Regional medical councils sabotage, but doctors support the "More doctors" initiative.

247 - A group of doctors (most with more than 45 years of professional experience and with experience in management positions throughout their careers) released a signed manifesto on Tuesday (24) in support of the federal government's "More Doctors" program. The document outlines a panorama of medicine in the country, highlighting the problems of the lack of professionals to work in more peripheral areas. The doctors also mention the demonstrations that took place in the country in July and partly in defense of bringing foreign doctors to the country.

"Therefore, the group of doctors signing this document affirms that the Mais Médicos program immediately satisfies the needs of underprivileged and socially depressed populations, contributing to their access to better conditions of citizenship. We are convinced that this program will progressively consolidate and will find its support in the population. The medical profession itself, by not feeling harmed by colleagues entering the system, will adopt a more rational and amicable stance, and our organizations will have to realistically update their positions," they state.

Check out the full text:

More Doctors Program. Doctors' Opinions.

For many years there has been a global consensus that the occurrence of diseases is basically associated with lifestyles. General medicine, practiced with adequate resources, takes into account the socio-environmental situation for the correct elaboration of the clinical diagnosis, a fundamental step in the legitimate art of medicine.

Until about forty years ago, this practice was carried out in Brazil by doctors immediately after graduation, mainly those who settled in the interior cities of their states – and generally came from there – or in the peripheral neighborhoods of capitals and large cities. Supported by a school curriculum rich in practical experience, these doctors attended to and resolved more than 80% of cases with the highest level of expertise, including the treatment and control of the most frequent diseases in all specialties, numerous surgeries, childbirths, fractures, any type of infection, and even urgent and emergency situations. They were called family doctors, general practitioners, or – simply – DOCTORS.

In addition to knowing their patients by name, maintaining a humanized relationship with them, and living very close to them, they also carried out, through various means, intense activity in disease prevention and health promotion. They already had a perfect understanding that this practice was much less costly than medical-hospital care, with effective results for improving the quality of life of the population.

This practice was recognized worldwide in 1978 at the 1st International Conference on Primary Health Care, promoted by the World Health Organization and UNICEF, which resulted in the Alma-Ata Declaration.

Over the years, many things have happened that have led to deficiencies in the country's healthcare system. The vast size of the country was not taken into account; the population grew; education shifted to emphasize complementary exams and almost completely disregarded patient history and physical examinations, investing far more time in theoretical instruction than in practical training; costs increased due to excessive investigations, lack of medical records, payment for procedures, and even misuse of resources; financial resources did not keep pace with the growing needs of the sector. The causes are numerous, and so are the contributing factors. We doctors share some of the responsibility. The people took to the streets, expressing their indignation and provoking a reaction from government officials of all parties.

It has become particularly noteworthy that there are no doctors in over 700 municipalities, and that there is a shortage of doctors in the Family Health Program in over 1.500 municipalities.

In response to the outcry, the government, through the Ministry of Health, launched the "More Doctors" program, prioritizing Brazilian doctors and, in a second phase, if vacancies became available, foreign doctors, preferably with experience in Family Medicine. The requirement that foreign doctors should be required to take a diploma revalidation exam is not applicable, as the doctors will remain temporarily in the country, only in the municipalities to which they have been assigned, in the area of ​​Primary Health Care. Furthermore, according to paragraph 2 of article 48 of Law 9.394, the Guidelines and Bases of Education, international reciprocities are permitted.

There was evident boycott of the program, in addition to dozens of lawsuits against it, which, if accepted, would mean continuing to leave millions of Brazilians without any medical assistance in their communities, which could imply failure to provide aid.

Fortunately, judges have systematically denied injunctions or actions, as in the case of the ruling by Federal Judge Luis Alberto Aurvalle, who understood that "the opposite danger is more serious, since the total lack of medical assistance for the population is more harmful to the public interest than the assistance provided by foreign doctors"; this ruling was due to the attempt to discredit Cuban doctors.

