Estructura organizacional de la medicina interna en Chile / Organizational structure of internal medicine in Chile

RESUMO

Internal medicine, as a comprehensive discipline, has become increasingly dismembered during the last decades due to several reasons, some of which are the growing complexities of its practice, its obstinate confinement to hospital-based practice, its generation of and subsequent disfunction from general internal medicine and the medical subspecialties. In Chile, internal medicine is currently organized in three levels of patient care, each of anarchical and distorsioned proportions. These levels do not constitute a fluent network of progressive patient care, but rather and heterogeneous combination of ironclad compartments in search of their own autonomy. Most of the currently practicing subspecialist are self-qualified or have received quick training through short rotations by not always well-qualified centers. Many are only former internal medicine residents. In this setting, it is not posible to devise a prospective plan of subspecialty training. To make internal medicine in Chile efficient and timely, it is necessary to restore and restructure a rational patient care network that will do away with the current red tape and waiting list as well as to allow the insertion of well-trained specialist in the corresponding levels of patient care