Can we improve primary adult medical care? Podemos mejorar la atención médica primaria del adulto?

Abstract

In Chile, primary medical care of adult patients is delivered mostly by young physicians, who work with little or insufficient interaction with their referral centers and with the main teaching hospitals. These physicians have no defined expectancies of a professional career in the field of primary care and they generally recent the lack of a programmed post-graduate education. After 3 to 5 years as general practitioners, some of them may have access to a formal teaching program to become specialists in internal medicine but, as in many other countries, it usually becomes a transit stage leading them to a subspecialty. This position paper adopted most of the proposals raised in a recent meeting, with the participation of universities, scientific and medical organizations, and the Ministry of Health, and modifies some of them. Because financial limitations may hinder the possibility of residency training programs in primary care internal medicine (as established in the USA), primary car