{"id":8990,"date":"2019-08-19T07:06:18","date_gmt":"2019-08-19T07:06:18","guid":{"rendered":"https:\/\/jurmed.ro\/medici\/?p=8990"},"modified":"2019-08-19T07:06:18","modified_gmt":"2019-08-19T07:06:18","slug":"medicii-capabili-nu-sunt-neaparat-apanajul-centrelor-universitare","status":"publish","type":"post","link":"https:\/\/jurmed.ro\/medici\/medicii-capabili-nu-sunt-neaparat-apanajul-centrelor-universitare\/","title":{"rendered":"„Medicii capabili nu sunt neaparat apanajul centrelor universitare!”"},"content":{"rendered":"

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0\u00a0 \u00a0 \u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Inte\"\"<\/a>rviu cu dr Memu Eustatiu, Presedintele Comitetului de organizare al celei de a V-a editii a Conferintei de Cancer Bronhopulmonar de la Drobeta-Turnu Severin, 6-7 septembrie 2019, un eveniment organizat de Asociatia de Chirurgie Toracica Moderna, presedinte Conf univ dr Alin Demetrian, sub egida UMF Craiova, in parteneriat cu Societatea Romana de Pneumologie.<\/p>\n

 <\/p>\n

Se vorbeste mult despre munca in echipa. Cu cine faceti dvs echipa, in afara compartimentului de chirurgie toracica, in spital si in judetul Mehedinti?<\/strong><\/p>\n

Chirurgia toracic\u0103 poate fi considerat\u0103, mai degrab\u0103, o supraspecializare chirurgical\u0103 de\u0219i preg\u0103tirea prin reziden\u021biat se face distinct la noi \u00een \u021bar\u0103. Majoritatea patologiei este de tip cronic \u0219i subacut: tumori toracice, pleurezii, patologie non-tumoral\u0103 de resort chirurgical (emfizem pulmonar, pneumotorace, chisturi, abcese pulmonare cronice, bron\u0219iectazii, pericardite). Prin urmare, cea mai mare parte a pacien\u021bilor ne sunt trimisi de c\u0103tre colegi de alt\u0103 specialitate: pneumologi, interni\u0219ti, cardiologi, oncologi, medici de familie. \u00cen zilele noastre pacien\u021bii sunt complet investiga\u021bi preoperator prin imagistic\u0103 (radiografie, computer tomografie, rezonan\u021b\u0103 magnetic\u0103), spirometrie, evaluare cardiologic\u0103, analize de laborator, endoscopie digestiv\u0103 superioar\u0103, endoscopie bron\u0219ic\u0103. Postoperator, aproape toate cazurile necesit\u0103 examen citologic \u0219i\/sau histopatologic, tratamente adjuvante oncologice, radioterapie, recuperare respiratorie, chimioterapie antituberculoas\u0103. \u0218i, bine\u00een\u021beles, orice interven\u021bie chirurgical\u0103 implic\u0103 o anestezie. Iat\u0103 cu c\u00e2te specialit\u0103\u021bi colabor\u0103m, zic eu, cu succes, pre-, peri- \u0219i postoperator.<\/p>\n

Cu cati medici de familie colaborati? Cati v-au sunat in ultimul an sa discute cu dvs despre un caz, pe cati i-au sunat pentru a le cere detalii despre un pacient?<\/strong><\/p>\n

Realitatea este c\u0103 nu avem prea mult\u0103 comunicare direct\u0103. Sunt sigur c\u0103 dumnealor v\u0103d biletele de externare ale pacien\u021bilor no\u0219tri, dar \u00een h\u0103\u021bi\u0219ul birocratic extrem de cronofag nu mai este timp pentru asemenea comunic\u0103ri. Sincer, nu cred s\u0103 fi vorbit la telefon cu mai mult de zece medici de familie din Mehedin\u021bi \u00een cei zece ani de existen\u021b\u0103 a chirurgilor toracici \u00een Spitalul Jude\u021bean Drobeta Turnu Severin. Iar postoperator de obicei se \u021bin pacien\u021bii (cei care se \u021bin!) de recomand\u0103ri \u0219i vin la control.<\/p>\n

