Open Journal Systems

EDITORIALS

Received: January 15^th 2015
Accepted: January 30^th 2015

Renewal of work philosophy at the IMSS

Germán Fajardo-Dolci*

*Titular de la Unidad de Educación, Investigación y Políticas de Salud. Dirección de Prestaciones Médicas del Instituto Mexicano del Seguro Social

Communication with: Germán Fajardo-Dolci
Telephone: 01 (55) 5761 0704
Email: fajardo.german@gmail.com

The Instituto Mexicano del Seguro Social (IMSS) is the main institution of social security in México and has been a pioneer in Latin America in the comprehensive organization of medical atenttion. This and many other achievements have been possible due to the preparation and performance of its staff, their professionalism, humanitarian sense, commitment to the institution and solidarity with the population. Today, the IMSS is ready to face not only the present but also the future and anticipate what is best for the institution and its insured population.

Keywords: Social Security; Work philosophy; Efficiency organizational

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The Instituto Mexicano del Seguro Social (IMSS) is the first social security institution created in the country and over its 70 years of institutional life it has been a cornerstone for building the Sistema Nacional de Seguridad Social in order to achieve a healthier population with a better quality of life.

IMSS, founded in 1943, is the result of the dreams, aspirations, and collective effort of several generations of Mexicans to more safely address the risks of illness, disability, and retirement.¹ In terms of health care it is the national institution with the most effective coverage, serving half the country’s population.² Through the thousands of institutional workers and its medical and paramedical branches, including the personnel engaged in education and research, it has contributed many significant achievements to national and international medicine.^3-5

At its inception, IMSS pioneered the organization and management of health services, developing an innovative health care model that included all ages and the whole family. As part of this model, in 1955 they implemented the Sistema Médico Familiar as a basis for healthcare and initially had general practitioners attending minors and others who attended adults, but that came to be transformed in 1975 into an integral professional practice, which was consolidated with the addition of the first graduates of the Family Medicine specialty created in 1971.

Management by the then directors of the Jefatura de Enseñanza e Investigación in 1974 allowed this specialty to gain the academic recognition of the Universidad Nacional Autónoma de México, which encouraged several Latin American countries to send their professionals to study this specialty at IMSS. 

Time and history allow us today to evaluate the creation of the Family Medical System, the first structured, early, and visionary response of the Sistema Nacional de Salud to implement in Mexico the approach to comprehensive care that years later was agreed upon at the International Conference on Primary Health Care in Alma Ata, promoted by the World Health Organization in 1978.⁶

In the hospital setting, IMSS has also been a pioneer in Latin America in the integral organization of health care, creating the first medical centers to combine various specialty hospitals in one physical space. Centro Médico "La Raza" founded in 1952 and Centro Médico Nacional created in 1963, have been the incubators of great projects of medical care, education, and research, as well as witnesses to more than five decades of progress and transformations of Mexican institutional medicine, such as the first kidney transplant in an adult from a living donor in 1961, whose survival was 22 years. 

The list of achievements in hospital care is extensive, and to this we must add the completion of the first hand replantation in 1967, the first kidney transplant in an infant in 1985, the first successful heart transplant in 1988 and liver transplant in 1989, the first transplants of bone marrow and liver in children in 1989 and 1993, and the first organic whole separation of Siamese twins in 2004.

But the successes of IMSS institutional medicine are not limited to the field of curative medicine, on the contrary, the creativity of the institutional health professionals have expanded the field of preventive medicine for greater impact on national public health and the enrolled population.

Today IMSS workers are proud that the various institutions of the Sistema Nacional de Salud have adopted the goals, strategies, and actions for the integration of PREVENIMSS health programs, established in 2004, whose current campaign “Chécate, Mídete, Muévete” (“Check yourself, measure yourself, move yourself”) has revitalized it.⁷

The consistent work of the institution and its employees, and the credibility gained in public administration and in Mexican society, in 1974 led the Federal Government entrust it with the administration of a program to address the health of the rural population in poverty and marginalization, initially under the name of IMSSCOPLAMAR, currently known as IMSSPROSPERA.

The inhabitants of rural areas and some less-developed urban areas of the country have received the benefits of this program for four decades, which has helped to change the face of those communities, but above all, the lives of their inhabitants.^8,9

These and many other achievements have been possible thanks to the preparation and performance of its staff, their professionalism, humanitarian feeling, commitment to the institution, and solidarity with the population. Being employed by this institution is a great distinction and it is not uncommon to hear from workers expressions like "I have green blood", "I have the eagle tattooed on my heart," "I am proud to be part of IMSS". These expressions are symbolic and translate the philosophy of the workers and their sense of belonging to an institutional family. Moreover they reflect the reciprocity of workers to an institution that today provides good working conditions and tips the balance toward solidarity, social justice, and development.

