Brazil Blossoms

Based on HNSC experience, a formal stage in hospital medicine under the supervision of Luciano Bauer Grohs, MD, one of the founders of GEAMH, has also been integrated into internal medicine training at Nossa Senhora de Pompéia Hospital in the city of Caxias do Sul, located 125 kilometers from Porto Alegre.

Our group has developed medical education in the inpatient setting. Because there is no hospital medicine society in Brazil, we have tried to coordinate with the Brazilian Society of Internal Medicine, encouraging discussions about hospital care and promoting workshops about mechanical ventilation, central vein access, and early goal-directed therapy for sepsis. More recently, we have chosen to work independently, believing that hospital medicine is distinct from internal medicine.

When we organized the Brazilian Annual Congress of Medical Residents in 2006, we had the opportunity to bring together medical residents and professors from different medical areas. The Congress’ main focuses were rational use of drugs and technology and the relationship between the young physician and the pharmaceutical industry. The participation of Robert Goodman (of No Free Lunch fame) was an important part of the convention.10

Slow and Steady Growth

We understand that there is a long journey ahead, beyond educational and medical assistance. Our group is still far from promoting research. But hospital medicine specialization has launched in Brazil. Dr. Watcher has said to us, “In the United States, the hospitalist field is the fastest growing specialty in the country—and probably in the history of the country. Hospitalists are transforming the delivery of American hospital care and improving quality, patient safety, education, end-of-life care, and more. We are thrilled to partner with our Brazilian colleagues as, together, we try to improve the quality of care for hospitalized patients everywhere.” We are confident that his vision will become a reality in Brazil in the near future. TH

Note: We are in debt to the professors at the Hospital Conceição Internal Medicine Residency Program, without whom our initiatives would never have blossomed. Special thanks to Eduardo Fernandes, Sergio Prezzi, and Paulo Ricardo Cardoso.

Dr. Barcellos is a specialist in internal medicine, emergency medicine, and critical care. He is professor in Nossa Senhora da Conceição Hospital’s Hospital Medicine Residence Program and president of GEAMH, a local association designed to promote the understanding and diffusion of hospitalist principles.

Dr. Wajner is a specialist in internal medicine and emergency medicine and a Master of Science student at Universidade Federal do Rio Grande do Sul.

Dr. de Waldemar is a specialist in internal medicine and emergency medicine.

References

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2. Agência Nacional de Vigilância Sanitária. Lei nº 8080. D.O.U. – Diário Oficial da União; Poder Executivo. September 20, 1990. Available at: http://e-legis.bvs.br/leisref/public/showAct.php?id=16619&word=. Last accessed January 28, 2007.
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10. No Free Lunch Web site. Available at: www.nofreelunch.org. Last accessed January 28, 2007.