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Madrid Meeting ASPROMEL-CGCOM-OMC on Fundamental Rights of Physicians

Madrid Meeting ASPROMEL-CGCOM-OMC on Fundamental Rights of Physicians
 

The imbalance between rights and duties of the physician affects the quality of care

Inherent to the practice of medicine are a series of physicians’ rights and duties whose imbalance may come to affect the quality of care, as was highlighted at a conference on the fundamental rights in the exercise of medical profession, organized by the representatives of Private Medicine , of the General Council of medical Colleges CGCOM-OMC in collaboration with the Professional Association of Physicians in Free Practice (ASPROMEL). In the same a review was made to a number of rights related to the exercise of the profession that must always be present and on which a "collective thinking" is required, as many of the participants agreed.

Madrid 05/11/2016 medicosypacientes.com/SP
From left. to right .: Drs. Nieto, Bolliger, Rodriguez Sendín, Carmona and Romero.
 
During the meeting the participants talked about the rights linked to clinical practice and related to the exercise of the profession, the doctor-patient relationship, the field of health systems and health of physicians itself, to training, research and teaching, and also related to labor policy and salary. All of them represent a quality -guarantee for the patient as well as a support for confidence and security of citizens.
 
The conference was inaugurated by Dr. Juan José Rodriguez Sendin, president of the Medical College OMC, and Dr. André Bolliger Horisberger, president of the Professional Association of Physicians in Free Practice (ASPROMEL) 
 
Dr. Carmona, national representative of private medicine, said the aim of the meeting  to be "very timely in these times" where "the rights of doctors must be approached in a transversal way, as they cover all categories and specialties." However, as he regretted "these rights of doctors, despite everyone's assumes them as facts are not written anywhere."
 
The origin of this meeting, as recalled by the national representative of private medicine arises from the "Madrid Declaration", June 2015, (http://www.medicosypacientes.com/articulo/medicos-de-ejercicio-libre-de-europa-estudian-el-modelo-de-colaboracion-publica-privada-en) expressed in a resounding rejection of the violation of certain fundamental rights to every physician, driven by the European Association of Physicians in Free Practice  (EANA).
 
 
The chairman of the OMC, Dr. Rodriguez Sendín recalled during the inauguration, the obligations and commitments of doctors are necessarily linked to a number of rights; "It is impossible to serve those duties without guaranteed rights," he said.
 
At another point in his speech he said that the medical profession is justified on a bases of science, and grounded on four premises: "Using always the applied knowledge to the needs of patients. This knowledge grows through scientific development and innovation; a constant research for possible improvements will be pursued, and the scope of excellence is only possible if accompanied by ethical components established by the code of ethics ".
 
The link between rights and duties were illustrated with some examples such as freedom of prescription, the use of  techniques, as well as the right to a correct living wage. "Salaries and conditions of employment are a clear example of our rights, but they should be considered as a response to the duties with our patients," according to his words.
 
Moreover, he referred to the dilemma of how far "the duties of doctors and their rights may be conditioned to the means that the administration or the payer want to impose," or, on the contrary, "should remain a series of constant rights or duties “ In his view," the patient's life depends not only on the physician but also on the environment and the system in which the latter exercises “.
 
During the inauguration, the president of ASPROMEL and Treasurer of EANA,  Dr. André Bolliger, brings the best wishes from Brussels to Madrid for the organization and the success of today’s meeting. He thanked the President and the National Representatives of Private Medicine of the OMC, for the excellent cooperation they already have shown a year ago for the organization of EANA meeting in this very building. As a Psychiatrist and Psychotherapist, he explained that the respect of the fundamental rights of physicians have to be center-stage, because the severe and chronic imbalance between duties and rights are a major cause for burnout syndrome in health professionals. And we need healthy health professionals in healthy health systems in healthy societies. 
 
In the first Round-Table of the day, Dr. André Bolliger, noting the need for this type of Forum or Think Tank where  to talk about fundamental rights of doctors , focused his speech on" Human rights and the Doctor “. From his point of view," rights should not remain 'abstract letter', but "must be lived and implemented".
 
He approached at another point in his speech, the link between human rights and the doctor who, in his opinion, "is bidirectional". "The doctor, as a human being, is a beneficiary of human rights that protect him and, contemporary, as a professional is the guarantor of these same human rights for his patient, being the point from which emanate codes of practice and ethics".
 
The Vice-President of the OMC, Dr. Serafin Romero, also participating in this first table, elaborated on the "Rights in the field of doctors' own health and to be recognized socially." He recalled that doctors as citizens must have the right to health and as workers must have guaranteed services in labour health , tailored to their jobs and protected by regulations.
 
Dr. Romero cited the Code of Ethics where the protection of the health of physicians is also contemplated and therefore as a citizen who gets assistance, which results in the Comprehensive Care Program for Sick Doctors (PAIME) that provides for the health of health professionals. The OMC asks that health of health professionals  is certified through a Periodic Validation.
 
Moreover, in the international arena, Dr. Romero claimed that " international declarations that protect the volunteer and cooperating doctors have to be maintained in order to allow the development of their work."
 
At another point in his speech, he referred to the right to defend the professional prestige, "only from the professionalism and the abandonment of the culture of complaint we’ll be able to renew our social contract,  which is what  guarantees  us the recognition by the citizens “.
 
Rights in the exercise of the profession
 
For his part, the President of the Medical Association of Badajoz, Dr. Pedro Hidalgo, focused on the "Rights in the exercise of the medical profession” by means of a Decalogue based on the Code of Ethics, which includes, among others , the right to exercise their medical activities freely and without pressure of any kind. 
 
In addition, the doctor has the right to be respected in his clinical judgment (diagnosis and treatment) and in his freedom of prescription, as well as in its decision to reject the care of a patient, provided that such aspects are sustained on ethical, scientific and normative bases .
 
Another of the rights to which referred Dr. Hidalgo is to develop his career in facilities which ensure the safety and hygiene, according to the provisions of the regulations.
 
To receive from the institution which makes the provision of services, personal support services, supported by fully trained personnel and equipment, instruments and supplies equipment, tools needed, according to the service provided is another of the rights to which he referred.
 
Dr. Hidalgo also included the rights to refrain from guarantee results in relation to a particular healthcare process and the right to abstain to make final judgments about the expected outcomes of care .
 
Other rights mentioned by the speaker were those relating to respectful treatment, access to continuing medical education, to participate in research and teaching, to associate in organizations, professional associations, to facilitate defense of their professional prestige and be paid for professional services rendered according to their employment, contract or the agreement with the patient's condition.
 
To conclude his paper Dr. Hidalgo showed that the Spanish Penal Code still does not recognize the physician as an authority.
 
The first Round-Table was concluded by the national representative of employed doctors in Private Medicine , Dr. José María Nieto, who presented his approach on "Rights and Professional Training in the field of Research and Teaching" highlighting the right to specialized training, after obtaining the grade. Regarding continuing education he stressed the duty and the right on it by the professionals. In addition, he referred to the physician's right to participate in research projects and teaching as part of their professional development. 
 
In short, and in his view, "it is society itself that should give the professional the right to training, since it is  receiving the benefit of improving the skills manifested in the professionalism of the doctor."