Alvaro Nagib A taliah
*Im proving the general practitioner for better health
A
th ro u g h o u tt th e e n d o f th isth e w o rldc e n tu ry .a re fa c in g m a jo r c rise s a n dm e d ic a I c a re sy ste m u n d e rg o in g m a jo r re fo rm o A ll sy ste m a n d h e a lthc a re p ro v id e rs a re re a liz in g th a t th e re is n o t e n o u g h m o n e y
a n y w h e re in th e w o rld to p a y fo r a ll th e n e w m e d ic a I
te c h n o lo g y . T h e U S A sp e n d s a p p ro x im a te ly 1 ,2 5 0 b illio n
U S $ a n n u a Ily in m e d ic a I c a re , w h e re a s d e v e lo p in g
c o u n trie s su c h a s B ra z il, w h ic h try to fo llo w th e A m e ric a n
m o d e l, sp e n d a ro u n d 3 0 b illio n U S $ a n d th e re su lt is a n
a lm o st c o m p le te d isa ste r a s re g a rd s th e h e a lth o f th e
p o p u la tio n . A fu rth e r p ro b le m in B ra z il is th a t m e d ic a I
sc h o o ls a s w e ll a s p o st g ra d u a te p ro g ra m s a ll fo llo w th e
A m e ric a n sy ste m , th u s p e rp e tu a tin g th e c risis.
F o rtu n a te ly m a n y o f o u r u n iv e rsitie s a re w e ll a w a re
o f th is p ro b Ie m a n d a re se a rc h in g fo r w a y s to m in im iz e
th e p ro b le m . O n e a lte rn a tiv e fo r c o u n trie s lik e B ra z il c o u ld
b e to se rio u sly c o n sid e r m o re in v e stm e n ts in th e h e a Ith
e d u c a tio n o f th e p o p u Ia tio n fro m p rim a ry sc h o o l u p to
p o stg ra d u a te c o u rse s.
T h e p u rsu it fo r e ffic ie n t u se o f re so u rc e s in th e U S ,
C a n a d a , th e U K a n d o th e r in d u stria liz e d c o u n trie s h a s le d
to th e im p le m e n ta tio n o f a "g a te k e e p e r", a n o th e r n a m e
fo r th e g e n e ra l p ra c titio n e r, a n d to th e a p p Iic a tio n o f
*
MO, PhO, MCE
Chaiman, Oepartment of infernal Medicine, Escola
Paulista de Medicina, Editor, São Paulo MedicaI Journal.
e v id e n c e b a se d m e d ic in e . In o th e r w o rd s, th e ro le o f th e
g e n e ra l p ra c titio n e r w ill b e fu n d a m e n ta l a n d m e d ic a I c a re
w iU b e b o n d to d e c isio n s g u id e d b y th e c u rre n t b e st
a v a ila b le e v id e n c e .
In th e Ia st 1 8 m o n th s, d u rin g th e In te rn a I M e d ic in e
G ra d u a tio n P ro g ra m o f th e E sc o la P a u lista d e M e d ic in a ,
w e h a d th e o p p o rtu n ity to in c o rp o ra te in to th e te a c h in g
p ro c e ss th e p ro b le m b a se d Ie a rn in g (P B L ) sy ste m a n d
e v id e n c e b a se d m e d ic in e . In th is p ro g ra m th e stu d e n ts
re c e iv e tra in in g in th e P B L sy ste m to id e n tify th e h e a lth
p ro b le m s o f th e p a tie n ts a n d to d e c id e o n th e b e st tre a tm e n t
b a se d o n th e b e st a v a iIa b le m e d ic a I e v id e n c e .
A t th e sa m e tim e stu d e n ts a tte n d a c o u rse o n e v id e n c e
b a se d m e d ic in e w h ic h e m p h a siz e s th e im p o rta n c e o f
c ritic a I a p p ra isa l o f m e d ic a llite ra tu re ; th e y a lso h a v e th e
o p p o rtu n ity to m a k e u se o f th e re so u rc e s o f th e C e n tro
C o c h ra n e d o B ra sil.
A stu d e n t sa tisfa c tió n su rv e y sh o w e d stu d e n ts'
e n th u sia sm w ith th e c o u rse . P e rso n a lly I a Iso o b se rv e d
th e sa m e fe e lin g w ith in fa c u Ity m e m b e rs. W e th e re fo re
b e lie v e th a t in c lu sio n o f lin k e d p ro g ra m s o n P B L a n d
e v id e n c e -b a se d m e d ic in e in a ll g ra d u a te a n d p o stg ra d u a te
m e d ic a I p ro g ra m m a y b e a g o o d stra te g y to u se re so u rc e s
m o re e ffic ie n tly , fo llo w in g th e e x a m p le s se t b y C a n a d a
a n d th e U K . T im e is sh o rt, e sp e c ia lly o u r o w n tim e , w e
sh o u ld n o t w a ste it.
