publicado em 21/03/2013 às 20h04:00
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Medical Demography: Where is my doctor? Missing or not missing doctors in Brazil?

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Foto: Cremese
Julio José Seabra Santos, president of the Regional Council of Medicine of the State of Sergipe (Cremese)
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Julio José Seabra Santos, president of the Regional Council of Medicine of the State of Sergipe (Cremese)

The uninformed, in his eagerness to criticize the Medical Entities are not updated with the work that the CFM and CRM s been doing to declassify government claims scientifically and bad managers who lack medical in Brazil.

WHO, PAHO does not define desirable number of doctors per capita or recommend a single parameter or national goal. It happens that there statistics of European countries that the WHO itself recognizes that it must be applied to other countries, especially outside of Europe.

However, the government "believes" that the World Health Organization (WHO) recommends one doctor for every thousand inhabitants and also believes that having a malformed doctor is better than no offer to the public.

One of the most consistent to disallow this ideological mantra Medical Demography is the study in Brazil, which began in 2011 and in February this year was the launch of volume 2, made by CFM / CREMESP / s CRM: Medical Demography 2.

So if they were contemporaries, they would know that already emptied the arguments that have been advocating, based on ideological postulates and that, anyway, insist on collecting or gathering are still reluctantly "weapons" that argument by statistical inconsistency, because of population growth 1970 to 2010 was 104.8% while the doctors was 530%, where 42% are 39 years of age.

The country has never had so many practicing physicians and the perspective now is to maintain this upward curve. While the rate of population growth slows, the opening of medical schools and vacancies in existing courses experiencing a new boom. Between October 2011 and October 2012, were accounted for 16,227 new medical records.

The total number of doctors has increased markedly in recent decades, but there is a perception of a scenario of strong inequality regarding the distribution of doctors across the territory of the country and some areas in public health, due to the absence of public policies to strengthen SUS, which do not stimulate the migration and attachment of medical care in the voids nor its relationship with the public, the lack of implementation of the State Plan for Career, Job and Salary of Medical, linkages precarious employment and lack of perspectives.

On the lack of doctors to be stressed that the number of doctors in the country has increased, but the solution to the end of the inequitable distribution of doctors and access to the Brazilian health care will be achieved with the adoption of public policies structuring long term decision based on priority of federal, state and municipal levels, to increase the volume of investments in the sector; qualify modernize and enhance the management and the Medical and Medicine, not opting for import of low quality.

Most professionals have chosen to settle in the South and Southeast and in the capital due to better working conditions. Those who live in the North, Northeast and poorest municipalities in the interior, resent the lack of investment in health. This scenario reproduces the population's access to health services and professionals.

A simple opening more schools and more places in existing courses is not sufficient to reduce regional inequalities in areas of low concentration of doctors in remote areas, North, Northeast or the interior. After graduation, the newly formed physician tends to migrate to other more developed centers like São Paulo and Rio de Janeiro, among others. In general, the cities are more attractive to these professionals cities where they were born or graduated. This persistent flow of doctors toward the same places can further aggravate inequalities and have other unintended consequences to the Brazilian health system.

The automatic revalidation or facilitated the diplomas of foreign doctors trained abroad or Brazilians, if it occurs, will not be a factor reducing inequalities automatic distribution of physicians in Brazil. The study shows that, after their entry into the country, this group mostly has the same behavior of all other graduates in the country. That is, migrate and settle in more developed areas contradicting the ideological argument advocated by the Government that this quota will assume the posts in so-called empty assistance. This does not happen because when they see themselves in these areas face the same problems of Brazilian physicians: lack of infrastructure to work, lack of support from multidisciplinary teams, lack of prospects for professional development, lack of access to continuing education.

Physicians have been blamed for the failure of the public health system. This is a fallacy, an irresponsible simplification of the problem. Not solve the problem of society just putting a doctor with a stethoscope in each municipality. This is not the internalization of health care and we hope that the country needs. In fact, as partners and advocates of SUS doctors expect governments to do their part and provide real working conditions, invest in improving services and value network professionals. This attitude will bring gains for everyone, especially for the Brazilian who finally have access to quality care.

Despite all the problems existing, if health care is still working through the commitment of physicians to society and our charge for the involvement of government and other sectors of society in this debate. It is important to keep in mind that medical entities such as institutions, are always interested in dialogue and proposals and find answers to the problems of care for our population.

Source: CFM
   Palavras-chave:   Medical Demography    CFM    Federal Medical Council    Regional Council of Medicine   
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