Editorial

On June 16th 2009, a colleague sent the following message asking it to be spread by the Colombian Association of Psychiatry:

Colombian Association of Psychiatry: (Greetings) Through this means we wish to ask you to spread this message. The Usaquén Hospital, ESE, at this moment needs 2 psychiatrists to work in its services for children in Servitá and San Cristobal Niños; 4 hours in the afternoon in each one. It implies a professional services contract, and the payment is Col$ 2.520,000, with the obligatory deductions. If necessary, please contact the indicated e-mail. Thanks.

As a result of this message, by some called “el florero de Llorente”¹, quite an amount of answers have been received, in which the common denominator was criticism against this offer. The low salaries for psychiatrist were questioned, how in many occasions we psychiatrists are below other specialists was commented upon, and how psychiatry is considered as being less complex than other specialties. Likewise, the current situation of a medicine managed by some health care providing companies (EPS) and the marketing economy, the time we are allowed to attend on our patients, were criticized and we were asked to reflect on our profession and the work of the Association regarding the protection of the interests of its members. Finally, there were some who suggested different solutions: a forum within the framework of the Colombian Congress of Psychiatry, a press communiqué and the need to unionize, among others.

These were interesting comments that started a much-needed discussion that we hope will continue and get answers from the Association and from all of us who form part of it. Now, the Association’s statutes (Chapter 1, article 4b) state regarding its purpose that: “The Association shall seek the best for its members and defend the work interests of the same. It shall ensure the correct practicing of the profession and shall turn to the authorities to prevent its illegal practicing”.

Keeping in mind this statutory mandate, it is important to seek answers to the questions that the referred to message gave rise to and to others that may complement the debate and make us reflect upon our task:

1. Should there be a bottom charge for consultations? It is convenient to institute a bottom charge for the country as a whole or by regions? We must remember that the biggest problem seems to be in Bogotá, and this is due to the high amount of colleagues in the capital: almost 40 or 50% of all psychiatrists in the country.

2. How much should the minimal wage be for a psychiatrist? Is it recommendable to have one, given that it could become a bottom-top one?

3. What actions could the Association take to make its members respect what has been agreed to? For example, what could it do to help a colleague who, because in need, is tempted to accept a post as the one that gave rise to the discussion?

4. How long should an ideal consultation last? Half an hour? Should the first one be differential? And the following? Is it valid that the first should last 45 minutes and the others less? Does there exist a minimal time to attend on a patient with psychiatric problems?

5. How many patients maximum should a psychiatrist see in one day? Is there any evidence on how many people at most we are able to attend on adequately in one day?

6. Being aware of the number of psychiatrist is a fundamental piece in the mechanism of this problem: how many psychiatrist should there be in the country and how many in each region?

7. What type of work contracting the should Association recommend for its members?

8. What communications would be relevant and how should they be delivered?

We hope that the questions that the above message has given rise to and these new ones will help us to study in depth this problem and to assume our position with respect to the same, as persons and as professionals.

Carlos Gómez-Restrepo
Director-editor
Revista Colombiana de Psiquiatría
cgomez@yahoo.com

¹. The breaking of Llorente’s flower vase in a dispute between Llorente, a Spaniard, and some Colombian patriots, was the spark that ignited the revolution against Spain.