Orlando Monteiro da Silva

Olhar para o passado, analisar o presente para antevermos o futuro no setor da saúde.

Aceda ao Spotify na web para ouvir a minha entrevista a este novo projeto da publicação O Jornal Dentistry.

You may be interested in my monthly article in the Portuguese publication Dentistry.

Open the English version of the article (pdf).

Open the Portuguese version of the article (pdf)

There is a different and deeply unfair treatment in Portugal and many European countries between employees and self-employed professionals. It is essential for liberal professionals to implement their own Statute. So that some don’t remain “more equal” than others.

The National Association of Liberal Professionals, ANPL, is assumed in Portugal as the only interprofessional voice for the defense and promotion of liberal professionals, freelancers and consultants, understood as the “holders of qualifications of an intellectual nature, including those of artistic and cultural, promoting their responsibility, autonomy and independence in the best interests of consumers and the community in general”.

Our reflection is as follows:

The organization of work is undergoing profound changes. Liberal professionals and alike, freelancers and consultants, will take an even more relevant role in the new realities that are affirming themselves.

In the European Economic Area, one in six self-employed workers works in a sector related to the liberal professions, and the trend is to increase.

In Portugal, despite the fact that there are already over 400,000 regulated professionals and more than 200,000 exercising qualified but unregulated professional activities, we see self-employed professionals without proper representation and defense of their interests in the economic, fiscal and social protection areas.

It is time to face and change this situation.

Only when they are properly heard and recognized, will it help to mitigate the tendency of proletarianization and remunerative degradation of these professionals and their consequences, such as the affectation of the quality in the provision of the respective services as freelancers as well in companies and organizations.

Thus, starting with the foundations, it is essential to implement the Statute of the Liberal Professional, so that around it a European and national legislative and regulatory building is consolidated allowing the integration, valorization and framing of these professionals.

A statute that recognizes in liberal and equivalent professionals a different form of practice, not only by specific training and qualifications, but above all by technical autonomy and independence, based on professional, corporate and organizations ethics, in many aspects an interdisciplinary ethics, oriented to the best interests of consumers and the community in general.

A Statute that integrates and contemplates essential aspects such as, among others:

• guarantee of equity in the applicable taxation
• adequate social protection in unemployment and underemployment
• the existence of civil and professional liability insurance, illness assistance and accidents at work
• parenting support
• specificity in retirement and other pensions
• work life balance
• access to continuous and postgraduate training
• intellectual property defense
• sustainability and environmental protection
• acquisition and consolidation of digital skills
• integration and recognition of migrant’s qualifications
• and finally, recognition of new professions and activities as well as emerging forms of work

Having observed this framework of basic requirements, we will be able to accommodate in this Statute, not only those who exercise the classic liberal professions, some of them organized in public and private professional associations, but also a set of other professionals who have been affirming the relevance of their activities in the economy and in various sectors and areas of knowledge, consultants, freelancers and digital nomads.

It should be recalled that the professional associations regulating in several countries specific aspects relating to the particular professions organized in them are faced with limitations imposed by different European and competition legislation, with regard to the approach of important aspects affecting their professionals:

in particular the impediment to engage in or participate in trade union activities or which relate to the regulation of the economic activities of its members.

However, an important part of the challenges and problems that affect liberal professionals are precisely related to these “prohibited” areas, for example, hiring modalities, wage or fee issues.

On the other hand, trade unions do not incorporate the concept of liberal profession in Portugal. Now, this omission also contributes, in addition to the social emptiness resulting from leaving hundreds of thousands of professionals without a voice.

There is a different and deeply unfair treatment in Portugal and many European countries between employees and self-employed professionals. It is essential for liberal professionals to implement their own Statute. So that some don’t remain “more equal” than others.

The ANPL is a structure that aims to help fill this gap, available to establish partnerships at national, European and global level, thus contributing to give voice to liberal professionals.

