Prof Manfred Stauber, former President of ISPOG gave in Berlin a presentation on the first years of ISPOG. (Presentation: http://www.ispog.org/url/download/312)
Being the important Kyoto Congress of 2007 a good example, ISPOG is growing and expanding to the Iberoamerican, Middle and Far East Countries, and connecting actively with global societies that share common fields of interest.
From the time ISPOG was created, professional and social position of Ob Gyns has changed, and ISPOG acknowledges the new situation and is concerned about of the well being of the professionals.
The XX century produced a male chauvinist paternalistic doctor centered model, asymmetric relationship with the patient at the same time medical societies enjoyed a strong economic and political influence. In our XXI century, after Evidence Based shift of our scientific activity, civil societies have produced a decline in the authority of doctors, among other “paternal” characters, as the political or religious authorities, adapting rapidly to a market-like model of provider/user or client management centered model.
Market-biased use of epidemiological evidence has encouraged the appearance of a “health bureaucracy” highly influenced by pharmaceutical lobbies and technocrats. Patients themselves feel they have obtained more power, and view upon themselves more as ‘clients’ than as ‘patients’, or another sort of patient than the old one, which demands another role for the doctor as well. Of course there will always be a difference between professional judgment and ‘pleasing the client’ which might give tension between the patients, the doctors and the new powerful leading actors: the Managers.
Globalization of economy has produced a growth in the number of immigrants, low income, unemployed, and ethnic minorities. In summary, there is more poor people living in the developed (before “rich”) countries, and the professionals are not enough supported by governments to face this new reality.
Few countries have psychologists working clinically in the hospital wards. Most of doctors only have a possibility of referring the patient to a psychiatric ward, or perform a written consultation, with little or none interdisciplinary exchange. Social workers are few and share a similar lack of contact.
In the more populated countries the new scenery has caused:
- Less time and economic recognition for time spent with each patient.
- Disconnection among primary health centers and hospital services
- Increasing paper, or computer work, with the professional filling in many records and in some way forced to adapting the patient to the protocols, in spite of using them as a useful guide that must be adapted to each patient.
- Growth of Law suits and “defensive” medicine contaminating consultations and procedures. This is why Informed choice’ is more and more important, requiring good communication skills and solid bioethical principles of the gynaecologist, midwife or nurse.
- “Burned out” professionals, violence against doctors, etc.
ISPOG is responding to these new challenges support for the professionals that take care of women .
Midwives, Nurses, Neonatologists, Psychiatrists, Psychologists, Psychoanalists, OB Gyns , all of you are needed and welcome. Please feel free to join ISPOG.