GENERAL RIGHTS OF DOCTORS

 DOCTORS’ RIGHTS


The medical service rendered to society, the ethical guidelines of the profession and the health legislation with its penalties for infringement of the relevant rules and obligations, as well as the patients’rights, generate corresponding rights for physicians.

GENERAL RIGHTS OF PHYSICIANS

1. To be freely chosen by their patients as a repository for their health and confidence.

2. Receive dignity and respect.

3. Have access to continuing medical education and be considered on equal opportunities for professional development.

4. Have the availability and timely human and material resources necessary for the proper performance of his career.

 5. To receive protection and compensation for health damage and harm that they cause, arising and / or resulting from acts proper to the practice of their profession.

6. To receive extra compensation for professional risks.

7. - Receive compensation for their professional obligation to assist anyone in any situation anywhere in the world.

8. To receive a fair fee or salary, commensurate with their dignity, responsibility and preparation, regardless of the outcome of their work.

 9. Protection, preservation and restoration of their professional standing.

10. Getting associated for the defense of their professional interests and  not receive differential or discriminatory treatment.

11. Autonomy of practice.

12. Participate freely in patient care.

13. Access to research and teaching in the field of their profession.

14. Get evaluation of their practice in all areas by doctors with equal or superior knowledge.

15. To participate on equal terms in commissions on development and establishment of budgets, rates and scales of their health care.

16. To participate on equal terms in the planning, development and management of health systems.



SWISSpsy / ASPROMEL, Madrid, October 26, 2014

Health professionals' health and labour policy

France : due to massive mobilizations of health professionals, the French Labour Ministry created a working group on burnout syndrome in health professionals. Suicide rate among health professionals is significantly higher than in general population.

Italy : The European Commission ( EC ) refers Italy to Court for not respecting the European Working Time Directive ( EWTD ) in the public health system.

Spain : The European Commission requests Spain to respect forensic doctors' rights to maximum working hours and and minimum rest periods.

The SWISSpsy INSTITUTE advocates by means of its working groups for a sound analysis and a re-equilibration between the current paradigms in medicine to guarantee health professionals's health in healthy health systems, which are the key- conditions for patients' safety and public health.   

HEALTH SYSTEMS AND THE LAWS OF THERMODYNAMICS

  Health systems are social and living systems

• Social and living systems are networked and highly nonlinear

• Such systems are governed by the laws of thermodynamics

• Power is work ( energy expenditure ) per time- unit

• Endurance capacity of man and his health systems is determined by the factor of

the " effort " that can be resumed to discomfort in the form of "fatigue" .

• Zeroth Law of Thermodynamics : If a system A (service provider ) is in thermal equilibrium to a system B ( service consumer ) and B ( service consumer) to a system C ( service financier ) , then also A (service provider ) is in balance with C ( service financier ) . The state quantity , which is coincident within these systems is the temperature ( the higher the temperature of a body , the larger is the average speed rate of its particles )

• First law of thermodynamics : The energy of a closed system (human, health systems ) remains unchanged. Various forms of energy can therefore interconvert , but energy can neither be created out of nothing , nor can it be destroyed. No system does work without supplying any other form of energy and / or without reducing its internal energy.

• Second law of thermodynamics : heat can not pass by itself from a lower body temperature ( lower rate of speed of its particles ) to a body of higher temperature ( higher speed rate of its particles). For example, heat can not pass by itself from  service providers to more and more demanding service consumers. Or: heat can not pass by itself from service consumers to increasingly demanding service financier ( insurances ). The inflation spiral and cranking the economy needs energy.

• Third law of thermodynamics : it is not possible to cool a system to the temperature of absolute zero. A person , or a health care system can not  be cooled to absolute zero . ( its particle velocity magnitude is zero )

• From all that follows that one-sided money exploitation and profit maximation of the health systems through the financial industry while ignoring the laws of thermodynamics leads to overheating and burning out of people, to non-renewable yield of the energy content and reserves of the systems and to the eventual collapse of the health systems.

WORKING GROUP ON LINKEDIN

This working group has extended its activity by creating a group on www.linkedin.com health professionals'health

ITINERARY TO BURNOUT IN HEALTH PROFESSIONALS

Definition : burnout is

1.    an experience of physical, emotional and mental exhaustion, caused by long-term involvement in situations that are emotionally demanding.

2.    The index of dislocation between what people are and what they have to do. It represents an erosion in values, dignity, spirit and will and erosion of the human soul.

Manifestation :

1.    Emotional exhaution

2.    Depersonalisation

3.    Lack of personal accomplishment

Itinerary to burnout

Motivation to study medicine:

Humanistic values and ethics are the main motivators for students in medicine. During medical training there is still insufficient focus on health aspects in the health systems concerning health professionals. There is insufficient training in conflict - management, business management, team-work and job-sharing. There is insufficiency in intervisions and supervisions.

Once finishes university training the young doctors are exposed to :

1. daily contact with illness, pain and death

2. excessive work load

3. increasing lack of social support ore even hostilities and 
    attacks increasing ( 20% in 10 years ) in a context of 
    feminisation of medical profession.

4. often working with colleagues who suffer already burnout 
    síndrome

5. excessive bureaucratic load

6. increasing penetration of health systems by the market 
    society and its beliefs

confronted to that reality young doctors with their humanistic motivations and ideals too often enter into the process of burnout which goes through the following phases :

1. phase of illusion and enthusiasm

2. phase of dis-illusionment and disappointment

3. phase of profound frustration

4. phase of despair then falling apart and getting sick 
    or entering the following phases

5. phase of cynisme and detachment

6. phase of making money

7. phase of being eaten up by the market society

In the sake of healthy health systems, of healthy health professionals, of quality of care, of cost-effectiveness, of patient security, of motivated future young doctors and last but not least healthy society, the following preventive mesures are a must, whereby continuity of the process is of paramount importance.

1. redefinition of health professions in the context of 
    society and social security systems

2. systematic and continued analysis, identification and 
    updating of health aspects in health systems

2. structuring multiprofessional care-teams

3. prevention and assessment concerning burnout risks

4. training of health professionals in social competence 
    and networking

5. training in conflict - management

6. training in management of change ( change as an 
    opportunity rather than a threat )

7. intervention of trained coaches in health systems

8. intervision and supervision for health professionals

9. tutoring of medical students

10. enhancing job-sharing for a better job-family balance

11. enhancing personal development plan to foster 
      personal growth

12. training in human sciences