The surgeon in the present socio-economic context.

In recent years, the economic situation in Spain has had an effect on all parts of our society. The national healthcare system has been greatly affected, as economic and political decisions have had negative consequences for both patients as well as medical professionals. Cutbacks in service portfolios, copayments for medications, salary reductions, lack of professional incentives, and practically nonexistent funding for training and research have all resulted in a loss in healthcare quality. The main problem of these measures is that they follow guidelines that are exclusively political, without the necessary participation of healthcare professionals. Surgeons cannot and should not overlook these changes that are encroaching on their future professional careers. Of late, some Spanish autonomous communities have been trying to implement a private administration model in public hospitals, although we really do not know what the benefits for patients are or if healthcare costs are able to be reduced, for that matter. There have been no economic studies that answer the question of which model is the most efficient. In regions that have opted for the private management model, there is a general lack of transparency. Justification of expenses should be an objective of any healthcare organization, whether public or private. But this is not necessarily synonymous with reducing the range of services provided. The public administration of hospitals in our country is currently undergoing a process of transformation toward a more efficient model, which in many places is being spearheaded by the healthcare professionals themselves. Current neoliberal guidelines defend private administration models, arguing the need for efficiency. Nevertheless, in said models and due to economic reasons, there is a risk for adopting objectives or priorities that have little to do with patient needs. This situation can pose doubts or ethical conflicts for medical professionals, while their work conditions become less favorable. Recently, in the Community of Madrid, healthcare workers have rejected the imposition of this model in several hospitals with a committed and exemplary attitude, and regional administrators have had to change their decisions after a court sentence. Optimizing the administration of available resources should be a priority objective in all medical centers, particularly in surgical units. However, providing quality care should be equally important. Measures such as extending the ordinary work day, overloading surgery schedules or reducing personnel on duty should be carefully considered as they can result in a loss of quality of care or patient …