THE SHORTAGE OF DOCTORS

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

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The first military hospitals in Saint Petersburg

Vestnik of Russian military medical Academy ◽

10.17816/brmma50571 ◽

2020 ◽

Vol 22 (3) ◽

pp. 258-266

Author(s):

N. V. Milasheva ◽

V. O. Samoilov

Keyword(s):

Medical Care ◽

Military Medicine ◽

Senior Physician ◽

Military Hospitals ◽

Saint Petersburg ◽

Peter The Great ◽

Russian State ◽

Shortage Of Doctors ◽

History Of ◽

Hospital Doctors

Abstract. The documentary materials from the funds of the Russian State Archive of the Navy, other archives, published letters and documents of Peter the Great, his Daily Note and other sources about the history of the first military hospitals (infirmaries) of Saint Petersburg are studied. At the same time, the history of the first military hospitals is reflected against the background of the difficult events of the Northern War of 17001721, with which the establishment of hospitals for the Russian army and the navy and the development of military medicine are inextricably linked. The organization of military medicine became aggravated immediately with the outbreak of hostilities, with the first wounded and sick. The fight against the plague epidemic and other infections during the war, the shortage of doctors, healers, infirmaries, hospitals and their own national staff greatly complicated the provision of medical care. Numerous documents and facts prove that the events before 1715 can be attributed to the first stage in the development of military medicine in Saint Petersburg. It was established that in 1704 the issue of establishing a military land hospital in the northern capital was already discussed (Peter I, A.D. Menshikov, N.L. Bidloo); hospital), and the senior physician of the Navy Yang Govi served in it with zeal In 1713, by the decree of the Great Sovereign Y. Govi, he was appointed head of the Admiralty Hospital, doctors, apprentices and medical students in it. By that time, Dr. R. Erskine actually assumed the office of archiatrist (until 1712). A detailed statement of Lieutenant General R.V. Bruce on the number of sick and wounded who received medical care in hospitals and hospitals in Saint Petersburg from 1713 to 1715. The decree of Peter I on the construction of a complex of General hospitals with anatomical theaters on the Vyborgskaya side (1715) according to Dr. Areskins drawing, and the establishment of a medical school (until 1719) are the next stage in the development of military medicine in Saint Petersburg, prepared by all previous events.

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THE PEDIATRICIAN AND THE PUBLIC

PEDIATRICS ◽

10.1542/peds.11.4.416 ◽

1953 ◽

Vol 11 (4) ◽

pp. 416-418

Keyword(s):

Medical Training ◽

Considerable Extent ◽

The Public ◽

Individual Physician ◽

Good Medicine ◽

Shortage Of Physicians ◽

Shortage Of Doctors ◽

The Subject ◽

Training Resources ◽

The Individual

Since you were interested in some casual remarks I made concerning the dispersion of our medical training resources in this country, I am going to impose on your patience by further expanding the subject. Much has been said and written lately about the shortage of physicians and allied technical personnel. In spite of the fact that we have more physicians per thousand population than any other major country, we are constantly being told that we face a critical shortage of doctors and that something must be done about it. It is true that the demand of the general population for health services has vastly increased. Whether this increase is due to an intelligent understanding by more people of what good medicine can offer, or to overindulgence in the luxuries of medicine, may be open to question. The fact remains, however, that in spite of a constant increasing number of doctors per thousand, and greater productivity of the individual physician by reason of better transportation, improved mechanical aids, and an increased number of technical assistants, the load on medicine steadily increased. This load has been diminished in no way by dividing "Gaul" not into three parts, but into six. This alleged shortage of doctors and other health personnel is partly due to faulty distribution but it is also to a considerable extent an artificial creation brought about by unnecessary expansion of government medical services.

