[Practice of Internal Medicine in Latin America. Role of the internist].
This article explores the causes of the crisis in the role of internists. As in the United States, the progressive specialization of internists lead to a dehumanized, expensive and technical practice of medicine. Aiming to better incomes and prestige, more than 60% of internists practice as specialists. Primary care physicians, with a very low rate of problem solving, cover 75% of consultations. Specialists, with increasing costs, cover the rest of consultations. Patients, medical schools and health organizations are claiming the return of the general internal medicine specialist. To increase the interest for general internal medicine, several strategies are applicable. Medical students interested in general internal medicine could receive a focused training, provided by these specialists. A greater emphasis should be put on primary care. More independent, secondary care diagnostic and treatment centers, should be created. Continuous medical education should be done with periodical re certification of physicians. The public health system should increase its wages and the generalist view should be maintained by physicians when practicing at their private offices.
Varela
Nacor
N
Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile. nacorvarela@hotmail.com
D002568:Certification; D003479:Curriculum; D006301:Health Services Needs and Demand; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000639:trends; D007843:Latin America; D011364:Professional Practice; D013038:Specialization