Dr. Pere Mir
Near the end of the second decade of this century and in my third decade of professional exercise (begun in 1992) I allowed myself to write a reflection on the doctor of the twenty-first century. Different is the doctor who formed my professors who reached a professional maturity beyond 50 years. I see myself different and I see my profession different. I see myself different because I have had to recanalize my profession.
My profession has changed. The lonely, egocentric, humanist doctor sitting on the other side of the table has been transforming to a medical technician, nearby, teammate and globalized, who has removed the table from the middle. Progress in knowledge advances at a speed that forces super-specialization to be able to stay updated. Current professionals must be committed, interdisciplinary, cooperative, compassionate and capable of providing comprehensive and integrated assistance, especially to patients suffering from chronic diseases. Health demands increase with the aging of the population, chronic diseases and technological innovation. I see a doctor who is progressively more knowledgeable about TICs, more empathetic and more friendliest. Skin with skin with its patients. He will be a more emotional doctor and will treat the patient from a global perspective, deepening in his emotions, his personal, family stability, his readaptation, his perspectives, his hopes and the results of his treatments.
Canadians say that an ideal physician – who they call an expert doctor – must perform in their work activity six roles: professional, leader, collaborator, communicator, health promoter and academic. For each of these roles, specific competences are defined, and recommendations and strategies have been developed so that the medical programs can orient their objectives towards achieving them.
Necessarily in our country there must be a change also economic. Salaries in other countries double or triple the Spanish salaries, our best professionals must work in Spain. The contribution of the professional to Public Health would be more productive, more intense and more committed, would definitely be better. We can not defend a health system of excellence paying unwarranted salaries. To this it is added that 1 in 3 doctors work in conditions of labor instability (especially young people). The recognition to the professional has been devalued and this necessarily affects its profile and involvement.
This doctor should receive training in those aspects that it does not have: communication, social networks, geobiology, telemedicine, … Likewise, improve those precarious aspects: bioethics, computer science, languages, navigation, 3D printing, …
Universities and academic training will be diversified to hospital centers that are capable of offering comprehensive training for students. Hard and inefficient stereotypes will be broken. New doctors will be born much better trained, efficient and able to see the disease, the patient and their context, in an integral way.
We must lose weight, abandon all those treatments that are not supported by scientific evidence, harmful, ineffective and inefficient. We must abandon the excessive irradiation of our patients, especially children. And to require the health authorities to comply with the European regulations on irradiation control material to our patients (Dosimetry Card) that should already work in our country according to the European Directive from February 2018.
Finally, thanks to each of my patients, they are all an opportunity for me to be a better physician. And thanks to the whole team of professionals who work with me, it is a pleasure to work with professionals with their responsibility and their high level of competence. Learning and improving in Medicine has no end, it is a constant, vital, professional, scientific, responsible, committed and self-designed path.
The next 10 years there will be radical social changes that will overflow what happened in the previous 50 years. The doctors have a social commitment that will force us to lead the new reflections on health, society, the elderly, dependency, rights and humanity, there we will be demanding social progress and health to the new political class that has to allow us to forget the current one.
I see an open and promising future, but we all have to change many things. Health for everyone.
Dr. Pere Mir
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