Cum decurge colaborarea cu medicii pneumologi din judet?<\/strong><\/p>\n

Foarte bine. Exist\u0103 nuan\u021be \u00eens\u0103. Istoric, neexist\u00e2nd chirurgi toracici p\u00e2n\u0103 la angajarea mea aici \u00een 2009 cazurile erau trimise la Timi\u0219oara sau Craiova. Din 2009, a ap\u0103rut o colaborare, progresiv tot mai bun\u0103.<\/p>\n

Cum ajung pacientii la dvs, care este traseul si cum ar putea fi simplificat? Care este modul in care doriti sa comunicati cu colegii- sa va sune, sa va dea mail?<\/strong><\/p>\n

Trebuie \u021binut cont de particularit\u0103\u021bile modului de organizare local, care este probabil comun multor spitale jude\u021bene de urgen\u021b\u0103 neuniversitare: compartiment de cinci paturi \u00een cadrul sec\u021biei de chirurgie. Ideea acestei structuri organizatorice este de a asigura urgen\u021bele, astfel c\u0103 pacien\u021bii de acest tip ajung prin UPU. Ceilal\u021bi ajung prin modul amintit la prima \u00eentrebare. Pentru ace\u0219tia ideal\u0103 este prezentarea cu toate investiga\u021biile \u0219i consulturile de alt\u0103 specialitate (inclusiv preanestezic) efectuate, concluziile de rigoare trase \u0219i planul terapeutic stabilit \u00eentr-o consulta\u021bie \u00een ambulatoriu. Dar… Modul de comunicare cu colegii? Telefonic pare mai facil dar este… perturbator uneori. Sistemul de mesagerie (SMS prin re\u021belele de telefonie sau oricare dintre cele via internet) ori emailul sunt mai „a\u0219ezate”, calme, dar nu c\u00e2t ai bate din palme. Pentru consulturile intersec\u021bii emailul este prea mult. Pentru comunicarea cu medicii de familie este ideal!<\/p>\n

Sunteti un comunicator deosebit, cu un umor negru, acid de multe ori. De fiecare data cand vorbiti despre comunicarea cu pacientul vi se schimba tonul vocii si cumva, amaraciunea se simte in tot ceea ce spuneti. Care ar fi mesajul dvs pentru pacienti, cum ati dori sa se comporte cu dvs si colegii dvs, ce pot face ei diferit, in asa fel incat consultatia sa decurga mai bine, mai eficient, mai firesc..<\/strong><\/p>\n

M\u0103 izbesc uneori de un fel de suspendare a lor. \u00cencerc s\u0103 le explic c\u00e2t mai clar, chiar desenez, ca apoi s\u0103 constat c\u0103 nu au \u00een\u021beles. Unii refuz\u0103 mental concretul, altora li se pare probabil c\u0103 nu se poate a\u0219a ceva \u00een „micul” (?!) ora\u0219 de provincie unde se afl\u0103. Cred c\u0103 este bine s\u0103 \u00een\u021beleag\u0103 c\u0103 exist\u0103 posibilit\u0103\u021bi terapeutice \u0219i \u00een cancer \u0219i c\u0103 medicii capabili nu sunt neap\u0103rat apanajul centrelor universitare.<\/p>\n

Afirmati intr-un interviu anterior ca va ocupati si de infectii. La ce anume va referiti? Cum decurge colaborarea cu medicii infectionisti?<\/strong><\/p>\n

Chirurgia toracic\u0103 poate fi util\u0103 \u00een cazurile de pleurezii ori pericardite infec\u021bioase (tuberculoase sau netuberculoase), supura\u021bii pulmonare cronice, mediastinite, abcese ale peretelui toracic, chisturi hidatice toracice. \u00cen plus, \u00een Drobeta Turnu Severin, colegul meu (dr. D\u0103nu\u021b Popovici) \u0219i cu mine suntem singurii medici care efectu\u0103m bronhoscopii, fiind solicita\u021bi la unele cazuri de infec\u021bii bronhopulmonare pentru bronhoaspira\u021bii \u0219i recolt\u0103ri de aspirat bron\u0219ic pentru examene bacteriologice \u0219i BK. Colaborarea cu ceilal\u021bi medici implica\u021bi (infectioni\u0219ti, pneumologi, anestezi\u0219ti) este excelent\u0103.<\/p>\n

