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Ernesto Gil Deza

Henry Moore Oncological Institute
 Humanization of the Medical
Figure

6 Epistemological
Fragility of knowledge vs. Omniscience
6 Ethical
Conflict of Interests vs. Medical Sanctity
6 Practical
Burnout syndrome vs. Omnipotence
 Burnout Syndrome

6 Freudenberger (1974)
6 Maslach (1977)
³It is a syndrome that causes emotional
duress, detachment and reduced efficiency,
which can occur in people whose work is to
assist others´
 It can affect

þ Doctors

þ Nurses

þ Pharmacists

þ Psychologists

þ Social
Workers
þ Administrative workers
 Burnout syndrome
characteristics
6 Final stage of professional stress
Emotionally exhausted
Personal Detachment
Low self esteem and insatisfaction

66% of clinical oncologists

 Maximum stress

6 Incorrect course of action /inability to act

6 Implausible expectations
 Incidency

610 ± 70 %
 Severity

25 studies show
40% more suicides in male doctors
130% more suicides in female doctors
 Cause of professional stress

³Becoming a physician has meaning far beyond completing

medical school and residency. It is the entry to a way of life,
the one characteristic common to every true profession. O

   
       
    
  

 
    . There are no part-time professionals;
having accepted such a calling, one is bound to live it or to
leave it. This does not mean that a physician cannot be a
good spouse, a good parent, or a good citizen of his/her
community; it just means that the spouse, parent, and citizen
is always a physician as well´.
 Challenges of professional life

6 Truth
6 Illness
6 Family
6 Death
 Handling the truth

The most important organ for

handling the truth is our ear, not
our tongue.
 Illness

6 Preventable
6 Curable
6 Paliable
6 Feared
6 Terminal
 Caring for the family

6 Human group that

looks after a dying
pacient
6 Family Illness
6 Previous mournings
6 Family structure
6 Roles
6 Children
 The dilemma of death

6 Existential
6 Instantaneous
6 Irreversible
6 Inevitable
6 Uncertain
6 Incomprehensible
6 Shocking
6 Inexplicable
Current medical paradigm
 Challenges of modern times

O  

Diagnosis
 Evluation of Burnout Syndrome

6 Tiredness
Unable to concentrate
Depression
Insomnia
Changes in Appetite
Evaluation of Burnout Syndrome
j Tiredness

j Insatisfaction
j Indifference
j Cynisism
j Short temper
j Lack of input
Evaluation of burnout syndrome
j Cansancio
j Insatisfaccion

j A feeling of professional failure

j A feeling of personal failure
jNoxious Habits
jJob abandonment
 Evaluacion del burnout

j Tiredness
j Insatisfaction
j A feeling of professional failure
j A feeling of personal failure
j Noxious habits
j Job abandonment

j Social relationship problems

±Marital ± familiar
j Permanent death
jProfessional abandonment
jSuicide
Evaluation instruments
 Prevention and teatment

The care for ourselves should be

an essential part of our
professional activity
First Step
 First Step

6 Understanding our limitations

Discovering our limits
Respecting them
Magical

6 Prehistoric evidence
6 ³Savage´ and ³Urban´ tribes.
6 Imposed diagnosis.
6 Conjural therapy
6 Esoteric knowledge
6 Clonal transmission
Clinical

6 Empirical
6 Relational
6 Experimental
6 Exposed diagnosis
6 Universal knowledge
6 Scholar transmission
Pathological

6 Two diagnosis moments:

Clinical + Certification.
6 Knowledge specialization is
born.
6 The body-soul dicotomy is
fundamented
Assisted

6 Three diagnosis
moments:
Clinical
+ Complementary
studies
+ Certification.
6 Images
6 Laboratory
 Predictable


  
u
 6 Genetic Diseases
6 Old Age
6 Alzheimer
  

6 Cancer
6 Cardiopathies
 

6 Endocrinopathies
Desire Derived

6 Cosmetics
6 Transexuality
6 Ortodonciy
6 Plastic Surgery
6 Obesity
Co-Active

6 Irritable colon
6 Alopecy
6 Menopause
6 Osteoporosis
6 High Cholesterol levels
6 Femenine Sexual
Deficiency
 The magical mentality
persists«even if we don¶t know it

Horus

Latin
interpretation

Transformation into
Recipe
 Doctor-Doctor relationship

6 Influence on the doctor-

patient relationship
Care for second opinions
Respecting the missing
colleague
Explain personal point of
view in case of a
disagreement
Written note to the treating
doctor.
Second step
 Second step

6 Understanding conflicts
Discovering barriers
Trying to overcome them
 Third step.
Fighting Burnout
 Advice for fighting Burnout
Syndrome
6 Teamwork
Work training and rules (watch out for ³elitism´
)
Personal Vocations
 Advice for fighting Burnout
j Teamwork
± Work training and rules (Watch out for
³elitism´ )
± Personal Vocations
± Periodic Vacations
± Critical Replacements
± Weekly meetings
± Group diversions
± Communication training
 Advice for fighting Burnout

6 Task Redesign
Containment of Pacient and Family
Paliative Care
Clinical research
Teaching
Public Education
Recreational workshops
 Advice for fighting Burnout

6 Generating an integrating medicine

Patient
Family
Society

They are, or should be, part of the team«

 Thank you very much.

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