[Work efficiency of the health center physician]

Factors that most directly restrict the efficiency and effectiveness of the family doctor's work in primary care are analyzed. They are the following: excessive bureaucracy, lack of motivation and incentives for a job well-done, a gradual decrease in resources available for primary care in comparison with specialized care, difficulties in primary care work management, lack of communication between medical specialized services and primary care, and the difficulty of measuring the primary care output. There will be proposed the following changes: a reduction of unnecessary bureaucracy, rationalitation opposite to rationing in the management of resources, to increase the participation of the family doctor in the management of resources, promotion and incentives for increasing the cooperation between primary care and medical specialized services sponsored by Public Health Administration, to define and establish criteria to evaluate the primary care output, and a policy of encouraging medical training through the development of a professional career in primary care sponsored by Public Health Administration.