An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil

An evaluation of the professional, social and demographic profile and quality of life of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil

Author Tallo, Fernando Sabia Autor UNIFESP Google Scholar
Abib, Simone de Campos Vieira Autor UNIFESP Google Scholar
Baitello, André Luciano Google Scholar
Lopes, Renato Delascio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Faculdade de Medicina de São José do Rio Preto Departamento de Cirurgia
Duke University School of Medicine Division of Cardiology
Abstract OBJECTIVE: To describe the profile of physicians working at the Prehospital Emergency Medical System (SAMU) in Brazil and to evaluate their quality of life.METHODS: Both a semi-structured questionnaire with 57 questions and the SF-36 questionnaire were sent to research departments within SAMU in the Brazilian state capitals, the Federal District and inland towns in Brazil.RESULTS: Of a total of 902 physicians, including 644 (71.4%) males, 533 (59.1%) were between 30 and 45 years of age and 562 (62.4%) worked in a state capital. Regarding education level, 45.1% had graduated less than five years before and only 43% were specialists recognized by the Brazilian Medical Association. Regarding training, 95% did not report any specific training for their work at SAMU. The main weaknesses identified were psychiatric care and surgical emergencies in 57.2 and 42.9% of cases, respectively; traumatic pediatric emergencies, 48.9%; and medical emergencies, 42.9%. As for procedure-related skills, the physicians reported difficulties in pediatric advanced support (62.4%), airway surgical access (45.6%), pericardiocentesis (64.4%) and thoracentesis (29.9%). Difficulties in using an artificial ventilator (43.3%) and in transcutaneous pacing (42.2%) were also reported. Higher percentages of young physicians, aged 25-30 years (26.7 vs 19.0%; p<0.01), worked exclusively in prehospital care (18.0 vs 7.7%; p<0.001), with workloads >48 h per week (12.8 vs 8.6%; p<0.001), and were non-specialists with the shortest length of service (<1 year) at SAMU (30.1 vs 18.2%; p<0.001) who were hired without having to pass public service exams* (i.e., for a temporary job) (61.8 vs 46.2%; p<0.001). Regarding quality of life, the pain domain yielded the worst result among physicians at SAMU.CONCLUSIONS: The doctors in this sample were young and within a few years of graduation, and they had no specific training in prehospital emergencies. Deficiencies were mostly found in pediatrics and psychiatry, with specific deficiencies in the handling of essential equipment and in the skills necessary to adequately attend to prehospital emergencies. A disrespectful labor scenario was also found; the evaluation of quality of life showed a notable presence of pain on the SF-36 among physicians at SAMU and especially among doctors who had worked for a longer length of time at SAMU.
Keywords Emergency Medicine
Mobile Units
Role of Physician
Emergency Medical System
Language English
Date 2014-09-01
Published in Clinics. Faculdade de Medicina / USP, v. 69, n. 9, p. 601-607, 2014.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
1980-5322 (Sherpa/Romeo, impact factor)
Publisher Faculdade de Medicina / USP
Extent 601-607
Origin http://dx.doi.org/10.6061/clinics/2014(09)05
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000343983100005
SciELO ID S1807-59322014000900601 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/8597

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