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Shortage of Doctors

BMJ ◽

10.1136/bmj.2.5455.239 ◽

1965 ◽

Vol 2 (5455) ◽

pp. 239-239

Author(s):

G. T. Pitts

Keyword(s):

Shortage Of Doctors

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Shortage of Doctors

BMJ ◽

10.1136/bmj.1.5277.556-a ◽

1962 ◽

Vol 1 (5277) ◽

pp. 556-556

Author(s):

J. E. Arnott

Keyword(s):

Shortage Of Doctors

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Culture of Blame—An Ongoing Burden for Doctors and Patient Safety

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234826 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4826 ◽

Cited By ~ 1

Author(s):

Ognjen Brborović ◽

Hana Brborović ◽

Iskra Alexandra Nola ◽

Milan Milošević

Keyword(s):

Patient Safety ◽

Healthcare Workers ◽

Health Workers ◽

Patient Safety Culture ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Single Item ◽

Shortage Of Doctors ◽

The Impact

Introduction: Every procedure in healthcare carries a certain degree of inherent unsafety resulting from problems in practice, which might lead to a healthcare adverse event (HAE). It is very important, and even mandatory, to report HAE. The point of HAE reporting is not to blame the person, but to learn from the HAE in order to prevent future HAEs. Study question: Our aim was to examine the prevalence and the impact of culture of blame on health workers’ health. Methods: A cross-sectional study on healthcare workers at two Croatian hospitals was conducted using the Hospital Survey on Patient Safety Culture (PSC). Results: The majority of PSC dimensions in both hospitals were high. Among the dimensions, Hospital Handoffs and Transitions and Overall Perceptions of Safety had the highest values. The Nonpunitive Response to Error dimension had low values, indicating the ongoing culture of blame. The Staffing dimension had low values, indicating the ongoing shortage of doctors and nurses. Discussion: We found inconsistencies between a single-item measure and PSC dimensions. It was expected that Frequency of Events Reported (PSC dimension) relates to Number of Events Reported (single-item measure). However, in our study, the relations between these pairs of measures were different between hospitals. Our results indicate the ongoing culture of blame. Healthcare workers do not report HAE because they fear they will be punished by management or by law.

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Validation studies of virtual reality simulation performance metrics for mechanical thrombectomy in ischemic stroke

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2018-014510 ◽

2019 ◽

Vol 11 (8) ◽

pp. 775-780 ◽

Cited By ~ 11

Author(s):

Robert Crossley ◽

Thomas Liebig ◽

Markus Holtmannspoetter ◽

Johan Lindkvist ◽

Pat Henn ◽

...

Keyword(s):

Virtual Reality ◽

Ischemic Stroke ◽

Construct Validity ◽

Mechanical Thrombectomy ◽

Performance Metrics ◽

Group Differences ◽

Delphi Panel ◽

Simulation Performance ◽

Shortage Of Doctors ◽

Stroke Group

IntroductionMechanical thrombectomy (MT) has transformed the treatment of ischemic stroke. However, patient access to MT may be limited due to a shortage of doctors specifically trained to perform MT. The studies reported here were done to (1) develop, operationally define, and seek consensus from procedure experts on the metrics which best characterize a reference procedure for the performance of an MT for ischemic stroke and (2) evaluate their construct validity when implemented in a virtual reality (VR) simulation.MethodsIn study 1, the metrics for a reference approach to an MT procedure for ischemic stroke of 10 phases, 46 steps, and 56 errors and critical errors, were presented to an international Delphi panel of 21 consultant level interventional neuroradiologists (INRs). In study 2, the metrics were used to assess 8 expert and 10 novice INRs performing a VR simulated routine MT procedure.ResultsIn study 1, the Delphi panel reached consensus on the appropriateness of the procedure metrics for a reference approach to MT in ischemic stroke. Group differences in median scores in study 2 demonstrated that experienced INRs performed the case 19% faster (P=0.029), completed 40% more procedure phases (P=0.009), 20% more steps (P=0.012), and made 42% fewer errors (P=0.016) than the novice group.ConclusionsThe international Delphi panel agreed metrics implemented in a VR simulation of MT distinguished between the computer scored procedure performance of INR experts and novices. The studies reported here support the demonstration of face, content, and construct validity of the MT metrics.

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