Exista medici in Romania care roaga pacientii sa fie atenti la personalul medical, sa se asigure ca cei care ii ingrijesc se spala pe maini. Ce parere aveti despre asta?<\/strong><\/p>\n

Cred c\u0103 acest mod de abordare face parte din medicina personalizat\u0103 practicat\u0103 de mult timp \u00een sistemul public de s\u0103n\u0103tate \u00een urma umilirii salariale a personalului medical \u00eencep\u00e2nd cu anii socialismului. Dar solu\u021bia este ca \u0219efii de sec\u021bii sau orice serviciu medical s\u0103 imprime \u0219i cultive personalului din subordine o rigoare fireasc\u0103. Iar cadrele de predare s\u0103 insiste asupra igienei m\u00e2inilor, metodelor de antisepsie \u0219i asepsie. Normal c\u0103 administra\u021biile unit\u0103\u021bilor sanitare trebuie s\u0103-\u0219i fac\u0103 treaba prin asigurarea condi\u021biilor \u0219i materialelor necesare.<\/p>\n

Sunteti presedintele comitetului de organizare al celei de a V-a editii a Conferintei de cancer bronhopulmonar, eveniment ce avea loc pentru prima data la Drobeta. Ce mesaj aveti pentru colegi, de ce ar fi bine sa participe la aceasta conferinta, ce vor putea afla despre aceasta patologie pentru care screeningul este prea scump?<\/strong><\/p>\n

\u00cencerc\u0103m s\u0103 atragem aten\u021bia asupra cancerului bronhopulmonar, care este cam neglijat. Dac\u0103 \u00een Rom\u00e2nia socialist\u0103 se lupta cu tuberculoza, iat\u0103 c\u0103 ne-am occidentalizat. Este prima cauz\u0103 de mortalitate prin cancer la b\u0103rba\u021bi, iar la femei nu este departe. Trebuie s\u0103 promov\u0103m preven\u021bia, adic\u0103 lupta cu fumatul. Depistarea precoce \u00eenseamn\u0103 computer tomografie, nu MRF sau radiografie. Tratamentul chirurgical, cel mai eficient \u00een cazurile precoce, este complet neglijat de factorii decizionali. Radioterapie nu exist\u0103 \u00een toat\u0103 Oltenia, cu excep\u021bia Craiovei! Pacien\u021bi sunt \u0219i vor fi tot mai mul\u021bi, nu este o solu\u021bie s\u0103 fie to\u021bi \u00eendruma\u021bi spre centre universitare, mai ales c\u00e2nd ai muguri pe care-i po\u021bi ajuta s\u0103 \u00eenfloreasc\u0103, nu s\u0103 se ofileasc\u0103! Persoanele cu cancer bronhopulmonar merit\u0103 mai mult!”<\/p>\n

La Conferinta de cancer bronhopulmonar vor participa dr. Nelly Cherciu, dr Michael Schenker, dr. Constantin Darius Ungureanu , dr. Constantin Ple\u0219an, dr Eleodor Carstoiu, dr Daniela Cirnatu, asist univ dr. Valentin Co\u0219ei, dr. Elena Vlad, dr. Rus Ovidiu, dr Irina Dr\u00e3gan, dr Carmen Marcu, Prof univ dr Silviu Sofronie, Prof asoc dr Costin Popescu, dr Ahileas Chimorgiachis, Conf univ dr Claudia Toma si alti invitati implicati in managementul cancerului bronhopulmonar.<\/p>\n

Pentru inscrieri la conferinta puteti accesa site-ul flashmedical.ro sau puteti apela la Florin Cristea, 0756030353 sau pe mail florin.cristea@houston.ro<\/a>. „<\/p>\n","protected":false},"excerpt":{"rendered":"

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