[Incorporation of specialists to primary health care to increase its efficiency]

In the last decade, the number of general practitioners has decreased in Chile and there is a lack of interest among new doctors to work in Primary Care. The low number of positions for primary care physicians in the national public and community health services are one cause, among others, for this decrease. On top, there is a lack of incentives and continuous training in community health services. This situation lead to reinforce primary care with internists, gynecologist, surgeons and psychiatrists in training. During their residence, part of the working journey of these trainees will be carried out in general medical outpatients clinics. This solution has been criticized by university authorities. The other solution is to incorporate certified basic specialists in teams of three to five, in outpatient clinics of communities with high number of beneficiaries. This initiative is supported by the great number of specialists available in Chile, but is hampered by the lack of working positions and financing. It would increase the problem solving capacity at the primary level, decreasing the number of specialist derivations, that collapse secondary levels of health care.