Doctor conducted for 40 years, it is not enough to manage a structure for the elderly

Viterbo – The appeal of a doctor in charge of an RSA in the province rejected by the TAR

Viterbo – ( – “Medical doctor” and then “family doctor” for about forty years, but it is not enough. To manage a facility for the elderly, it takes specialization.

The Lazio TAR rejected the appeal of a doctor against the Lazio Region for the cancellation of the warning to replace the doctor in charge of an RSA managed by a congregation of religious in the province of Viterbo where the interested party had assumed the role of “Responsible doctor”, stipulating an intellectual work contract, on November 19th of last year.

For the Region, the former doctor did not meet the requisites required to be able to fill this role. In particular, “suitable qualification”, required by the DCA (decree of the commissioner ad acta) n. 8/2011, to perform the related functions in a nursing home for the elderly.

On July 9, the effectiveness of the contested provision was suspended, while at the public hearing on October 12, at the request of the parties, the appeal was retained for decision. The sentence rejecting him was published on 24 November.


Healthcare worker

According to the professional – in light of the fact that the decree of the Ministry of Health of 30 January 1998 provides for the equivalence between the specialization in “geriatrics” and that in “internal medicine” or “general medicine” – since there is no specialization in ” general medicine ”, it must be considered that he intended to refer to the certificate of specific training in general medicine, which is obtained after attending a three-year regional course.

“Since article 6 of the legislative decree exempted from obtaining this certificate, by right, doctors who have a conventional relationship with the national health system on 31 December 1994 – therefore the defense argues – considers the applicant to be in possession of the requisites required to cover the role of doctor in charge of an RSA, having performed the functions first as a ‘medical practitioner’ and subsequently as a ‘family doctor’ for about forty years “.

In essence, the doctor points out that the decree does not only refer to the possession of a specific specialization (geriatrics, physiatrics or equivalent qualification), but also enhances the work actually carried out.

In the present case, the Lazio Region failed to assess the forty-year work carried out by the applicant as a medical practitioner or as a general practitioner.

In particular, the decree, with regard to healthcare residences for the elderly, provides that the management of the RSA is entrusted to the responsible doctor in possession of the specialization related to the type of user (geriatrician, physiatrist or other specialist) or with documented service activity for at least five years in the sector with presence of at least four hours a day for six days a week and with responsibility for health care and the psychophysical conditions of the guests, this function is also extended to any semi-residential units present in the same structure.

“The appellant is peacefully lacking one of the required specializations”, reads the sentence.

And again: “The fact that there is no specialization in” general medicine “in the current system cannot lead to the conclusion, invoked by the appellant, that the ministerial decree intended to refer to the certificate of specific training in ‘general medicine’ , and that therefore said certificate constitutes a sort of equivalent qualification with respect to the specialization in ‘geriatrics’. Nor can it be considered that the applicant, inasmuch as he is entitled to carry out professional activities as a general practitioner, can be considered in possession of a qualification comparable to the specialization in ‘geriatrics’. Otherwise, if we opine, we should arrive at the inadmissible conclusion of believing that general practitioners are entitled to carry out professional activities that the legal system reserves exclusively for doctors with specialization in ‘geriatrics’ “.

“The professional activity carried out by the applicant as a medical practitioner or general practitioner does not integrate the specific requirement referred to above, consisting of the performance of service activities ‘in the RSA sector’ in the manner indicated”, they say in conclusion the administrative judges, rejecting the appeal.

December 6, 2021



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