Doctors’ health: taking the lifecycle approachBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7086 (Published 26 November 2013) Cite this as: BMJ 2013;347:f7086
All rapid responses
In Colombia the 21st century began with two vital events: the unstoppable spread of Internet, and the destructive impact produced not only in health sector, but in all society, of bad implementation at practice of a new legislation for health care in our country, popularly called by us the Law 100.
Big social and professional changes such as globalization, interconnection, robotization have been introduced by the rapid evolution of the world wide web. In only two decades, after the introduction in 1977 of script languages on the code HTML for enhancing web sites and making them more interactive, world dynamics have abruptly changed. We have passed from a real world to a virtual one characterized by the daily increase of our permanence directly ahead of the user interface of our personal computer, of our smart mobile phone. The functionality of web pages, data input forms, pop up windows, interactive work, have brought us to new transitional professional challenges, to new paradigms and we have changed our traditional and obsolete daily working form. With the new scientific and technological advances around the world also are rapidly changing the traditional dynamics of health care services to contribute better to the population welfare. However the most worrisome situation that are facing now physicians, nurses, specialists, doctors, an in general all people who are working in health sector is related with the ugly dynamics of our health social security system because this organization can not yet solve the big and horrendous social troubles produced as a logical consequence of bad application of that law at practice. Every day are decreasing the quality in services at health dispensaries mainly because people and directors of companies and cooperatives of health sector are violating the natural principles and laws designed to protect the people's rights. The saddest of this situation is that Colombian government leaders don´t want to assume their corresponding role in correctly guiding the public policy directed to guarantee to all people the constitutional right of their access to good health services, without any kind of exclusivity. We can not also ignore the permanent protest people meetings, declarations, and conferences made against the illegal implementation of Law 100 at practice and against the poor quality of health care services in Colombia.
Human resources are the main protagonists, the leading authors and therefore the decisive force in the provision of health care services to the population. Nurses, physicians, general practitioners, specialists, doctors are the competitive force in the Colombian health care system. They are the main supporters of that form of social and economic organization.
The practice of medicine in Colombia has been linked to new substantial changes that have produced radical transformations in the daily work of human resources. All medical professionals are loosing the autonomy in management of their professions. Their monetary level and social status are radically decreasing because the influence of a new trading financial model in Colombian health care that favors to people thirsty of cheap labor who belong to the high social spheres, to political and economical sectors of our country, people who have taken possession of the economy in health care, and who have the attention engaged only in costs and financial yield. They are not interested in healing the sick and saving lives, their blank is the money collected by our compulsory prepaid health care system. They subordinate to general practitioners and specialists to a regime of work force recruitment, of new forms of linking labor which reduces their income, in terms of minimum salary wages, decrease their time for making professional and scientific activity, restrict their time for building affective relations with their respective families, for helping to structure life´s projects to their family members. Now it is not possible to take free time for rest. They have not only extremely changed the correct provision of health services but also they have radically modified the social status of health care professionals and their quality of life.
Physicians, specialists and doctors are facing several challenges related with their professional levels, their performances within an organizational climate where they are subject to several hard conditions such as a high productivity according to imposed daily work standards, number of clients (patients), observed in one hour, time devoted to them, total daily formulated medicines, total amount of patients referred to specialists, and number of high cost laboratory and diagnostic tests daily ordered.
Conflicts, daily tensions with their patients and directors, absence of free time for resting provide conditions for the appearance of addictions, such as consumption of alcoholic beverages, use of psychoactive substances, permanent smoking and the occurrence of familiar dysfunctionality, burnout, and other physical and mental diseases.
The exercise of medical profession in Colombia has undergone great transformations. From being a liberal autonomous activity it has passed to be an organized process, carried and supervised by unscrupulous people who cynically use physicians and other professionals for profit or economical advantage.
We want to participate in the 2014 International Conference on Physician Health in London.
Competing interests: No competing interests