RESUMO
Multiple studies have reported a high prevalence of mental health problems among male and female physicians. Although doctors are reluctant to seek professional help when suffering from a mental disorder, specialised services developed specifically to treat their mental health problems have reported promising results. The purpose of this article is to describe the design and implementation of the Professional Wellbeing Programme (Programa de Bienestar Profesional) of the Uruguayan Medical Council (Colegio Médico del Uruguay). The context, inputs, activities and some of the outputs are described according to a case study design. The main milestones in the implementation of the programme are also outlined, as well as the enabling elements, obstacles and main achievements. Emphasis will be placed on the importance of international collaboration to share experiences and models, how to design the care process to promote doctors' access to psychiatric and psychological care, the need for them to be flexible and dynamic in adapting to new and changing circumstances, such as the COVID-19 pandemic, and to work in parallel with the medical regulatory bodies. It is hoped that the experience described in this work may be of use to other Latin American institutions interested in developing mental health programmes for doctors.
Assuntos
COVID-19 , Pandemias , Humanos , Masculino , Feminino , Uruguai , EmoçõesRESUMO
Son múltiples los estudios que informan de una alta prevalencia de problemas de salud mental en médicos y médicas. Aunque los médicos presentan resistencias a la hora de solicitar ayuda profesional cuando están aquejados de trastornos mentales, los servicios especializados desarrollados específicamente para tratar sus problemas de salud mental han reportado resultados prometedores. El propósito de este artículo es describir el diseno y la implementación del Programa de Bienestar Profesional del Colegio Médico del Uruguay. El contexto, los insumos, las actividades y algunos de los productos se describen de acuerdo con el diseno de un estudio de caso. También se sefñalan los principales hitos en la puesta en marcha del programa, así como los elementos facilitadores, los obstáculos y los principales logros. Se enfatizará la importancia de la colaboración internacional para compartir experiencias y modelos, cómo articular el proceso asistencial para fomentar el acceso de los médicos a la atención psiquiátrica y psicológica, la necesidad de que sean flexibles y dinámicos para adaptarse a circunstancias novedosas y cambiantes como la pandemia por COVID-19 y la necesidad de que vayan en paralelo con las exigencias de los organismos reguladores de la práctica médica. Se espera que la experiencia descrita en este trabajo pueda ser de utilidad a otros colectivos latinoamericanos interesados en desarrollar programas de salud mental para los médicos.
Multiple studies have reported a high prevalence of mental health problems among male and female physicians. Although doctors are reluctant to seek professional help when suffering from a mental disorder, specialized services developed specifically to treat their mental health problems have reported promising results. The purpose of this article is to describe the design and implementation of the Professional Wellbeing Programme (Programa de Bienestar Profesional) of the Uruguayan Medical Association (Colegio Médico del Uruguay). The context, inputs, activities and some of the outputs are described according to a case study design. The main milestones in the implementation of the programme are also outlined, as well as the enabling elements, obstacles and main achievements. Emphasis will be placed on the importance of international collaboration to share experiences and models, how to design the care process to promote doctors' access to psychiatric and psychological care, the need for them to be flexible and dynamic in adapting to new and changing circumstances, such as the COVID-19 pandemic, and to work in parallel with the medical regulatory bodies. It is hoped that the experience described in this work may be of use to other Latin American institutions interested in developing mental health programmes for doctors.
RESUMO
Multiple studies have reported a high prevalence of mental health problems among male and female physicians. Although doctors are reluctant to seek professional help when suffering from a mental disorder, specialised services developed specifically to treat their mental health problems have reported promising results. The purpose of this article is to describe the design and implementation of the Professional Wellbeing Programme (Programa de Bienestar Profesional) of the Uruguayan Medical Association (Colegio Médico del Uruguay). The context, inputs, activities and some of the outputs are described according to a case study design. The main milestones in the implementation of the programme are also outlined, as well as the enabling elements, obstacles and main achievements. Emphasis will be placed on the importance of international collaboration to share experiences and models, how to design the care process to promote doctors' access to psychiatric and psychological care, the need for them to be flexible and dynamic in adapting to new and changing circumstances, such as the COVID-19 pandemic, and to work in parallel with the medical regulatory bodies. It is hoped that the experience described in this work may be of use to other Latin American institutions interested in developing mental health programmes for doctors.
RESUMO
The use of doping has been banned for almost a century due to the risk involved to the athlete's health. Since then, the criterion of prohibiting substances has been reinforced to improve performance, becoming a rarely controversial issue nowadays. However, opinions defending the liberalization of doping has been sometimes given based on various arguments. One of the most common is the impossibility of completely eradicating doping and that this can be safe, from the point of view of health, if it is done by qualified doctors. This paper presents the arguments against the liberalization of doping from a medical point of view, contemplating various aspects. Those related to the use of substances such as: lack of clear criteria for inclusion in the list of prohibited substances and the unclear margin between the use of medication for treatment and for doping. Arguments related to health protection such as: the risk of sport for the athlete, the healthy sport, doping substances have few health risks, the use of medications, allow genetic doping because it is inevitable, risks of self-medication or use of medication without a prescription. Arguments related to sports performance such as: Doping products do not improve performance, doping is comparable to other performance improvement techniques, match genetic differences among athletes. And other arguments such as: prohibition favours doping, the control of doping increases the risks of doping itself, the high cost of anti-doping fight or the few anti-doping resources. The proposal for liberalization of doping under medical control is analyzed and discussed as well as the effects of liberalization on children and adolescents. At the end the medical ethical aspects related to doping are presented to conclude with the opposition of the medical profession against doping and its liberalization
El dopaje está prohibido desde hace casi un siglo debido al riesgo que implica para la salud del deportista. Desde entonces, el criterio de prohibición de sustancias se ha reforzado para mejorar el rendimiento, convirtiéndose en un tema poco controvertido en la actualidad. Sin embargo, a veces se han emitido opiniones en defensa de la liberalización del dopaje basadas en diversos argumentos. Uno de los más habituales es la imposibilidad de erradicar por completo el dopaje y que éste puede ser seguro, desde el punto de vista de la salud, si lo practica médicos titulados. Este artículo presenta los argumentos en contra de la liberalización del dopaje desde el punto de vista médico, contemplando diversos aspectos. Los relacionados con el uso de sustancias tales como: falta de criterios claros para su inclusión en la lista de sustancias prohibidas y el margen poco claro entre el uso de medicamentos para tratamiento y dopaje. Argumentos relacionados con la protección de la salud como: el riesgo del deporte para el deportista, el deporte sano, las sustancias dopantes tienen pocos riesgos para la salud, el uso de medicamentos, permitir el dopaje genético porque es inevitable, los riesgos de automedicación o uso de medicación sin prescripción. Argumentos relacionados con el rendimiento deportivo tales como: los productos antidopaje no mejoran el rendimiento, el dopaje es comparable a otras técnicas de mejora del rendimiento, diferencias genéticas entre los deportistas. Y otros argumentos como: la prohibición favorece el dopaje, el control del dopaje aumenta los riesgos del dopaje, el alto coste de la lucha antidopaje o los escasos recursos antidopaje. Se analiza y discute la propuesta de liberalización del dopaje bajo control médico y los efectos de la liberalización en niños y adolescentes. Al final se presentan los aspectos éticos médicos relacionados con el dopaje para concluir con la oposición de la profesión médica al dopaje y su liberalización
Assuntos
Humanos , Doping nos Esportes/ética , Desempenho Atlético/ética , Substâncias para Melhoria do Desempenho , Teoria Ética , Automedicação , Fatores de Risco , Ética MédicaRESUMO
No disponible
