2014 marked the sixtieth anniversary of the appearance of the World Medical Journal (WMJ). The journal is published quarterly and it reflects the aims and activities of the World Medical Association.

It is not the task of the WMJ to publish new scientific medical research. This is clearly the function of the multitude of information available in either broad-based or specialised journals. However, there is a place for publishing overviews of trends, new areas of medical progress which may not appear in the general run of medical journals and which can increase physicians’ awareness of developments of which they may be unaware. It has sections on Medical Ethics and Human Rights, Medical Science, Professional Practice and Education, the Secretary General’s column, and a section on Regional and National Medical Association (NMA) News where we will try to report on regional developments and NMA initiatives or problems.

We hoped that readers will find it interesting, informative and helpful. As ever, the Editor will be pleased to consider any papers or information for publication.

Interview with Miguel Roberto Jorge, President of the World Medical Association by WMJ Editor Peteris Apinis

Apinis: You are a physician known worldwide and a leader among psychiatrists.

Could you comment on whether doctors in the world are burned out? Are doctors more threatened by anxiety and depression than other people? Is it true that doctors in certain professions (such as anesthesiologists and psychiatrists) are more at risk of suicide than people of other professions? How can we help doctors in the world to feel appreciated and reduce the risk of burnout?

Jorge: There are studies indicating a high prevalence of burnout among physicians worldwide even considering that burnout is not equally distributed among them.

Providing medical care usually in difficult circumstances exposes physicians to continuous stress at work and burnout is one of the consequences of this kind of situation.

On regards of anxiety and depression, some data suggest that physicians do not present more depression than other people but the rate of suicides among physicians is higher than in the general population and, again, the distribution of suicide rates among different medical specialties is not equal. In my personal opinion, the best way for a physician to feel appreciation and reduce the risk of burnout is to dedicate to build a good relation with patients and share with them the power to take decisions on treatment alternatives.

Apinis: We see a new trend in world politics – doctors are undervalued. The global trend is growing: doctors’ earnings are declining against average earnings in the country. Politicians and financiers, meanwhile, talk publicly that preparing doctors is too expensive, that universal health coverage should be cheaper to have health specialists. How can we build the prestige of our global profession and restore the remuneration?

Jorge: I can identify different situations in your question. Nowadays, compared to past times, medical doctors are given less value and I believe the dehumanization of the medical practice has contributed to this situation. Physicians not always have enough time to dedicate themselves to build a good physician-patient relationship that takes the individuality of each patient in consideration.

And even when they have that time, they are more prone to pay attention to lab exams than to listen to the person they have in front. I do not know if just earnings of medical doctors are declining but I believe the reasons for that are multiple and linked to profound changes in the work market everywhere in the globe. To prepare good professionals, in any area of work, deserves meaningful investments. And I do not believe that to prepare good primary care physicians will cost less than to train a good specialist. Any system of care, and particularly those under the Universal Health Coverage, requires good primary care physicians as well as good specialists.

Apinis: In Tbilisi, the WMA accepted a declaration on euthanasia. In this declaration, the WMA condemned euthanasia and assisted suicide. As physicians, they can’t and don’t want to perform euthanasia or assisted suicide. However, surveys show that physicians as patients would like to shorten their lives when they encounter major physical and mental health problems. These are doctors as patients who are most likely to refuse complicated and excessive treatment if it can’t significantly prolong survival and improve the quality of life. How would you comment on a situation where a doctor, as a patient, requires euthanasia or assisted suicide?

Jorge: Indeed, the WMA took a very clear position opposing physician assisted suicide and euthanasia. We think that physicians should not involve in such practices. We want our patients to be sure that we value their lives and that we are there to protect and to help them even in very difficult situations.

Physicians, when they become patients, are patients like any other person. There is no different ethics for physicians being patients. But the same is also true as for any other person: we should abstain from futile and undesired treatment, we must respect a demand for ending treatment and we have to give comfort and to alleviate pain. . .

Read the entire interview in the WMJ. . .

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