I had to go by car every day. There she was the only doctor for Rascafria, Alameda del Valle, Oteruelo and Pinilla. “When recipes were written by hand.” They were in the late 80’s and early 90’s. “I saw patients in these four cities, took their prescriptions to the pharmacist and then he delivered the medicines in his car. Many times, if there was an emergency I would have to stop the consultation,” recalls Isabel.

There is no dearth of stories. “One day I was having dinner and they told me that an elderly neighbor was very ill. He had a very severe abdominal aortic aneurysm. The hospital, Ramon y Cajal, is 90 kilometers away., We will have to wait for the ambulance. “He came back alive, but died in the operating room.” Rural medicine is very difficult. Before being deployed to Rascafria, she did her internship in Pezuela de las Torres, another small town in Madrid. “We witnessed a traffic accident. The nearest hospital was in Guadalajara. We had to take him in an ambulance to the border of Castilla-La Mancha, and there transfer him to another ambulance that belonged to another autonomous community. “That’s how things worked back then.”

After her three-year journey in Rascafria, Isabel arrived in 1991 in Senientos, another town in Madrid (today 2,097 inhabitants). There he spent a large part of his career: 16 years, between 1991 and 2017., “At least now we had four doctors for three cities, Senientos, Cadallo and Rosas de Puerto Real.” In 2007 Isabel was transferred to Villa del Prado (7,200 inhabitants). “We improved the ratio there, four doctors and one pediatrician for the entire municipality.” If you think you have already experienced it all, in 2011 you started working in Navas del Rey (3,200 inhabitants) in a rural emergency care service that opens when the health center is closed.

Here he entered another dimension. Their day starts at 3 pm and ends at 8 am the next day. Approximately 17 hours for which he charges an additional fee of 17 euros and an additional fee of 300 for rurality supplement, “I’ve managed to work 58 hours a week.” There are at least five doctors, five nurses and five guards who cover the afternoon and evening hours on Mondays and Fridays and work 24 hours a day on weekends and care for residents of Navas, Chapinería, Colmenar de Arroyo, San Martín de Valdaiglesias. Let’s serve. Pelayos de la Presa, Navalgamela and Aldea del Fresno”.

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As far as the material resources it has are concerned, taking into account that it is an emergency center, they are summarized in an ultrasound machine and a defibrillator. ,No tests, no X-rays and very restricted medicines, Neighbors with serious emergencies sell out. And at least my center has doctors, but there are 29 centers across the region that have only nursing staff. The system should be able to provide answers regardless of political color, and now they are not being given that. Isabel remembers having to deal with three serious emergencies at the same time, “requesting a helicopter to transport a minor, attending an accident at the same time and seeing a man with internal bleeding in another room.” To see another person.” Isabelle assured that she would retire at the age of 65 and would not get engaged again. It is working to its limits. In Madrid, 12 doctors from emergency services outside hospitals have just requested transfers.

PSOE criticizes that the quality of healthcare depends on zip code and where you live. “Using the pandemic as an excuse, the Community of Madrid has eliminated primary care and emergency services outside hospitals, especially in small towns,” says the socialist deputy. Daniel Rubio, “We demand full medical equipment in all centres. In Cadelso de los Vidrios there is one doctor for 2,300 patients. “This is just an example.” One doctor is recommended for every 1,200 cards. Rubio points out that hospital emergencies have increased by 42% as patients are forced to go to hospitals because “the resources for primary care have been exhausted.”

Health assures that it understands the concern about the lack of human resources in rural health, and has conveyed this to the Ministry, which it accuses of “lack of action” in covering these positions. The Health Ministry says they are trying to ensure that professionals working in smaller towns do not deny them the special salary supplement. The average salary of a rural doctor is 2,400 eurosWhich may be more depending on age.