PISCO, Dr Luis
Portugal: Family doctor
Luis Pisco is a family doctor from Portugal and a Fellow of WONCA and leader in family medicine in his own country.
What work do you do now?
Although I graduated as MD from the University of Coimbra in 1979, I´m now a invited Professor at the Department of Family Medicine, Faculty of Medical Sciences, Nova Medical School, in Lisbon, with the teaching responsibilities divided between ten colleagues. I also work as International Officer for the Portuguese Association of General and Family Medicine.
Since October 2011, I have been the Vice-President of the Executive Council of the Regional Health Authority of Lisbon and Tagus Valley (ARSLVT ) and responsible for Primary Health Care and Public Health. It is the biggest Health Region in Portugal covering a geographical area of about 13,000 square kilometres which corresponds to 15% of our territory, but we provide primary care to 3.6 million registered users, which is around 34% of the Portuguese population.
The ARSLVT includes 15 groups of health centers representing a total of 90 health centers and 138 Family Health Units. We have 32 hospitals organized in 16 hospital units.
As in many other regions we have an increased prevalence of chronic and degenerative diseases, diagnosed at increasingly earlier stages of disease, an increase in situations of dependency, a big variety of psycho-social problems and situations related to mental health, increasing immigrant population and changes in family structure. It is a big challenge for our National Health Service to provide access and good quality of care.
Other interesting things you have done ?
I worked as a GP for fifteen years in a rural area near the seaside, 80 Km north of Lisbon. It was a solo practice with around 1850 patients. I also have training and experience as an occupational doctor, mainly organizing an Occupational Service for primary care professionals.
I also have a long term interest in quality improvement. I had the first training in the area of quality improvement, in 1985, within the Portuguese and Spanish joint programme supported by both Ministries of Health and WHO. I worked as co-ordinator and trainer in several courses on continuous quality improvement, at national and international level.
In January 1999, I was elected President of the GP Association for three years and re-elected twice (around ten years as President and twenty five as board member).
Other posts I have held are:
• From April 1999 until October 2005, I was appointed by the Minister of Health, as Director of the National Institute for Quality in Health Care.
• Country representative in EQuiP (European Association for Quality and Safety in Family Medicine) since 1991 and from 2002 to 2008 Executive Committee member.
• An appointment by the Council of Ministers Coordinator of the Mission for Primary Health Care (MCSP) from October 2005 to April 2010 as responsible to make a national primary care reform.
• Board Member of the European Society of Family Medicine (2001-2007).
Finally I’m honored to be a Fellow of the World Association of Family Doctors (WONCA) which I was awarded in 2007 and an Honorary Fellow of the Royal College of General Practitioners and more recently a Member of the International Advisory Board of the British Journal of General Practice.
What is it like to be a family doctor in Portugal?
It is difficult but challenging. The generation of family physicians who took care of the Portuguese population for the last 35 years will soon retire and young people will have to build their way and participate in what will be the future of the NHS and of family medicine in the country. The economic situation is difficult and NHS provides an invaluable service especially to poorest people and the good work of PHC will surely be recognized. Young doctors are a generation of very knowledgeable doctors, much supported by APMGF and with very active participation in the Vasco da Gama Movement.
What are your interests outside work?
As for the majority of family doctors, intensive work does not leave much room for family and rest. Married to another family doctor (Ana) we have two fantastic children (Ana and Luis). The two grandchildren (Francisco, 7 years and Miguel, 4 years) occupy most of the time available. In addition, whenever possible reading, music, photography and the desire to pay more attention to my stamp collection.
What future hopes do you have?
Together with a group of both older and young colleagues, I would like to organize the biggest event ever organized by WONCA and 2020 could be a good date for that. Our dream is to have more than 5000 GP’s from all around the world in Lisbon for WONCA World conference.