By Andrea Hargraves SÃO PAULO, SP (FOLHAPRESS) – More than a quarter of doctors in São Paulo do not adopt the healthy lifestyle habits that patients usually recommend, such as the regular practice of physical exercise.
An unprecedented survey conducted by APM (Associação Paulista de Medicina), with 778 doctors working in the state of São Paulo, showed that 27% of them do not exercise.
The rate is almost double that recorded among adults in 26 Brazilian capitals plus the Federal District (15%), according to data from Vigitel 2021, a telephone survey conducted by the Ministry of Health that surveys risk factors for chronic diseases.
Among those who do some physical activity regularly, 15% do it five or more times a week; 13.75% four times; 23.52% three; 15.94% two; And 4.7% is just one. Most of them (68%) devote no more than 30 minutes to exercise.
The World Health Organization (WHO) recommends 150 to 300 minutes of physical activity per week.
The APM survey was conducted through an online questionnaire and does not have a systematic design to represent the entire São Paulo category. More than half (53%) are doctors in the capital; 39% inside; and 8% from other countries. Most (54%) are up to 50 years old.
“The goal was to understand more or less healthy habits among colleagues to think about campaigns and other prevention strategies,” says anesthesiologist and intensive therapist Jose Luis Gomez do Amaral, president of APM.
According to the survey, more than half of physicians use some medication (54%). Sedatives, anxiolytics and antidepressants are the most consumed (30%), followed by medications to control high blood pressure (24%), cholesterol levels (19.8%) and diabetes (11.5%).
Among the health problems they had or experienced in the past year, the most cited are: sleep disturbances (44%), headaches (30%), mental disorders (22%) and sexual dysfunctions (11%).
And the mental health of those who look after us also inspires us to care: 72% reported frustration and impatience. 21.5% depression 26%, changes in memory; and 31% lack of attention and focus. According to the survey, a quarter of respondents (24.94%) said they do not take time off.
Another survey released in September by a medical platform, with specialists from across the country, showed that a third of them had developed symptoms of depression in the past 12 months. A similar percentage say they have symptoms of anxiety disorders and fatigue. However, most of them declare that they did not seek professional help to deal with these problems.
The factor most associated with “burnout” was the excessive number of hours worked, followed by insufficient wages and lack of professional fulfillment.
Dr. Anna Amorim, MD, director of professional practice at the Paulista Society of Family and Community Medicine, says there has been a marked increase in mental health problems for doctors who are on the edge of the public health system, in primary care, and who are also working on shifts in hospital emergency rooms.
“These issues are largely related to occupational burnout, but they do not come alone. They are often associated with the entire work team. One case that has been identified as motivating is, without doubt, the epidemic that has resulted in an increased workload without additional human resources.”
In the survey, only half of the doctors said they work eight hours a day and 44 hours a week, which is what the constitution requires. The other part of the category adopts working hours of 50 hours (25%) or even 60 hours or more (24.3%).
Amaral, of the APM, says more studies will be needed to assess the amount of this mental suffering as a result of the pandemic, lack of physical activity, overuse and working conditions. He comments, “There is a clear process of swindling doctors, with precarious working relationships. All of this affects mental health.”
According to Dr. Anna Amorim, the instability of employment contracts, with many self-employed professionals being employed as legal entities through Social Health Organizations (OSS), has had negative effects on physicians and the care provided to the population.
“Professionals feel less connected to services. They pay much more for quantitative numbers than for qualitative numbers. In practice, this affects care. Professionals who don’t feel covered, who are sick and who are maxed out end up giving up their jobs.”
Recent cuts in federal government resources in critical programs such as Farmácia Popular and HIV-Aids, which can lead to drug shortages, as well as changes to primary health care (primary health care) strategies, without consulting health professionals who are in the end, are Also factors of psychological suffering, according to Amorim.
APM research shows that the impact of Covid has been significant among clinicians and continues to have negative effects. About 68% said they had been infected once or more, 28% said they had not contracted the disease, and the rest said they did not know.
Among those who complained about the long-term effects of Covid, 32% reported fatigue; 16%, amnesia; 15% hair loss. 14% muscle pain. 11.7% persistent cough. and 10.4% loss of smell or taste.
Nine out of ten doctors say they have had at least one dose of the Covid-19 vaccine. More than half (58.6%) were immunized with the four doses; 33% with three; 6.2% with two; 0.4% with one. Only 1.41% of respondents said they had not taken any dose. “The vast majority of clinicians are in favor of a science vaccine,” Amaral says.
According to him, the research carries other good news regarding smoking: only 5% of doctors declare themselves to be smokers, compared to 9% of the Brazilian population in general, according to Vigitel. The vast majority (77.7%) said they had never smoked and 16% said they had given up the habit.
“When I started practicing medicine, in the ’70s and ’80s, there was a very high percentage of doctors smoking. This change is very important. It’s not enough to describe smoking cessation, you have to set an example.”