Propuestas para salir de la crisis

Abstract

Primary health care crisis is shown in user satisfaction surveys and in the discouragement of professionals. Government, scientific societies, and unions have drawn up numerous documents with proposals to get out of the crisis, but very few have been applied or ended up with a significant change. The crisis is inherent to the primary care discipline because person centered care and population health condition interventions are not aligned with the growing medicalization of a health system focused on health problems care. The proposals are along the following lines: the integration of services in order to deal with the growing increase in chronic pathologies and comorbidity; the transition from control and command leadership to shared leadership; innovations aimed at easing the shortage of family doctors, including increasing other team members and the incorporation of new professions; organizational innovations aimed to improve accessibility, but at the same time increase continuity; the rational use of telemedicine; the modification of the undergraduate curriculum to finally include the discipline of family medicine; and the generalization of successful local community care projects. The future economic crisis, the shortage of professionals and the growing population aging could lead to the gradual application of some of these proposals, since it is not expected that a radical reform will take place.