{"id":301829,"date":"2025-10-27T13:47:29","date_gmt":"2025-10-27T12:47:29","guid":{"rendered":"https:\/\/slf.se\/vastra-gotalands-lakarforening\/?p=301829"},"modified":"2026-03-19T07:01:40","modified_gmt":"2026-03-19T06:01:40","slug":"fler-har-fast-frisor-an-fast-lakare","status":"publish","type":"post","link":"https:\/\/slf.se\/vastra-gotalands-lakarforening\/nyheter\/fler-har-fast-frisor-an-fast-lakare\/","title":{"rendered":"Fasta l\u00e4kare \u00e4r avg\u00f6rande"},"content":{"rendered":"\n

Satsningar p\u00e5 den s\u00e5 kallade omst\u00e4llningen till god och n\u00e4ra v\u00e5rd<\/em> har i m\u00e5ngt och mycket resulterat i v\u00e4lmenande projekt och i floskler \u2013 men med lite f\u00f6r\u00e4ndring p\u00e5 golvet. Prim\u00e4rv\u00e5rdens uppdrag har \u00f6kat \u2013 och prim\u00e4rv\u00e5rdens l\u00e4kare \u00e4r fortfarande alldeles f\u00f6r f\u00e5 i f\u00f6rh\u00e5llande till uppdraget. S\u00e4rskilt saknas specialister i allm\u00e4nmedicin. N\u00e5gra projekt g\u00f6r skillnad, men oftast bara i marginalen. De flesta leder till rapporter eller administrat\u00f6rer utan f\u00f6rst\u00e5else f\u00f6r verkligheten, som efter m\u00e5nga arbetstimmar rapporterar sj\u00e4lvklarheter som nyheter \u2013 s\u00e5som att patienter vill f\u00e5 ett gott bem\u00f6tande.<\/p>\n\n\n\n

Effekterna av l\u00e4karkontinuitet \u00e4r v\u00e4l belagda<\/em><\/strong>, \u00e4ven i nordisk forskning. F\u00e4rre akutbes\u00f6k, b\u00e4ttre h\u00e4lsa och n\u00f6jdare patienter framtr\u00e4der tydligast. Hade en ny medicin eller operationsmetod gett samma resultat hade vi g\u00e4rna betalat dyrt. Tyv\u00e4rr befinner vi oss l\u00e5ngt fr\u00e5n m\u00e5let om fast l\u00e4karkontakt med rimlig lista \u2013 och det saknas \u00e4ven en tydlig plan f\u00f6r att n\u00e5 dit. Att d\u00e5 samtidigt halvhj\u00e4rtat f\u00f6rs\u00f6ka f\u00f6rb\u00e4ttra bemanningen\u00a0och \u00e4nd\u00e5 st\u00e4ndigt \u00f6ka prim\u00e4rv\u00e5rdens uppdrag\u00a0\u00e4r en ekvation som inte g\u00e5r ihop.<\/p>\n\n\n\n

Pseudol\u00f6sningar l\u00f6ser inte grundproblemet<\/h2>\n\n\n\n

Sverige har i dag, j\u00e4mf\u00f6rt med de flesta andra utvecklade l\u00e4nder, en sjukhustung v\u00e5rd. Det varken kan eller ska vi \u00e4ndra \u00f6ver en natt. Men vill vi f\u00f6rverkliga id\u00e9n om den fasta l\u00e4karen som patientens och sjukv\u00e5rdens bas beh\u00f6ver vi ett l\u00e5ngsiktigt arbete d\u00e4r b\u00e5de m\u00e5let och v\u00e4gen dit \u00e4r tydligt uttalade. Politiskt fokus p\u00e5 pseudol\u00f6sningar som tillg\u00e4nglighet<\/em>, oavsett behov, och digitala quick fixes f\u00f6r\u00e4ndrar inte verkligheten. Fler svenskar har en fast fris\u00f6r \u00e4n en fast l\u00e4kare.<\/p>\n\n\n\n

Omst\u00e4llningen \u2013 eller utflyttningen av uppdrag<\/em><\/strong> och patienter till prim\u00e4rv\u00e5rden<\/em><\/strong> \u2013 har\u00a0p\u00e5g\u00e5tt l\u00e4nge, men resurserna har inte f\u00f6ljt med. Allt fler patienter, fr\u00e4mst med folksjukdomar, f\u00f6ljs i prim\u00e4rv\u00e5rden. D\u00e4rtill f\u00e5r prim\u00e4rv\u00e5rden st\u00e5 f\u00f6r kostnader som andra delar av samh\u00e4llet tj\u00e4nar p\u00e5 \u2013 s\u00e5som f\u00f6rskrivningen av NOAK i st\u00e4llet f\u00f6r Waran.<\/p>\n\n\n\n

