Beyond its impact on public health, the pandemic of COVID-19 has lacerated the medical industry in Puerto Rico, directly affecting the services provided to patients.
The closure of medical offices and other outpatient services during the government-imposed "forced closure" affected not only patients with chronic diseases, but the stability of this professional sector.
This situation has precipitated the withdrawal of doctors, dentists, and therapists. Meanwhile, nurses and other health professionals, who have been laid off by the notable drop in hospital censuses, have accepted job offers abroad, despite the high risk of contagion of this virus. The permanence of others, such as respiratory therapists, meanwhile depends on various bills seeking to raise their wages beyond the minimum allowed.
Meanwhile, next year, the flight of doctors, especially primary doctors, could increase if an amendment to the 2019 Incentive Code that expands the categories of doctors who can qualify for the 4% preferential rate of income tax does not prosper.
“Yes, there are people who have retired due to the pandemic, especially doctors over 70 years old, "said the president of the College of Surgeons Víctor Ramos.
According to the doctor, the average age of the country's medical class is 60 years , although in the case of surgeons, he assured that the average is higher.
"We are going to see it more (the flight of doctors) when there is more control of the pandemic, depending on how 45% passes," he said Ramos.
According to the also pediat ra, Senate Bill 1620, which extends the term of decree request for all qualified doctors until December 31, was approved in the House this week and now depends on the signature of the governor.
Ramos recalled that the The COVID-19 pandemic has represented an economic challenge for health professionals that is now reflected in an increase of at least 20% more in the operational cost of their offices due to the strict hygiene and social distancing protocols that they have to comply.
He warned that it is time for the rates to be reviewed as they have continued with them for 26 years.
“Today (yesterday), we met with the insurance commissioner to discuss the increase in costs due to the COVID, "said Ramos, who particularly referred to the purchase of personal protective equipment, among other expenses that doctors have had to make in their offices.
According to the doctor, this increase in costs could be another fact Or to re-trigger the flight of doctors as it did in 2006 if no action is taken now.
One of the effects on patients of this whole situation, he said, is an even longer delay in medical appointments and evaluations.  In the case of respiratory therapists, Diana Acosta, president of the Puerto Rico Respiratory Care Association, assured that many have been temporarily laid off or suspended due to the drop in hospital censuses.
People do not trust hospital care and there are many patients with chronic diseases (with their deteriorating conditions), "he said.
According to Acosta, many respiratory therapists have had to make the decision to withdraw from their profession prematurely or to request licenses to staying at home because of the risk of contagion.
“Others have seen a risk of moving to the United States and, after being temporarily suspended due to hospital discharge, have preferred that moving into their homes, qualifying for unemployment, although some have received financial aid, but others have not, "he said.
According to Acosta, the economic impact of respiratory therapists has been great since many do not qualify for the Health Reform, coupons or other aid.
He added that, in Puerto Rico, there are about 1,200 licensed respiratory therapists, of whom about 750 work in hospitals, with an average age of 48 to 55 years and an average salary of $ 7.25 to $ 10 an hour. , although they require a university degree, two revalidations and the renewal of the degree every three years.
Acosta warned that there are two measures that concern respiratory therapists, Senate Bill 221 (to regulate and temper the practice of this profession) and Joint Resolution 555, which establishes economic incentives for different health professionals, including respiratory therapists. Both were approved in the House, but with amendments.
"We must do justice to these employees who are on the front lines, at the risk of catching, infecting others in their families or dying," he said.
For his part, Jaime Plá, from the Hospital Association pointed out that hospital censuses remain low, although there was a slight increase. Despite the layoffs, a dramatic flight of health professionals has not been noted as many fear to leave due to the risk of contagion in other countries, said Plá.
Adalisse Martínez, spokesperson for the Hospital de Niños San Jorge, indicated that the drop in the patient census caused this institution to dismiss 244 employees, although it highlighted that 141 have already returned or are in the process of returning to their jobs. Among these, he said, are nursing personnel, clerical, respiratory therapists and medical technologists.
Julio Irson, from the College of Practical Nursing of Puerto Rico, indicated that layoffs and suspensions due to hospital discharge in the country accelerated the flight. of these professionals. He indicated that, in Puerto Rico, there are about 70,000 nursing professionals, but in the last six months about 2,000 have left. He pointed out that some have sought other work options, and regretted that many have not yet been hired again in hospitals since the economic incentives they have received are for service to COVID-19 patients.
Juan Rexach, president of the Laboratories Association, agreed that the economic impact of the health sector has been significant in the last three months.
"We have not been able to make even 10% of regular billing," he said.
Although acknowledged that, in the last two weeks, the volume of patients has risen in laboratories in the metro area, this has not happened in those in rural areas.
He mentioned that one laboratory has already closed and others have also, but temporarily. On the other hand, he emphasized that there are employees who have refused to work for fear of becoming infected.