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C
heers
!!!
R
ev
A
ssoc
M
ed
B
ras
2016; 62(9):809-810
809
EDITORIAL
Cheers!!!
W
anderley
M
arques
B
ernardo
1
1
Professor, Habilitation (BR: Livre-docência), Faculdade de Medicina da Universidade de São Paulo (FMUSP). Coordinator of the Programa Diretrizes, Brazilian Medical Association (AMB)
http://dx.doi.org/10.1590/1806-9282.62.09.809Cheers!!!
Here’s to the numerous achievements of this innovative
health system!!!
Let us honor and reward those responsible for these
victories!!!
Let us sit at the same table, walk alongside them, and
become one of them...
It is humanly impossible to understand how it is pos-
sible to produce so much, with so little resources, so little
power, so little time and so little policy. There is so much
evidence of the benefits that the words written here would
be insufficient to describe it, especially in relation to the
important results obtained in one’s personal healthcare.
So, struggling not to hold back on the truth, without
minimizing the recognition of such evidence, I will limit
myself to ten (10) minor aspects, in which the results are
not very visible and palpable, but can clearly illustrate
these actions and their effects.
Action n
o
1:
standardizing conducts for various clin-
ical situations, through evidence-based guidelines.
Effect
n
o
1:
homogeneity and equity in healthcare for all patients,
to the point of not identifying differences in the quality
of the public and private systems.
Action n
o
2:
releasing (all based on scientific evidence)
the register of medications, but at the same time not
clearing its use in the public system.
Effect n
o
2:
conflict
and chaos in decision making, putting physicians, patients
and service providers against each other.
Action n
o
3:
valuing physicians and healthcare pro-
fessionals, providing them with optimal working condi-
tions.
Effect n
o
3:
irresistible attraction among physicians
and professionals to work mainly in the public system,
including “international physicians” who voluntarily
cooperate with the program.
Action n
o
4:
involving the judiciary in decision-mak-
ing in health, as evidence of scientific credibility and mul-
tidisciplinary vision.
Effect n
o
4:
judges take on a role
that does not belong to them, and for which they are not
prepared, although despite this they have to defend the
rights denied to patients.
Action n
o
5:
minimal and improper investment in
public health policies, maintaining the epidemic incidence
of old and new diseases in the territory.
Effect n
o
5:
stand-
ing out on the world scenario as an exporter of diseases,
but always with a certain degree of internal exclusivity.
Action n
o
6:
regulating the release of diagnostic pro-
cedures, based on evidence and with fair distribution in
the territory.
Effect n
o
6:
encouragement and consolida-
tion of the culture of “overdiagnosis” in society, where
doing more, no matter what it entails, is better than doing
nothing or doing less.
Action n
o
7:
regulating the indications for therapeu-
tic procedures, and encouraging shared decision-making
between physician and patient.
Effect n
o
7:
world record
holder in unnecessary and inadvisable procedures (such
as cesarean section), with physician and/or patients at-
tributed with co-authoring this record.
Action n
o
8:
using evidence in the fight against futil-
ity and waste, the applicability to the individual, and the
implementation according to a loco-regional distribution
of the main problems.
Effect n
o
8:
achievement of eco-
nomic sustainability in health and the strengthening of
primary care.
Action n
o
9:
providing health services properly
throughout the entire territory, guaranteeing the necessary
minimum, attending to differences in local priorities,
measuring the results, and modulating strategies.
Effect
n
o
9:
improvement of health indexes and achievement of
patient satisfaction.
Action n
o
10:
educating based on scientific evidence,
with masters of strange languages, who teach what they
do not do, do not understand what we write or speak, but
who cares? What matters is that everyone wins.
Effect n
o
10:
Effects n
o
1 to n
o
10.
Numerous other actions could be described here, but
these would redundantly lead to the same conclusions:
the scientific evidence created in this country (or these
countries), the values and preferences of its patients, and
the experience of its physicians were, until recently, the
mainstay support in decision-making for these innovative
systems of private and public health.
RAMB, the
Journal of the Brazilian Medical Association
,
has been a vehicle for selfless and competent minds who
strive every day to produce scientific evidence to be used
in the best care for our patients. Each edition serves as a