I de f\u00e5 fall resurser v\u00e4l tillf\u00f6rs kopplas de n\u00e4stan alltid till nya uppdrag \u2013 inte till en f\u00f6rst\u00e4rkning av k\u00e4rnverksamheten. Ett tydligt exempel i v\u00e5r region \u00e4r Ungas psykiska h\u00e4lsa (UPH)<\/em> \u2013 viktigt, men inte en satsning p\u00e5 prim\u00e4rv\u00e5rdens grunduppdrag. Trots en n\u00e5got st\u00f6rre total prim\u00e4rv\u00e5rdsbudget i samband med UPH:s inf\u00f6rande har vi allts\u00e5 inte f\u00e5tt en meningsfull f\u00f6rst\u00e4rkning av basuppdraget \u2013 oavsett vad vissa politiker g\u00e4rna vill ge sken av.<\/p>\n\n\n\n

Varf\u00f6r andra l\u00e4nder lyckas b\u00e4ttre<\/h2>\n\n\n\n

Frustrationen m\u00e5nga av oss k\u00e4nner f\u00e5ngas av l\u00e4karen och f\u00f6rfattaren Fanny Nilsson, som i sin uppm\u00e4rksammade bok \u00c5k till akuten<\/em> f\u00f6rs\u00f6ker f\u00f6rst\u00e5 svensk sjukv\u00e5rd. I jakten p\u00e5 svaret har hon rest genom Europa f\u00f6r att ta reda p\u00e5 varf\u00f6r andra l\u00e4nder lyckas b\u00e4ttre.<\/p>\n\n\n\n

Hon konstaterar att alla brottas<\/em><\/strong> med samma grundproblem<\/em><\/strong> \u2013 en \u00e5ldrande befolkning, \u00f6kade medicinska m\u00f6jligheter och brist p\u00e5 personal och pengar \u2013 men att skillnaden ligger i hur v\u00e5rden organiseras och hur man prioriterar.<\/p>\n\n\n\n

I l\u00e4nder som Nederl\u00e4nderna och Spanien \u00e4r prim\u00e4rv\u00e5rden i h\u00f6gre grad systemets ryggrad. Resultatet \u00e4r tryggare och mer resurseffektiv v\u00e5rd. Fanny Nilssons slutsats \u00e4r att Sverige beh\u00f6ver satsa p\u00e5 prim\u00e4rv\u00e5rden, samtidigt som privatsjukv\u00e5rden beh\u00f6ver regleras tydligare \u2013 och att vi, oavsett driftsform, m\u00e5ste \u201dsluta med struntsjukv\u00e5rd\u201d.<\/p>\n\n\n\n

F\u00f6r det \u00e4r ocks\u00e5 d\u00e4r politiken har g\u00e5tt vilse<\/em><\/strong> \u2013 i tron att fler v\u00e4lmenande projekt, fler appar eller fler h\u00e4lsofr\u00e4mjande insatser med tveksam evidens ska l\u00f6sa strukturella problem.<\/p>\n\n\n\n

Patienten bollas runt<\/h2>\n\n\n\n

Hela sjukv\u00e5rden f\u00f6rv\u00e4ntas dessutom st\u00e4ndigt effektivisera, trots en \u00e5ldrande befolkningen och att vi kan g\u00f6ra alltmer. Sj\u00e4lvklart ska vi d\u00e5 inte g\u00e5 i f\u00e4llan och bli frustrerade p\u00e5 varandra inom v\u00e5rden \u2013 att andra s\u00e5 att s\u00e4ga h\u00e4rskar genom att s\u00f6ndra kommer inte att hj\u00e4lpa n\u00e5gon, allra minst v\u00e5ra patienter.<\/p>\n\n\n\n

Vi i v\u00e5rden beh\u00f6ver d\u00e4rf\u00f6r fortsatt st\u00f6tta varandra<\/em><\/strong> \u2013 l\u00f6sningen kan inte fortsatt vara att patienten f\u00f6rvandlas till Svarte Petter<\/em> och bollas runt f\u00f6r att ingen har tid eller plats, eller vill ta kostnaden. Precis som vi st\u00e5r upp f\u00f6r evidensbaserad v\u00e5rd i m\u00f6tet med patienten,\u00a0m\u00e5ste vi st\u00e5 upp f\u00f6r evidensbaserad organisering av v\u00e5rden. Forskningen visar att l\u00e4karkontinuitet f\u00f6rb\u00e4ttrar h\u00e4lsa, trygghet och kostnadseffektivitet.<\/p>\n\n\n\n

