Primary and community care: the recipe: overcoming boundaries and building alliances

Today, dealing with primary and community care is not a neutral choice. It is a stance, a political and cultural act. At a time when many professions are closing themselves off to defend their own identity, promoting listening and discussion means going against the grain and affirming a different principle: the National Health Service cannot be saved by cultivating divisions or defending boundaries, but by building alliances to overcome them.

In recent days, a group of sixteen physiotherapist associations worked together to create a real forum for physiotherapists, nurses, doctors, social workers, technical representatives, administrators and citizens, experts in urban planning and land use, community building, and social relations. It was an open workshop where everyone contributed their own perspective, leaving aside any desire for prominence.

Several considerations follow. The first is now clear and evident: to be truly effective, community work requires a simple but radical cultural shift. The message in this area is clear: the time has come to definitively abandon—as Mary Tinetti, professor at the Yale School of Medicine, emphasized in an influential article published in the American Journal of Medicine—the era of diagnosis-based treatment, because community health is always built with individuals, not with standardized protocols or automatic responses.

Networking

This reflection thus highlights the second key aspect: no health need is "single-professional." From North to South, from metropolises to rural or mountainous settings, communities heal when they network, connecting healthcare, social services, the local community, and citizens, especially by merging knowledge. Thus, the clear understanding emerges that no health need can ever be addressed by a single profession, because no one can do it alone. Solutions arise from collaboration, team building, and multidisciplinary work. Where communities are able to heal—that is, prevent, support, and care—it is because connections have been established between different stakeholders, public and civic, institutional and local.