Publications IPH Magazine Annals of Summaries: 38th Congress of Hospital Administration and Health Management Interview with Scientific Coordinator of the Health Management Congress

IPH - Health processes are supported by administrative processes. Which are the strategies to get the medical staff involved in the administrative processes? 

Gonzalo Vecina - This the million-dollar question. How to integrate the doctor into the management process and how to integrate the doctor into the care process, the caring for healing issue we were discussing. It is clear that the doctor is a unique professional in this process, since, among all professionals, he is the one who gives the diagnosis and the treatment, which makes him unique. On the other hand, especially at private hospitals where you have an open clinic board, this difficulty is even more important. In public and private hospitals with a closed clinical body there is a set of rules that you can adopt. And I also see that in private hospitals working with open clinic body in closed unities. Often in closed unities, such as the ICU, you work with a closed clinic body hired, hence the doctor integration with the team, there is less difficulties, or even, it is easier. Considering the different levels of difficulties to integrate the doctor to the team, we have seen this idea that was mentioned here: patient-driven care with different levels of deepness. As our Osvaldo* used to say, taking things to the patient instead of the patients to the things, with limitations obviously, it is something to pursue. The same must happen with the team, which means, we have to think that for a better care to heal we must rethink the work division in health services. Our work is over segmented. In a way that, today, we have the guy that pushes the gurney, the guy that takes the patient out of the gurney, the guy that puts the patient on the gurney; it is a crazy division of work. So the nurses are responsible for maintaining the daily life, the physiotherapist is responsible for breathing physiotherapy. Then the patient is overwhelmed with activities and his treatment is aggrieved. You focus only on the healing, but taking care is as important. In some hospitals in Europe and the United States, the idea is to focus on the patient, so the professional rethinks his or her place of work. The professional closer to the patient is the one to undertake the care he or she needs at the time. This idea demands a reorganization of the work process, a schedule of work process and the creation of new work agreements inside the admission unit. It is also possible to take this idea to primary care, which means, with distinct process of treatment. It is a different way of treatment, but in fact, it demands a pact among the professionals in the team. And the doctor must be a part of this pact. This is much easier with a team composed by professionals within several areas of expertise, the doctor must be incorporated. This is the type of care management that we should spread in the team and the doctor has to believe in this project; it is feasible, but not easy. 

*Osvaldo Artaza Barrios - Organización Panamericana de la Salud - México.