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The doctor claims that their rights are respected in terms of territorial equality

The doctor claims that their rights are respected in terms of territorial equality

The second panel of the day 'physicians’ rights, guarantee for patients', organized by the National Representatives of Private Medicine for Self Employed and Salaried Employees of the Medical College (OMC) in collaboration with the Professional Association of Physicians in Free Practice (ASPROMEL), analyzed the optional rights in the labor and salary level, being reflected that differences occur depending on the territory where it is provided, in addition to the variations between the public and private sectors.

Madrid 11/05/2016 medicosypacientes.com / RM
Drs. Luepke, Garcia, Abascal, Bolliger, Nieto, Briz, Hidalgo, Matas and Carmona. 

Dr. Vicente Matas, national representative of Urban Primary Care, explained that, although Article 14 of the Constitution contains, the Spaniards are equal before the law without any discrimination due to birth, race, sex, religion, opinion or any other condition or personal or social circumstance, reality shows that the autonomous communities act with differing views on what the compensation rights of doctors concerns. 

The laws provide a National Health System (NHS) to protect the health of the entire Spanish population, under conditions of effective equality, coordinated by the Inter-Territorial Council, inter alia in procurement policy and personnel. On the theoretical side, the doctor has the right to employment stability in his exercise or actual performance of the profession or duties corresponding to his appointment, to the timely collection of the remuneration and allowances by reason of service in each set, the continued training, appropriate to the role and recognition of their professional qualifications in relation to those functions.

The legislation also includes the right of the physician to receive effective protection in safety and health at work, as well as in general risks at the health center or derivatives of regular work, as well as in information and specific training in this area in accordance with the Law on Prevention of occupational Risks in addition to voluntary mobility, internal promotion and professional development, how to provide for the provisions in each case applicable, as well as the necessary rest by limiting the duration of working time, regularly paid holidays and permissions on the established terms .

Dr. Matas explained that the pay scheme for regulated staff is comprised of basic remuneration and additional remuneration and responds to the principles of technical and professional qualifications and ensuring the maintenance of a common model in relation to the basic remuneration. The fringe benefits are primarily aimed at staff motivation, the motivation of the activity and quality of service, dedication and achievement of the planned objectives.

According to Dr. Matas, "the tremendous effort required to become a medical specialist (note of admission, six years of school a year and preMIR four or five MIR) and major responsibilities assumed in the performance of the profession,  are not sufficiently recognized by the authorities, especially from the point of retributive view ", so he argued that" we need a sufficiently funded public health by means of finalists equitable budgets, enabling Spanish doctors to pay quality health care to all citizens ".

doctor-patient relationship

Dr. José Briz, vice president of the Professional Association of Doctors in Free Practice (ASPROMEL), analyzed the relationship between doctor and patient, which plays an important role in the practice of medicine and is essential for the provision of high quality health care. So, he emphasized that "most medical schools teach their students from the beginning to maintain a professional relationship with their patients, observing their dignity and respecting their privacy." Among the general rights of doctors, Dr. Briz said that they are freely chosen by their patients as depository of their health and confidence, receive dignity and respect and to participate freely in patient care. 

He also explained that the patient must have confidence as to the competence of their doctor and should feel they can give him confidenceHe also noted that "the better the relationship (mutual respect, understanding, trust, shared values ...), the better the quantity and quality of information about the patient's condition to be exchanged in both directions, improving the accuracy of diagnosis." If the ratio is poor, it is more likely that the patient distrusts the diagnosis and proposed treatment, reducing treatment adherence.

In this Round-Table, which was moderated by Dr. José María Nieto, national representative OMC of Private Medicine, Dr. Juan Antonio Abascal, secretary of ASPROMEL, showed how professional authority arises in the course of a long process of personal and professional maturation, as demonstrated by the lives of Socrates, Plato, Aristotle, Hippocrates, Dioscórido, Avicenna, Averroes, Al Farabi and others to this day. While power is achieved, the authority is recognized. The doctor achieved by this authority, to be recognized from power and society, the ability to exercise their profession freely and without pressure of any kind. Clinical judgment and freedom of prescription (diagnosis and treatment) is respected. “ Medical knowledge"  is a "knowledge” from civilization  and society. From the twelfth century the teaching of medical knowledge is performed under regulation, and compulsory membership of a professional corporation to exercise the profession, is established. Codes of Ethics are established. It is from the union authority from which will settle the social contract, not as a manifestation of power but as a social achievement. The citizen partakes of this achievement and is already the subject of law.

Failure to respect the fundamental rights inherent to their professional medical authority would amount to a breach of the social contract. The doctor has the right to generate social value, from social inclusion and civil development. He has the right to advance human rights through solidarity and international participatory movement. He has the right to fight against gender discrimination and for human rights of 3rd and 4th generation.

Dr. Olga Garcia, Treasurer of ASPROMEL presented the results of a survey on  two fundamental rights of doctors which are 1) To participate on a basis of partnership in commissions on development and establishment of budgets, rates and scales of their health care. 2 ). To participate on a basis of partnership in the planning, development and management of health systems. The conclusion which can be drawn from the survey is that in Bismarck models of health systems the right concerning partnership in questions of budgets, rates and scales is respected from a certain to a great extent, whereas in Beveridge-models is barely respected. Concerning the right of partnership in issues of planning, development and management, in both models of health systems the right is not respected at all.

Dr. Erik Luepke Estefan, chairman of a Working Committee of ASPROMEL  presented on one hand potential conflicts of interest in the field of the rights of doctors, on the other hand a comparative study between two health systems of Beveridge model, the UK with the NHS  and Spain with its SNS. 

Concerning potential conflicts of interest, Dr. Luepke proposed the following definition: "A conflict of interest is a situation in which the judgment of the individual concerning his primary interest, and integrity of action tend to be unduly influenced by a secondary interest, usually financial or of personal type .

Comparing British NHS to Spanish SNS Dr. Luepke showed that the British system is more centralized which means that also information is more centralized and easier to understand for both patients and physicians. The Spanish system is non-centralized. It is more difficult to gain information and to understand what it really means.

In the conclusions, Dr. Manuel Carmona, national representative of Private Medicine OMC said the physician's right to be freely chosen by patients as custodians of health and confidence, and to receive decent treatment for their part . 

Regarding the workplace, he stressed that the Constitution speaks of the same rights and duties for all, although there are notable differences depending on the territory in which one moves and in the health sector where one exercises. He insisted in claiming the right to participate in the planning, development and management of health systems.