Since IMSS was founded, its staff has without a doubt been the engine that successfully moves the machinery of social security, and despite the difficulties faced, such as the September 1985 earthquake that affected the functionality of several of the medical units, it has always given its best effort and caring attitude to serve the sick population.

For the institution, all employees are important: those working in headquarters designing policies, strategies, and institutional programs; those working in the municipal offices applying these guidelines and ensuring the operation of institutional programs; but particularly, medical and paramedical staff working in the medical units of the three levels of care, whose performance is invaluable because it is they who serve with solidarity, ethics, and humanism the needs of the population that goes in search of care and comfort for their ailments, hoping to preserve, improve, and restore their health.

Solidarity and ethical behavior are only possible in professionals gifted with humanitarian views, and IMSS medical staff have this quality in common, allowing them to travel the rough roads of perfection that lead people to understand that their greatest concern must be the human itself, to study and understand them, with all that that involves interest and respect for their life.¹⁰

While the reality is that today we face a difficult scenario that threatens the balance between supply and demand for health services due to the financial situation arising from macroeconomic conditions affecting the national economy, the difficulties faced by those who came before us were not less complex, but they overcame them with integrity, passion, dedication, and "love of the shirt." This is the time in which we have to live and the challenges we face as the family that we are, once again proving our ability to innovate in difficult situations and work together to find new solutions to old problems.

Using the platform offered by this magazine, which began in 1962 and has remained uninterrupted for over five decades,¹¹ we join the institutional and managerial effort to continue to promote the values ​​that sustain and encourage our organizational culture, especially those of solidarity, equity, and ethics, always seeking the benefit of the enrolled population.

IMSS is ready to face not only the present but also the future and to anticipate what is best for the institution and its enrolled population. No doubt it will be ever better prepared as its staff continues to generate knowledge through research and disseminates it through educational processes as it has always done. We have the necessary human resources to remain healthcare leaders in Latin America; we have researchers of all kinds: clinical, biomedical, public health, economics, and health services administration. We also have trained and experienced teaching staff for all levels: undergraduate, professional training, medical specialties, graduate courses in other disciplines, masters, and doctorates. We have expert personnel in all branches of medicine and paramedical staff in all areas, allowing us to opportunely prevent and detect disease and provide support services as well as curative and rehabilitative services.

Let's keep working together and strengthening the philosophy and pride of belonging to IMSS to continue to face the challenges ahead.

References

1. Sánchez Castañeda A. Las principales instituciones de Seguridad Social; el Instituto Mexicano del Seguro Social. En: La seguridad y la protección social en México. Su necesaria reorganización. Instituto de Investigaciones Jurídicas, UNAM. 2012. Capítulo Segundo. p. 25-34.
2. CONAPO. Proyecciones de la Población 2010 – 2050. Secretaría de Gobierno, México.
3. IMSS. Setenta años al servicio de los mexicanos. El IMSS a la vanguardia médica. 9 de marzo de 2013. [Cited 2015 Jan 26]. Available from http://www.imssaniversario.com/
4. Fajardo OG. Setenta años de medicina en el Instituto Mexicano del Seguro Social. Rev Med Inst Mex Seguro Soc. 2014;52(2):228-31
5. Cárdenas-de la Peña E. Servicios médicos del Instituto Mexicano del Seguro Social. Doctrina e historia. México: IMSS; 1973. p. 196.
6. OMS. Informe de la Conferencia Internacional sobre Atención Primaria de Salud. Alma-Ata, URSS, 6-12 de septiembre de 1978. Serie Salud Para Todos No.1.
7. Muñoz HO. Programas Integrados de Salud (PREVENIMSS). Rev Med Inst Mex Seguro Soc 2006; 44 (Supl. 1):1-2
8. Velásquez Díaz, Georgina. Programa IMSS-COPLAMAR. Secretaría de Salud. Salud y enfermedad en el medio rural de México. México D.F, México. Secretaría de Salud, 1991. p.413-21.
9. DOF. 05/09/2014. DECRETO por el que se crea la Coordinación Nacional de PROSPERA Programa de Inclusión Social.
10. Pérez TR. Humanismo y Medicina. Gaceta Médica de México. 2013;149: 349-53.
11. Echevarría ZS, Lavalle MC, Vásquez CL y Monroy RL. Editorial. “Nuestra Revista Médica”. 45 años de historia. Rev Med Inst Mex Seguro Soc 2007;45(6):533-535.

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