Orlando Monteiro da Silva

President of the National Association of Liberal Professionals

Health and Regulation Consultant

Past President of the World Dental Federation

European Union Transparency Register 742011744953-87 

Visit us at https://anpl.pt/en/.

Article originally published in the Observador newspaper.

At the moment I am about to leave the presidency of the Ordem dos Médicos Dentistas – Portuguese Dental Association (OMD), elected and serving five consecutive terms, I hereby present a short review and some facts regarding these last 20 years.  

Since then it was possible to:

• Increase the population’s accessibility to oral health from 15% in 2001 to more than 60%. To this end, Dentists who graduated from Portuguese Universities (currently registering approx. 11,000 active Dentists in Portugal) proved to be fundamental. And together, we achieved:
  • In private practice, integrated in a network comprised of approximately 6000 dental clinics that cover 97% of the national territory;
  • With the aid of the Dentist Voucher Programme, financed by the Portuguese Government, 3.5 million Portuguese were able to access dental care;
  • And, recently, with the integration of about 120 Dentists in the Portuguese National HealthCare System, a number that is foreseeable to increase to more than 300 in the next three years, in a concept of Universal Health Coverage.

• Achieve full recognition of dentistry as a medical profession, and dentists as “oral health doctors”, expanding their role and intervention in society, by introducing specialties and sectoral competences in dentistry.
• Successfully combating the previously high rate of illegal practice of the profession.
• License and certification of all dental clinics.
• Creation of an Oral Health Observatory, through which it was possible to study and promote both the profession and oral health, using barometers, campaigns and studies, providing public visibility and also revealing to be proficient in promoting more effective public health policies.
• Integrating the concept of Oral Health/General Health in the Portuguese society, an essential contribution towards life quality of the Portuguese population.   
• Implementing Continuous Training that will tend to be free for all Dentists.
• Deeming OMD’s Congress as one of the largest and most renowned in Europe.
• Implementing specialities and regulating sectoral competences in Dental Medicine.
• During this period, we unquestionably managed to project our profession effectively and made it relevant in the eyes of both society in general and at the level of public decisional platforms.  

At a national level, and as President of the Ordem dos Médicos Dentistas, it was also possible to occupy prestigious and prominent positions for all of us: 

• At the Presidency of CNOP – National Council of the Professional Orders;
• At the Economic and Social Committee;
• In numerous working groups and dialogue forums with political agents and civil society in general.

At an international level through the active participation in the most representative organisations of the profession, namely:

• In the Presidency and Committees of FDI – World Dental Federation;
• In the Presidency and Committees of CED – Council of European Dentists; 
• In the Presidency of FEDCAR – Federation of the European Dental Competent Authorities and Regulators;
• In several partnerships established with Portuguese speaking countries, namely Brazil.

Today, Portuguese Dentists and Dental Medicine benefit from automatic recognition within the European Union and are considered valuable professionals worldwide.  

I affirm, with the utmost pride in the profession, that the dental medicine practised in our country extends far beyond the limits of our borders. We are at the forefront of dentistry, recognized as a producer of knowledge and added value for Portugal.

Approximately 96% of OMD’s members practice in the private sector, in a country where, over the years, the public health system has repeatedly forgotten oral healthcare as a fundamental area for public health, which it undoubtedly is. As such, OMD maintained ongoing contacts with public decision-makers, creating a logic of permanent negotiation aiming, on the one hand, to defend the profession, Dentists and the general population and on the other, not less frequently, preventing harmful measures or inadequate policies from being implemented.

As other liberal professions, we have faced very difficult challenges during these last twenty years:

• The economic deregulation of the profession, as a result of globalisation;
• The economic crisis created by the subprime crisis and the subsequent Troika intervention;
• The consequent emigration of Dentists, frequently forced to do so, in the search for employment opportunities, namely in other European countries;
• The excess of pre-graduate education directly interfering in the offer of services;
• And, more recently, the crisis resulting from the COVID-19 pandemic, that lead to the suspension of all dental activity during approximately 45 days.

