Subespecialidades médicas y políticas de salud: visión del Ministerio de Salud / Medical subspecialties and health policies: Health Ministry view

RESUMO

Since the condition of subspecialty medicine in Chile has not been throughly studied, little can be said on an objective basis. From a standpoint of national health policies, the Ministry of Health wishes to establish a mixed system in which participating subsystem can define its own goals as means to meet the populations' health demands. The National System of Health Services (SNSS) in accordance with the social objectives, has decided to implement the delivery of integral health care, emphazing health promotion and disease prevention. The epidemiological priorities of the populations will guide the action of the SNSS. The more complex and expensive medical actions will be delivered at pre-established points of the patient care network. The desirable profile of physicians working in this setting includes philosophical as well as technical characteristics. The type of patient care to be delivered must emphisize preventive and promotional actions. Problem solving abilities will not ascribed to a particular type of institution but to where they may be more efficacious, in a context of quality and efficiency. Most activities will be carried on an outpatient basis, and primary care clinics will be strenghthened by becoming Health Centers. The model of patient care devised by the SNSS will require 6 different types of physicians. Health care givers must define periodically their needs in view of their own development plans and their beneficiaries' requirements. Nevertheless, it is impossible to predict with certainly for the long or medium term, how many physicians will be required at any level of patient care. The role that the SNSS may ascribe to specialist will condition the number of them that Chile will require