Prim\u00e4rv\u00e5rden och akuten st\u00e5r i dag kvar med patienterna n\u00e4r ingen annan tar emot. Sjukhus och specialistmottagningar kan ofta remittera vidare, avsluta eller begr\u00e4nsa infl\u00f6det \u2013 exempelvis genom h\u00e5rdare remisskrav och bed\u00f6mningar. Tar ingen annan emot, eller v\u00e4ntar patienten p\u00e5 tid till specialistv\u00e5rden, \u00e4r det prim\u00e4rv\u00e5rden och akuten som patienten v\u00e4nder sig till.<\/p>\n\n\n\n

V\u00e4gen till verklig omst\u00e4llning <\/h2>\n\n\n\n

Ut\u00f6ver ett konkret arbete f\u00f6r att f\u00e5 tillr\u00e4ckligt m\u00e5nga specialister i allm\u00e4nmedicin, s\u00e5 att befolkningen kan ha fasta patientansvariga l\u00e4kare, beh\u00f6vs \u00e4ven andra viktiga f\u00f6r\u00e4ndringar f\u00f6r en meningsfull omst\u00e4llning.<\/p>\n\n\n\n

Vi beh\u00f6ver ett b\u00e4ttre samarbete mellan sjukhus och prim\u00e4rv\u00e5rd<\/em><\/strong> utifr\u00e5n patientens och prim\u00e4rv\u00e5rdens behov \u2013 till exempel konsulttelefoner som faktiskt \u00e4r tillg\u00e4ngliga mer \u00e4n n\u00e5gra minuter per dag. Vi beh\u00f6ver \u00e4ven en \u00f6kning av fasta l\u00e4kare inom specialistv\u00e5rden \u2013 det \u00e4r alltid b\u00e4ttre att\u00a0till exempel\u00a0kunna kontakta patientens egen gynekolog \u00e4n gynekologkonsult UNS<\/em> i ett sv\u00e5rt \u00e4rende.<\/p>\n\n\n\n

Det \u00e4r i denna typ av sm\u00e5, konkreta steg som den verkliga omst\u00e4llningen till en god och n\u00e4ra v\u00e5rd b\u00f6rjar, snarare \u00e4n ytterligare en app eller projekt med oklar nytta.<\/p>\n\n\n\n

Helhj\u00e4rtade och konkreta satsningar p\u00e5 fasta l\u00e4kare<\/em><\/strong> med rimlig lista, kombinerat med tydliga steg mot b\u00e4ttre samarbete mellan v\u00e5rdniv\u00e5er \u2013 ist\u00e4llet f\u00f6r att bolla runt patienten \u2013 f\u00f6rst d\u00e5 kan vi g\u00e5 fr\u00e5n floskler och projekt till en rimlig arbetsmilj\u00f6 f\u00f6r oss l\u00e4kare och tryggare v\u00e5rd f\u00f6r patienterna.<\/p>\n\n\n\n

Jakob Nyhl\u00e9n<\/em>
Specialistl\u00e4kare allm\u00e4nmedicin
Ordf\u00f6rande Sektion Prim\u00e4rv\u00e5rd V\u00e4stra G\u00f6talands l\u00e4karf\u00f6rening<\/em><\/p>\n\n\n","protected":false},"excerpt":{"rendered":"

Satsningar p\u00e5 den s\u00e5 kallade omst\u00e4llningen till god och n\u00e4ra v\u00e5rd har i m\u00e5ngt och mycket resulterat i v\u00e4lmenande projekt och i floskler \u2013 men med lite f\u00f6r\u00e4ndring p\u00e5 golvet. Prim\u00e4rv\u00e5rdens uppdrag har \u00f6kat \u2013 och prim\u00e4rv\u00e5rdens l\u00e4kare \u00e4r fortfarande alldeles f\u00f6r f\u00e5 i f\u00f6rh\u00e5llande till uppdraget. S\u00e4rskilt saknas specialister i allm\u00e4nmedicin. N\u00e5gra projekt g\u00f6r … L\u00e4s hela<\/a><\/p>\n","protected":false},"author":5804,"featured_media":301834,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"local_restriction":[],"class_list":["post-301829","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"acf":[],"yoast_head":"\nV\u00e4stra G\u00f6talands l\u00e4karf\u00f6rening<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/slf.se\/vastra-gotalands-lakarforening\/nyheter\/fler-har-fast-frisor-an-fast-lakare\/\" \/>\n<meta property=\"og:locale\" content=\"sv_SE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Fasta l\u00e4kare \u00e4r avg\u00f6rande - V\u00e4stra G\u00f6talands l\u00e4karf\u00f6rening\" \/>\n<meta property=\"og:description\" content=\"Satsningar p\u00e5 den s\u00e5 kallade omst\u00e4llningen till god och n\u00e4ra v\u00e5rd har i m\u00e5ngt och mycket resulterat i v\u00e4lmenande projekt och i floskler \u2013 men med lite f\u00f6r\u00e4ndring p\u00e5 golvet. 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