We leave an exemplarily managed and economically robust Order, with a body of employees and collaborators that constitute an enormous added value in the day-to-day of this Institution.

I, therefore, leave, with great pride in this collective journey, and total conviction of having served the Ordem dos Médicos Dentistas and the profession to the best of my effort, and, above all, with a clear conscience of accomplishment during my time in service.

The vast experience acquired will be applied to national or international projects related to health and that deem to be challenging.

I wish my successor, my colleague Miguel Pavão, and all the members of his team, the greatest success for the mandate that is about to begin.  I declare my utter availability to collaborate with him and our Order, to the extent considered appropriate, especially in the handover to the next Governing Bodies, that will formally take office on July 18^th. 

Thank You!

Orlando Monteiro da Silva

From the 10th to the 12th November Ordem dos Médicos Dentistas (Portuguese Dental Association) organized its annual congress, in Porto. This year we celebrated 25 years of congress, a milestone for Portuguese dental medicine. Already a recognized brand!

PDA 25th Congress (2016)
Total congress participants – 3 686
Number of scientific presentations – 161
Hands-on courses – 95
Number of entries at Expo-Dentária – 12 404

Since 1992, when the first Portuguese Dental Congresses took place, the affirmation and credibility of dental medicine as a regulated profession increased in Portugal over the years. During those years, Portuguese dentists shared the passionate dedication to dental medicine that made all the difference in the affirmation and growth of this Congress that nowadays is visited by more than 12 thousand participants.

It is always a huge effort, given that the organization is mostly composed by volunteers, but at the end we are filled with an enormous pride and feeling of mission accomplished!

OMD congress is also an important moment to create closer ties between colleagues from different parts of the world.

As such, we organized a round table discussion concerning “Regulation in Dentistry: Recognition of Professional Qualifications”, where we had as guests/speakers: Andrew I Spielman (Associate Dean for Academic Affairs NYU); Gilbert Bouteille, (President of the National Association of Dental Surgeons in France); Gerhard Seeberger (FDI – World Dental Federation Speaker); Marco Landi (President of the Council of European Dentists); Óscar Castro Reino (President of the Spanish General Dental Council); Cédric Grolleau (Jurist of the National Association of Dental Surgeons in France); Filipa Carvalho Marques (Director of OMD’s Legal Department), and me as OMD President.

 

Can health be seen as a common economic activity? It was the main idea and the question that launched the debate.

The opinions of the speakers in this short coverage video:

At the Opening Ceremony we had the presence of the Secretary of State Assistant and of Health, Fernando Araújo and guests from national and international institutions and ambassadors.

(…) “Even in 1963, the year I was born, Bob Dylan wrote in the chorus of the song that was to become a true anthem, “(…) times are changing …”

They were, of course! Maybe at a more sociologic level, regarding habits and behaviours.

Then, as now, times continue to change…

We are currently experiencing a time of profound changes, levered essentially by globalization, currently in course, the internet and new communication and information technologies, among others.” (…)

See full speech here (pdf)

“For the times they are a-changing” we have to be ready!

The course of dental regulation in Portuguese-speaking countries was also another focus at OMD congress. Challenges faced by dentists of the Portuguese-speaking countries are very different but still very important to share experiences and opinions, in view of the population’s increasing demand for quality oral health care.

Portuguese-speaking Dental Association Forum: Representatives of the profession and industry from Brazil, Cape Verde, Mozambique and Portugal.

In addition to the scientific and social professional programme, Expo-Dentária occurs simultaneously, a dental equipment and material exhibition that boasts more than 12 thousand participants, and is currently the greatest oral health exhibition in Portugal. Expo-Dentária’s official opening was held in the morning with a flash mob for everyone’s surprise.

As a passionate runner, I highlight the moment when we received the Portuguese Winner Ultrarunner Carlos Sá at our congress. To overcome everyday challenges, we have to be resilient. Do not give up on obstacles. Carlos Sá, winner of the 2013 Badwater Ultramarathon, California (217 km) in 24:38min, is an inspiration.