The way to Solve the Deficit of Physicians in the Municipalized Urban Health Clinics

Abstract

The National Health Service of Chile was created in 1952. At that time the country had a high proportion of rural population and of children; its health problems were those of an underdeveloped nation. There was a shortage of physicians and these were unevenly distributed among geographical areas. The NHS approached this problem through the institution of Area General Practitioners (Médicos Generales de Zona), whose aim was to work in the farthest rural communities. Since then, the country has gone through fundamental demographic and epidemiological changes. Only 13,4% of the population now live in rural areas and living conditions in these areas are now much better than they were. Most people live in large cities and, within these, in poor communes. Public primary health care facilities are now under municipal administration, apart from the main structure of the health system; and they suffer a severe shortage of physicians and of other critically needed professionals. These facts are presented in the paper. The Primary Health Care Law passed in 1995 only made the situation worse. A new statute for engaging primary health care doctors for the public clinics serving urban areas with relatively high indices of poverty, through Law N19.664, is here proposed.