Therefore, the group of doctors who sign this document affirm:

1 – Medical assistance is an inalienable right of citizenship and a duty of the State, as stated in the Charter of Human Rights and the Constitution of the Federative Republic of Brazil;

2 – The “MORE DOCTORS Program” immediately satisfies the needs of underprivileged and socially depressed populations, contributing to their access to better conditions of citizenship;

3 - The type of care, based primarily on Primary Health Care, but also with increased funding for secondary and tertiary medicine in regional centers, is a step towards permanent future decentralization;

4- Statistics show that more than 74% of the Brazilian population supports the Program and appreciates the support of foreign doctors to underserved Brazilian citizens;

 5- The medical profession is composed of various classes, and there are tens of thousands of doctors who work tirelessly in small health posts, in emergency services, on shifts in urgent care or intensive care units, in peripheral neighborhoods, and other activities, whose behavior is one of the fullest dedication to those in need, without making medicine a business or an attempt to achieve social or economic status. But – unfortunately – these are the ones who risk being disregarded by the population, who do not understand why it is reported in the press that doctors in general do not accept the Program. To these colleagues, voiceless in the media, our tribute and support;

6- We are confident that this program will progressively consolidate and find its support in the population. The medical profession itself, not feeling harmed by colleagues entering the system, will adopt a more rational and amicable stance, and our organizations will realistically have to update their positions.

 

SIGNATORIES

 

Franklin Cunha – CREMERS 3254 – Retired: Former Director of AMRIGS; Former Counselor of SIMERS; Former Chief Instructor of the Gynecology and Obstetrics Service at HMIPV

• Airton Fischmann – CREMERS 3519 – Retired: Former Consultant for the Pan American Health Organization

• Mareu dos Santos Soares – CREMERS 3581 – Retired: Former Secretary of Social Security Services at INPS; Former Chief of Staff at INAMPS; Former Director of the Institute of Forensic Medicine

• Ruy Germano Nedel – CREMERS 3546 – ​​Retired: Federal Constituent Deputy; Former Regional Superintendent of INAMPS; Former Coordinator of the National Health Council; Former Full Member of the National Medical Residency Commission

• Nelson Carvalho de Nonohay – CREMERS 3092 – Retired: Director-Secretary of the University Cardiology Foundation; Former State Secretary of Health of the State of Rio Grande do Sul

· Júlio Hocsman – CREMERS 4410: Former State Secretary of Health of the State of Rio Grande do Sul

· Eduardo de Azeredo Costa – CREMERJ 13993: Former State Secretary of Health of the State of Rio de Janeiro/Leonel Brizola Administration; Director of FUNDACENTRO

• Celso Perez Melgaré – CREMERS 3501 - Retired: Psychoanalyst; Member of the Clinical Staff of Hospital NS Conceição

• Luiz Carlos Lantieri – CREMERS 3314 – Retired: Cardiologist; Former Coordinator of the AMRIGS Examination

· Flávio Pinto – CREMERS 3505 – Retired: Psychiatrist; Former Professor at the Faculty of Medicine of UFCSPA

· Humberto Scorza – CREMERS 3236 – Retired: Pediatrician; Public Servant

· Lúcio Barcelos – CREMERS 6520: Former Secretary of Health for the municipalities of Cachoeirinha, Gravataí, and Porto Alegre; Former Director of the São Pedro Psychiatric Hospital; Former President of the State Health Council

• Oswaldo Petracco da Cunha – CREMERS 1146 – Retired: Former Director of AMRIGS; Former Director of the State Health Secretariat of Rio Grande do Sul/Alceu Collares Administration

• Álvaro Petracco da Cunha – CREMERS 1571 – Retired: Former State Representative; Former Director of CORAG/Alceu Collares Administration

• Arnaldo da Costa Filho - CREMERS 378 – Retired: Former Professor of Higher Education at UFRGS; Former Superintendent of Physical Education at the State Health Secretariat

• Sergio Alexandre Goldani – CREMERS 5564 – Retired: Psychiatrist; Former Professor at DMI, retired from the Faculty of Medicine of UFRGS

• Luiz Octavio Vieira – CREMERS 4549 – Retired: Fellow in Pulmonology at Mount Sinai Hospital, New York; Former Teaching Assistant in Internal Medicine at UFRJ and the School of Medicine and Surgery; Former Board Member of the Hospital de Clínicas de Porto Alegre. Former President of FIERGS.

• Claunara Schilling Mendonça – CREMERS 20714: Family and Community Physician; Master's (and Doctoral candidate) in Epidemiology at UFRGS; Professor of Family Medicine in the Department of Social Medicine at UFRGS; Manager of the Community Health Service at the Conceição Hospital Group.

· Heloisa Helena Rousselet de Alencar – CREMERS 10635

Herberto Edson Maia – CREMERS 3579 – Retired: Psychiatrist; Professor at the Faculty of Medicine of the Federal University of Health Sciences of Porto Alegre; Professor of the Postgraduate Course in Psychiatry José de Barros Falcão, based at the São José Clinic and Divina Providência Hospital.