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Vol. 25. Núm. 1.
Páginas 3-4 (Enero - Abril 2016)
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Vol. 25. Núm. 1.
Páginas 3-4 (Enero - Abril 2016)
DOI: 10.1016/j.uroco.2016.02.007
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Professional view of urology
Panorama gremial de la urología
Luis Javier Aluma Sáncheza,
Autor para correspondencia

Corresponding author.
, Gino Alberto Arbelaez Cortesb
a Chairman of the Urologists Union of Colombia, Síndurcol, Full Member of the Colombian Society of Urology, Centro Médico Imbanaco Cali, Colombia
b Vice-Chairman of the Urologists Union of Colombia, Síndurcol, Full Member of the Colombian Society of Urology, Hospital Universitario del Valle, Clínica Nuestra Señora de los Remedios Cali, Clínica Saludcoop Cali, Colombia
Contenido relaccionado
Urol Colomb. 2016;25:1-210.1016/j.uroco.2016.02.006
Luis Javier Aluma Sanchez, Gino Alberto Arbelaez Cortes
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We are not born for ourselves alone


And I was wondering, intrigued and interested:

Well, what do you do with these hard rocks that make a kidney explode and people cry? Break them. It was explained, with a laser, to follow the fashion.

Bah! I replied. And if they are monstrous masses that eat up organs and the bladder? I asked, astonished.

We will confront them with force, I contested. Until they are destroyed and won over.

No, sir! You are “hard ones”, I concluded after many more questions. And I finished by saying “you have the power”.

In 23 years of Law 100, the reality of medical practice has experience many changes, with the majority being at the expense of quality, since the system is played to the full with the ignorance of the professional as regards their occupational rights and lack of unity. With absurd tolerance and biblical patriarchy, as doctors, we have changed the Hippocratic oath due to lack of voting, living with and consenting to the systematic abuse of the paymasters, who from their armchairs banish us from the justly paid event, and subject us to macabre and illegal taxation, where even the financial risk has to be shared, including placing us as actors of cost containment. The novelty of negotiating a longer and overdue list of services, for half or less, in order to save the hat of the drowned man, is now seen as unimpressible, because, what a surprise! We are already accustomed to it. In tragic times when the Country had to swallow a lot to reach the maltreated Peace, and we lectured on the issue. The years have gone by swallowing this unperturbed; dinosaurs of the size of the greed of a health providing body (EPS).

Pearls, there are many. The health services providers (IPS) or EPS go bankrupt, disappear from the market or change businesses, and the doctor, the weakest link in the chain, is left to waiting for the crumbs that the payer deigns to throw at him.

We still adore Moses who came down some mountain with the Social Security prices, but, paradoxically, this price list does not exist. Thus the unreal is the reality, the value of our work is rudely ignored; the Ministry itself recognises this absurdity, but offers an antiquated rate designed by economists, without being polluted by a medical assessment. These delays in fees of more than 15 years, which no health insurance group would withstand, are unrecoverable, and for this reason an new global contract model is urged for all specialities that partly compensate this truly legal loophole. So comfortable are we in the comfort zone, which the Law itself (Res 5925 of 2014) requires that a percentage of the medical fees are transferred, so that the government annually increases the capitation payment unit (UPC) to each EPS; we do not see this. Will it be what we do not want to see?

Much of these absurdities strengthen the dominant position of the EPS, completely illegal. Exploitation due to indifference, it has been more than 20 years since we sold the idea that our work has little value and that on the contrary, we must be thankful for the work opportunity offered, although poorly paid and with no guarantees. It sounds familiar, like a film of a city repressed by some dictator, but here the actor is you and me. And our families see it in the first row.

Nowadays, employment relationships with basic legal rights has become an illusion, to which we respond due to our social security and future pension, in a system that increasingly demands more requirements and guarantees, but that looks at all ways to lower salaries. The Ministry of Health is immersed in the dilemma of financially sustaining the health system, and our well-being will never be its priority.

To end, professional solidarity (which, by the way, should be an obligatory teaching subject in Post-Graduate programs) is appreciated at a distance, like the Andean bear, on the route to distinction and under the spotlight of many fortune hunters that do not doubt for one minute in dealing it the death blow.

In the light of a similar panorama, there are only two paths: we continue like silent partners, passive and resigned to jumping into the frying pan, burning our feet in the process. Or, opt out of the system altogether. As I would like to explain to that person, that the “hard ones”, if we have, and know how to take advantage of the “Power”, and totally legally, by the way. The government itself encourages these types of associations as state policy, and it is set out in Article 39 of the Constitution. Apart from the errors that the union movement has fallen into, so discredited due to public knowledge situations, the Union is a valid response to the prevailing inequity.

As I would like to explain to that person, is that on the 17 September 2015, the Urologists Union of Colombia, Sindurcol, with number 20150201301, was registered in the Ministry of Works, and that it is of a professional nature and first grade with national cover. That its e-mail is and its twitter is @sindurlcol. I would also like to mention, that one of the challenges is to achieve a Federation of medical unions, for which we need at least 20, and we already exceed this number because there are more “hard ones” from other specialties who will also open their eyes. And that with a Federation, like teachers or oil workers, we will talk hard with the central Government, looking for the utopia of a better quality of life. Why not?

How I would like…but that person has already gone. And perhaps he continues being convinced by the “powers” that we are the “hard ones” of Urology.

Join now!

“First they came for the communists, and I did not speak out - because I was not a communist;

Then they came for the socialists, and I did not speak out - because I was not a socialist;

Then they came for the trade unionists, and I did not speak out – because I was not a trade unionist;

Then they came for the Jews, and I did not speak out - because I was not a Jew;

Then they came for me – and there was no one left to speak out for me”.

Martin Niemoller.

Copyright © 2016. Sociedad Colombiana de Urología
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