r e v b r a s o r t o p . 2014;49(2):101–102
w w w . r b o . o r g . b r
Editorial
What
makes
us
accept
the
way
we
work?
Maybe
the
pleasure
of
practicing
medicine!
夽
O
que
nos
leva
a
aceitar
essa
forma
de
trabalhar?
Talvez
o
prazer
de
exercer
a
medicina!
Ourprofessionalactivityhasasideofsatisfactionand plea-sure, which is formed bypracticing our specialty: making diagnoses,operatingandevaluatingresults.Orthopedicsisa specialtywithobjectivediagnosesandtreatmentsthat gener-allybringfavorableresults,asassessedbyourpatients.
Theremunerationforourworkisourgreatproblem:we areverybadlypaidincomparisonwithotherprofessionals andwetakeonresponsibilitiesthatarenotmatchedinany otheractivity.Thedevaluationofmedicalactionsisabsurd inallsenses,anditisevenstrangethatsocietyacceptsthis situation.
Inrelationtopatients,thereisacertainauraofdignityin doctors’activitiesthatmakesremunerationsomethingthat canbequestioned.Thequestionthatalwaysarisesis:“Butif thereisnomoney,isthepersonjustleftwiththedisease?”
Forthemajorityofliberalprofessionals,their remunera-tionisrelatedtothecostofthework.Thisishowarchitects, engineersandlawyerswork:theychargetheirfeesbasedon percentagesofthecostoftheworktobecarriedout.Ifdoctors weretoreceiveapercentageofthehospitalbill,thisattitude wouldbeconsideredunworthy.
Whatmakesusacceptthewaywework?Maybethe plea-sureofpracticingmedicine.
Inparallelwiththiscomplexactivityofattendingpatients, treatingthemandbeingremuneratedinadequately,wehave theactivity ofcontinuingeducation atcongresses, one-day events,lecturesand,today,internettransmissions.Thereis nodoubtthatsuchactivitiesareintensiveandconsumealot oftime,buttheyareagreeablenonetheless.
Intheseactivities,ourvocationofworkingforlittlemoney orpayingtolearnreachesitszenith.
Doingcoursesand training, attendingcongresses, mak-ing presentations, participating in examinations, writing
夽
Pleasecitethisarticleas:CamanhoGL.Oquenoslevaaaceitaressaformadetrabalhar?Talvezoprazerdeexerceramedicina!.Rev BrasOrtop.2014;49:101–102.
or reviewing studies and recording videos are very tiring activities and,in somecases,expensive and done without remuneration.Nevertheless,onsomeoccasions,thereisgreat competitiontoparticipateinthem.
TheexaminationtoobtainthetitleofSpecialistin Ortho-pedicsandTraumatologyhasmorethan300examiners,who traveltoCampinasandevaluatepossiblenewcolleaguesover athree-dayperiod.Thisiswithouttakinginto accountthe organizers, members and former members ofthe Training andTeachingCommittee,whospendtheyearsettingupthe examination.
AttheBrazilianCongressofOrthopedicsand Traumatol-ogy,wehave300to400participantswhogiveclasses,organize roomsandguidestudies.Onceagain,thisiswithouttaking intoaccounttheorganizers,i.e.ourcolleaguesinthehostcity andmembersoftheTrainingandTeachingCommittee,who spendyearsorganizingthemeeting.
If we take into consideration theregional and specialty congresses,thisnumberofourcolleagueswhoworkwithout remunerationorwithsomelosseswilldoubleoreventriple.
Overthelastfiveyears,morethan900studieswere ana-lyzed forpublication inthe Revista Brasileirade Ortopedia (RBO), without counting articles that were rejected. If we suppose that each study had three authors and two eval-uators, morethan 4500ofour colleagues were involvedin ourpublications,onlyintheRBO,withoutconsideringother journals.
There isno doubt thata significant numberof our col-leaguesdoseveraloftheseactivitiessimultaneously,buteven so,ifweconsiderthemaccordingtounremuneratedactivity, thenumbersdrawourattention.
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rev bras ortop.2 0 1 4;49(2):101–102fromperformingthesetasks,whichnotonlyareunpaidbut alsogenerateexpenses.
Whatmakesusacceptthewaywework?Maybethe plea-sureofpracticingmedicine.
Incertaincases,theactivityofmedicaleducationisfunded bysomeofthe suppliersofmaterialsor evenbythe phar-maceuticalindustry,whichminimizesthefinanciallossdue tothecostofprofessionalimprovement.Enrollmentin con-gresses,travelforimprovement,assistanceforpublications and sponsorship for scientific discussion forums and con-gressesarecontributionswithoutwhichtheseactivitieswould beunviableforalargenumberofourcolleagues.
In the May 2013 edition ofthe New England Journal of Medicine, there was an article called “The Sunshine Act-effectsonPhysicians”,whichmakescommentsaboutanew Americanlawthatobligesdoctorstodisplayonapublicsite anytypeofaidreceivedthatisgreaterthantendollars.The lawstronglysuggeststhatsuchaid,regardlessofwhatitisfor, isdishonest.Doctorswillbeconsideredtobeunworthyand willhavetopubliclydisplaythevalueoftheirunworthiness.
Thisistheanalysisandassessmentofasocietythatplaces consumption above all rules, but condemns subsidies for medicaleducation,nottomentiondoctors’remunerationfor consultancyservicestocompaniesthatareactivewithinthe
field ofhealthcare.Even the public, who liveon discounts andfantasticsales,andwhoveneratemoneyaboveanyother value,regarddoctorsasprofessionalswhoshouldlivewithout aidfortheiracademicupdatingactivities.
Accordingtothisview,wemustalwaysimproveourselves, sincewearejudgedharshlywhenwemakemistakes,butwe mustneveracceptanyformoffinancialaidforour improve-mentprograms.
Thisisthesetofrules,formedbytheextremelylow remu-nerationofmedicalactions,theextremelylowsalaryandthe renunciationofanyexternalaid,thatiscalledtheworthiness ofdoctors.
Whatmakesusacceptthewaywework?Maybethe plea-sureofpracticingmedicine.
GilbertoLuisCamanho RevistaBrasileiradeOrtopedia E-mail:[email protected]
2255-4971/$–seefrontmatter ©2014SociedadeBrasileiradeOrtopediaeTraumatologia. PublishedbyElsevierEditoraLtda.Allrightsreserved.
http://dx.doi.org/10.1016/j.rboe.2014.03.022
