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RESUMO - A medicina geral e familiar em Portugal institucionaliza-se
nos princípios da década de 80. Como referências importantes
deste período inicial estão o seminário sobre «o
papel do clínico geral em cuidados de saúde primários»
(Escola Nacional de Saúde Pública, 1979), a criação da
carreira de generalista (1980), o início do internato da
especialidade (1981), a criação dos institutos de clínica
geral (1981-1983) e do Colégio de Clínica Geral na Ordem
dos Médicos (1982) e a realização em Évora do «Encontro
Internacional de Clínica Geral» (1984) organizado pela
APMC. Desta forma, a medicina geral e familiar portuguesa
estabeleceu muito cedo no seu processo de desenvolvimento
uma formulação explícita e amplamente aceite do
seu perfil profissional e dos seus requisitos de formação.
Por outro lado, estando a investigação em cuidados de
saúde primários numa fase inicial de desenvolvimento, é
ainda necessário criar as condições indispensáveis para
poder aspirar a um progresso rápido nesta área — financiamento,
integração no trabalho corrente, bases de dados
de fácil acesso, identificação de áreas prioritárias, estabelecimento
de redes de investigação e de estruturas de apoio
e acompanhamento.
A adopção de sistemas retributivos melhor adaptados à
prática da medicina geral e familiar, privilegiando o trabalho
organizado em equipas multidisciplinares, baseando-se
no princípio da «discriminação positiva» — pagar melhor
a quem trabalhar melhor —, e a reorganização dos centros
de saúde que se perspectiva («centros de saúde de terceira
geração») podem constituir as bases de uma reforma estrutural
do sistema de saúde necessárias para assegurar à
carreira de clínica geral as condições de exercício que é
possível encontrar hoje em muitos países europeus.
ABSTRACT - In Portugal general practice as a recognised medical specialty «took off» during the early 80’. From 1980 to 1984, the new medical specialty was approved, a new vocational training programme in general practice was adopted and initiated, three institutes for general practice were established by the ministry of Health, a college of general practice was established by the Portuguese Medical Association, an association of general/ family physician was organised and held its first international meeting on the role of general practice. In practically four years it was possible to establish the key elements of this profession’s reference framework — professional profile, regulatory mechanisms, training requirements and institutional basis and appropriate organisational setting for the profession. Although some important developments can also be found in the area of general practice research it is however recognised that important support mechanisms in this area are not yet available. The recent adoption of general practice paying schemes with performance related components on one hand and current initiatives to reform primary health care organisational infrastructures on the other, are very likely to create new opportunities for the development of the profession in Portugal.
ABSTRACT - In Portugal general practice as a recognised medical specialty «took off» during the early 80’. From 1980 to 1984, the new medical specialty was approved, a new vocational training programme in general practice was adopted and initiated, three institutes for general practice were established by the ministry of Health, a college of general practice was established by the Portuguese Medical Association, an association of general/ family physician was organised and held its first international meeting on the role of general practice. In practically four years it was possible to establish the key elements of this profession’s reference framework — professional profile, regulatory mechanisms, training requirements and institutional basis and appropriate organisational setting for the profession. Although some important developments can also be found in the area of general practice research it is however recognised that important support mechanisms in this area are not yet available. The recent adoption of general practice paying schemes with performance related components on one hand and current initiatives to reform primary health care organisational infrastructures on the other, are very likely to create new opportunities for the development of the profession in Portugal.
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Contexto Educativo
Citação
Sousa, Jaime Correia de; Sardinha, Ana Macedo; Perez y Sanchez, Jesus; Melo, Miguel; Ribas, Maria José - Os cuidados de saúde primários e a medicina geral e familiar em Portugal = Primary health care and general practice in Portugal. Revista Portuguesa de Saúde Pública. ISSN 0870-9025. Volume temático, Nº 2 (2001), p. 63-74
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública
