Ηealth’s foundation is falling apart: what can we do about it?

stethoscope 2019

(Hush Naidoo, Unsplash)

This article was exclusively written for The European Sting by Ms. Larisse Leal, a fourth year medical student at the Federal University of Juiz de Fora (UFJF-GV), Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


If we think about the health system as a well-structured building, then it must rest in a solid and strong foundation – the Primary Healthcare (PC). Hence, there will be possible to lift up the rest of the construction that is, in fact, the progressively more specialized health’s care. Nowadays, however, it seems that the Primary Healthcare is falling apart, mostly because of the young workforce gradual shortage of interest on that matter. Therefore, this is a subject we should talk – and do something –about.

The Primary Healthcare’s importance was first reinforced by the Declaration of Alma Ata (1978), where the values of social justice, the right to health for all, participation and solidarity; and the principles of equity, universality and accessibility were been established as the ones we should pursue in a health’s system. Achieving this, however, requires we put people at the center of the health care, taking into account their expectations and needs.

Unfortunately, the translation of these values into tangible reforms has been very uneven, although health’s equity enjoys increased prominence in the discourse of political leaders lately. Thus, it’s not rare to see part of the population going through unacceptable and avoidable situations, such as children missing out on essential vaccinations, pregnant women lacking the basic prenatal appointments, old-aged people suffering from uncontrolled chronic diseases (i.e. diabetes, high blood pressure, dyslipidemia), among many others undesirable situations.

Therefore, taking into account its undeniable importance, the remaining question is: why is the Primary Healthcare being so neglected, especially by our new workforce? Why do the majority of health students opt for specializations such as cardiology, dermatology, surgery and radiology; rather than choosing to enter the PC? The answer is quite wide, yet not simple.

Among the reasons that make our new generation to abstain from entering the PC, the following ones are the most representative: much lower payment, prestige and acknowledgment when compared with specialized fields; too much paperwork and the dense clinic scheduling, with only a few minutes per patient. However, the most significant reason seems to be the short exposure to the primary care (e.g. family care) during graduation and residency programs, whereas greater amount of time is dedicated to complicated, rare and unique medical problems. Furthermore, there is also a prevailing negative opinion on PC among residents and professionals, which might discourage even more the interest in primary care.

So what can we do about it? No doubt, we need to gather forces to reshape the culture of Primary Healthcare in our health’s schools and institutions. Thus, it would be necessary to gradually change the health courses’ curriculum in order to increase student’s contact with the family care, and make them work closely with PC professionals. Thereby, it would be possible to demonstrate them how challenging, satisfactory and promising could be a career in this field.  Moreover, we also need to encourage researches and scholarships in the primary care’s field, so that the prestige and interest in this area will able to increase further more.

References

World Health Organization. The World Health Report, 2008. Primary Health Care – Now more than ever. Available on: <https://www.who.int/whr/2008/en/ >. Access in January 17th, 2019.

Lahad A et al. How can we change medical students’perceptions of a career in family medicine? Marketing or substance? Isr J Health Policy Res, 7 (52), 2018. Available on: <https://ijhpr.biomedcentral.com/articles/10.1186/s13584-018-0248-6> Access in January 17th, 2019.

About the author

Larisse Leal is a fourth year medical student at the Federal University of Juiz de Fora (UFJF-GV), Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA Brazil), currently as an active Trainee. She takes a lot of interest on public health’s issues, in which area she hopes to contribute with researches, articles and extracurricular projects. Furthermore, she believes everybody has the right to health, regardless of their social status, gender, race, age and beliefs. She thinks it’s her duty, as a future health professional, to help society achieve this goal.

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