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Balint in Latin America
Kyle Hoedebecke

¿Habla español?
This year has been unusually difficult for global communities, with healthcare workers taking on a disproportionately large portion of that burden. Physicians world wide have been bombarded with COVID-19 cases on a daily basis for nearly a year. While the viral onslaught has aimed to break our spirits, the healthcare community has desperately searched for ways to maintain resiliency. That being said, participation in Balint groups proves to be one of the best options to ward off burnout during these trying times.

However, exposure to Balint groups has been limited to a small fraction of physicians in a few countries and in even fewer languages. The International Balint Federation (IBF) site lists these lucky few, which include several Romance languages including French, Italian, Romanian and two Portuguese-speaking societies among them. There is a curious  absence of any primarily Spanish speaking society on this list,  which I find notable due to the widespread use of this language. The Instituto Cervantes estimates that there are 580 million Spanish-speakers worldwide. After  Mandarin, Spanish is the most  commonly spoken primary language, with 463 million speakers. The United States also finds itself as the second largest Spanish speaking country in the world after Mexico, and we are set to claim the top spot by 2050. I do not mean this as a criticism;  rather, I find this to be a huge opportunity to bring Balint groups to our Spanish-speaking colleagues.

With one foot in the Spanish-speaking world and the other in the Balint world, we here in the United States find ourselves in the unique position to leverage decades of Balint experience in order to benefit our colleagues in Latin America and elsewhere whose primary language is Spanish. I have been involved in multi-centered international Balint groups since 2014 when I  spearheaded a collaborative  group between the IBF and  World Organization of Family  Doctors (WONCA) that continues to meet actively. Since then, several of my Hispanic col leagues have approached me  about bringing Balint to the Spanish-speaking primary care world  in order to help fight burnout and  emotional stress in their settings. They have little-to-no Balint support locally or in their native language. That need was further amplified as COVID-19 cases  and deaths mounted.

In conjunction with the Ibero American Confederation of Family Medicine, we began recruiting  actively in June 2020 for the first  ever multi-centered international  Balint group in Spanish. The positions were quickly filled with  family physicians from 12 differ ent countries across Latin America. The inaugural meeting took place in August 2020, and we  have met monthly via Zoom since then. As this is the first Balint  experience for each member, it took some time for everyone to understand the proper flow and  order of the encounters while simultaneously developing trust  and an increased comfort level  with each other. Having already  received very positive comments  from the participants, I hope to  formalize this feedback in the  near future in the form of an  anonymous survey.  In addition to engaging our  Spanish-speaking colleagues so  they and their patients may benefit from Balint work, we also look  forward to those participants serving as founding members of their respective national Balint societies to help the movement grow and flourish.

“Participating in a Balint group has helped me develop tools to better treat my patients and the exchange of ideas as well as experiences with my colleagues from other countries has been really enriching.” Dr. Sujey Ruiz (Mexico)

"Belonging to a Balint group has given me the opportunity to interact with colleagues from different cultures in an environment filled with trust and empathy. If two heads are better than one, imagine what can be done with an entire group." Dr Tania Peña (Mexico)

"Comparing the practice of medicine in different countries allows for a unique evaluation of how we provide care. It allows us to see that our experiences during this pandemic are similar in each country within our region."

"The exchange of information, ideas, and unique insights that each person brings to every case is extremely enriching for our own personal clinical experiences. Furthermore, this allows me to free my emotional baggage that has built up. I am happy to share this experience with colleagues from different countries."  Dr Elizabeth Portilla (Mexico)

"As doctors, we need to talk in order to free the thoughts that replay in our head that are related to the patients that rely on us. Balint groups make that possible. We explore our emotions and listen to our colleagues' experiences that are similar to our own despite being from other parts of the continent. We are not alone...we are doing well...we can do it better." Fernando Barrios Gonzalez (Paraguay)

 "Restoring the Core of Clinical Practice: What is a Balint group and how does it help?" by Laurel Milberg, PhD and Katherine Knowlton, PhD. Available in paperback or ebook Order Now

The American Balint Society
, is a 501c3 non-profit organization dedicated to improving the therapeutic relationships between healing professionals and their clients/patients. The American Balint  Society is a member society of the International Balint Federation