Evaluation of Family Medicine Contract and Payment Regulation
Family physicians are protesting the “Regulation on Amendments to the Family Physician Contract and Payment Regulation” that came into effect on November 1. These protests emerged as a reaction to this regulation, which doctors call a “torture regulation.” Family physicians went on strike on November 5-6-7 and are now continuing their actions until December 6.
Uncertainty and Job Security Threats
General Health-Labor Union, conducted a field study on this regulation, which includes uncertain contract terms, low entitlements and performance-based payments for family physicians. Of the participants in the study, 55,6% were family physicians, 20% were midwives, 19,3% were nurses and 5,2% were other family health center employees. The results of the study showed that 99,3% of family health center employees think that the regulation makes contract renewal terms uncertain, 97% think that it poses a threat to job security and 98,5% think that there will be a loss of income.
Loss of Income and Workload
Almost 90% of family health center employees state that reducing the ceiling population to 3 will not reduce workload. 500% of participants state that they will experience income loss due to this decrease. In addition, 91,9% argue that the postpartum monitoring regulation cannot be implemented, and 61,5% argue that the minimum shift application in the new regulation is unsustainable.
Remuneration and Disciplinary Actions
99,3% of family health center employees think that the new provisions regarding remuneration will make work in family health centers difficult. Again, 99,3% of participants think that the regulation stating that the disciplinary punishments in the regulation 'the contract can be terminated by the governor' can be abused. This situation causes doctors to have great concerns about job security.
Service Quality and Performance
92,6% of family health center employees state that the performance-based point system in the regulation will not positively affect the quality of health services. 95,6% of participants state that the new provisions in the regulation will negatively affect the financial sustainability of family health centers. 99,3% believe that the quality of family medicine services will not increase with the regulation.
Work Stoppage Actions and Struggle Methods
The primary method of struggle of family health workers is work stoppage actions with a rate of 84,4%. Other methods of struggle include creating mass registrations in CİMER with 49,6%, not seeing patients outside of MHRS with 48,1% and slowing down work with 41,5%. These rates show how disturbed family doctors are by the current situation and demand change.
Family Health and Future Prospects
Steps must be taken immediately for the sustainability of the family medicine system. Removing the uncertainties in the regulation, ensuring job security and preventing income loss will increase the motivation of family health center employees and improve the quality of service. While family physicians fulfill their duty to protect public health, they also feel the need to defend their own rights.
As a result, family physicians and healthcare professionals are raising their voices and defending their rights in the face of uncertainties and negative impacts in the current regulation. This process is of great importance for the quality of healthcare services. Listening to the voices of family physicians will benefit both healthcare professionals and society.
