Rome, Feb. 15 (Reuters) - Italian doctors increasingly stressed. The fear of making mistakes, sometimes grueling rounds, the fear of finding themselves 'walking' or retired too early, can be very heavy burden to bear. Especially on the shoulders of those white coats more fragile, in most cases, not wanting or not knowing where to turn, are likely to fall into the 'black hole' of depression. They are in fact at least 5 000 Italian doctors, lost and under stress, take refuge in alcohol and drugs, particularly cocaine. A number that makes an impression, if you think that it is professionals who deal with the health of citizens; 'the last picture the Italian doctors suffering from burnout (addiction professional), a disease which, if untreated, can also lead to extreme solutions. Taking them is Benjamin Palmer, a professor of surgery at the University of Modena and Reggio Emilia and project coordinator 'Physician heal thyself', a network that has, among its objectives, its protection of the white shirts that fall ill or are affected by bornout. The phenomenon in Italy about 30% of physicians over 50. Nearly 1 in 3. The scenario - shows a preview Adnkronos Salute - will be presented in detail during the second national conference of the network coordinated by Palmieri, scheduled for 4:05 March in Milan. "Physicians - Palmieri says - despite having lower levels of mortality than the general population, however, have a higher risk of being affected by some problems of physical and psychological. Who is exercising this profession, the average of the population is most affected by one or more of the 'd': drugs, drink and depression, namely drugs, alcoholism and depression, including suicide. "It is no coincidence that, Worldwide, suicide rates among white coats is two times higher than the general population among men and among women even four times. Numbers chills, which originated from the dependencies related to the profession. "Burnout - spiega Palmieri - è una sindrome caratterizzata da stress lavorativo, esaurimento (tensione emotiva, ansietà, irritabilità ovvero noia, apatia, disinteresse), conclusione difensiva (distacco emotivo dal paziente assistito, cinismo, rigidità)". A rimanerne colpiti, tra i medici, sono in tanti: "Si stima - sottolinea l'esperto - un 30% dei camici bianchi con più di 50 anni".A farne le spese sono soprattutto anestesisti, chirurghi, ginecologi e medici del pronto soccorso, in maggioranza uomini (nell'80% dei casi). "Tutti medici - spiega Palmieri - sottoposti a grande stress. Molti lavorano 50-60 ore a settimana, ma il sovraccarico non è solo di fatica: c'è quello emozionale e, sempre Moreover, there is the burden of bureaucracy and conflicts between colleagues. To all this add up cultural factors that make it difficult for doctors to ask for help. "And in fact, very few are those who launch a sort of Sos. We counted on the fingers of one hand." Approximately 99% of the white shirts in difficulty - emphasizes the expert - not or will not know where to turn. Of these - plus - 45% were self-care. "It remains to work." Almost all, even among those who use drugs, especially cocaine and alcohol, is a coexistence between occupation and abuse. "To end up in the tunnel dependence are mainly the most talented doctors and workaholics. "A fall into the trap - explains Palmieri - are just i camici bianchi che dedicano tutta la lora vita al lavoro. Sempre pronti a correre in ospedale e sostenere turni massacranti". Professionisti 'scoppiati' che iniziano a essere depressi e a rifugiarsi nell'alcol o nella droga o in entrambi. Svariate le forme depressive. "Ci sono - spiega l'esperto - quelle che si manifestano con rabbia e irritabilità. E ancora, casi in cui prevalgono mal di testa, nausea, disturbi del sonno". Le conseguenze di questo quadro clinico non possono non riflettersi anche sull'attività medica. "Aumenta ad esempio - afferma Palmieri - il rischio di ferirsi con un bisturi, o di pungersi con una siringa". A rimetterci è anche il rapporto con il paziente. "Studi scientifici - aggiunge l'esperto - hanno infatti demonstrated that a physician is not only less stressed willing to talk, but could more easily make mistakes, even fatal. "To cope with these problems will also be addressed in public care facilities, but it is not so simple." The Most of the time - said Palmieri - the doctor does not ask for help, because he is afraid of being recognized and have an impact on their careers. "There is another factor that does not facilitate the resolution of the problem. Not all doctors know suffering from burnout really be in trouble. "There is a 15% white coats to be affected to ignore. And about 18% living with a chronic state of depression. "Meanwhile, against doctors unaware e di una rete di assistenza debole, il fenomeno cresce. "Negli ultimi cinque anni - spiega l'esperto - il burnout nel nostro Paese è aumentato ogni anno dell'1%". Un trend che sembra trovare conferma in alcuni episodi balzati di recente alle cronache, con medici protagonisti di strane storie. L'ultimo caso in ordine di tempo è quello di una guardia medica di 58 anni che, a Roma, beveva durante il servizio. Avrebbe dovuto rispondere al telefono dell'ambulatorio e all'occorrenza curare i malati, di persona oppure dando indicazioni via cavo. Invece era spesso ubriaco. Oppure non c'era, avendo l'abitudine di anticipare di parecchio il suo orario di fine turno. Fatto sta che si è ritrovato imputato in un'aula del tribunale di Roma, con the accusation of service interruption of public utility and threats against his colleagues who, after months of endurance, had denounced result in suspension. And he, in revenge, began to call at all hours, on the lines reserved for public health emergencies, to fill them with threats and white coat finished improperi.Un more recently in the newspapers for anything but medical reasons is that , serving in a casualty department in Naples, has been surprised by the Police to buy cocaine. But when it comes to drugs is the episode that has done more buzz there was in December in Galatina, in the province of Lecce, where the medical director of the hospital 'Santa Maria Caterina Novella' ha addirittura inviato una circolare interna per ammonire il personale medico e gli infermieri a non fare uso di cocaina durante l'orario di servizio. L'invito era stato rivolto dopo alcune segnalazioni anonime giunte alla direzione sanitaria del nosocomio salentino. A pagarne il conto è stato però proprio il direttore sanitario, che è stato sospeso dalla direzione generale dell'Azienda sanitaria. Naturalmente il problema è internazionale e varca i confini italiani. Anche se negli altri Paesi sembra esserci una maggiore attenzione al fenomeno. "In Italia, da questo punto di vista siamo indietro", sottolinea Palmieri. "Manca un monitoraggio attento del fenomeno. Il ministero della Salute del Galles - aggiunge - sta ad esempio compiling a register of doctors and medical students who have experienced psychiatric illness or substance abuse, in order to establish how these people can continue to work or study in protecting the public interest. "During the second congress of the network ' Physician heal thyself ', will also present other international studies on the matter. "It' s been done - said Palmieri - a medical screening on Australian and New Zealand through an evaluation of anxiety and depression, which showed that the highest stress levels could be found between family doctors, compared to the average population. Similar conclusions were found from a study conducted in Great Britain which sought a correlation between personality and work through a questionnaire on anxiety and depression in primary care providers. "The survey results are telling:" It has been noted - said the expert - that the cases depression (10% and 16% non-severe borderline) were statistically associated with lack of free time because of work stress for the constant demands of patients, the fair amount of calls to a busy life, being single and childless , alcohol abuse, obesity, and unsatisfactory for a career in areas of little challenging. "
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