Abstract
BackgroundThis study analyzed the reasons why physicians migrated from the Program to Value Primary Healthcare Professionals (PROVAB) to the Mais Médicos (More doctors) Program in 2015, opting to become physicians of the Primary Health Care.MethodsThe focal group techniques were used consisting of six doctors that made the option to remain in the PHC, being the results analyzed through content monitoring as well as the respective categories, which were identified as theme analysis.ResultsIt was evidenced that the physician’s retention on primary care has a strong relationship with the acquisition of knowledge that is consistent with the context and the health needs of the population. Thus, appropriate competencies for the management of the different biopsychosocial characteristics of the territories, in consonance with abilities that use the communication centered on the patient as well as on the interdisciplinarity, producing health projects that include the uniqueness of the people, essential factor for the daily confrontation of the work of these physicians, strengthened by the training component of the program. Personal factors related to the empathetic profile with this level of care and the possibility of continuous improvement, besides the factors related to the adequate infrastructure and organizational climate with guaranteed salary in keeping with the complexity of Primary Care, positively influenced the permanence of these professionals and were drivers of changes in healthcare and management in the health units they were related to. The bond created with the team and patients was a great satisfaction factor for the professional, being identified by them as a possibility to make a difference in the treatment process of patients, strengthening the promotion of a healthier life through health education.ConclusionsPROVAB had an unparalleled contribution to the qualification of care in Primary Health Care, contributing to the birth of a new logic of medical training in Brazil. Its effective cooperation with the consolidation of the Mais Médicos Program, still in progress, is a great movement of resistance to the disarticulation and deconstruction of Unified Health System (SUS) which is in charge of public health in Brazil.
Highlights
This study analyzed the reasons why physicians migrated from the Program to Value Primary Healthcare Professionals (PROVAB) to the Mais Médicos (More doctors) Program in 2015, opting to become physicians of the Primary Health Care
The group was emphatic when affirming that their practice in Primary Health Care (PHC) during graduation was insufficient and they were still unprepared to join a Family Health Strategy (FHS) team, a strategy considered a priority because it contributes to the expansion, qualification and consolidation of the PHC in Brazil, increasing the resolution and impacting the health situation of people and communities, besides providing an important cost-effectiveness ratio [10, 17]
We found that the newly trained physicians started to work in PHC with a lack of skills, mostly due to their previous training in Higher Education Institutions (HEI), whose curriculum focused on privileging the specialties and the hospital locus, differently from the directions of the National Curricular Guidelines
Summary
This study analyzed the reasons why physicians migrated from the Program to Value Primary Healthcare Professionals (PROVAB) to the Mais Médicos (More doctors) Program in 2015, opting to become physicians of the Primary Health Care. In South Africa, 46% of the population live in rural areas, but only 12% of the doctors work in these territories [1] This problem is mainly caused by the chronic and growing deficit of doctors due to the increase in the population’s health needs and the insufficient number of doctors trained in the creation of new work centers. Countries such as the United States and the United Kingdom maintain rates of foreign doctors working in their country around 25 and 27%, respectively, meaning that even developed and rich countries may have deficits of this professional in rural and less privileged areas. Debt relief contracted by doctors in undergraduate courses, for providing service after graduating in difficult areas are some of the strategies that these countries use as a way of solving this challenge [4, 5]
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