To the Editor:
After reading the excellent article on family medicine in Brazil in the July issue,1 I was struck by the similarities and differences in the family medicine situation in my own country, Argentina.
In both countries, there are great pressures on medical students to become specialists rather than generalists, and one of these pressures is the influence of specialist teachers during medical training. However, in Argentina, there is an additional pressure: the fragmented health care system, composed of three subsystems, each serving different sectors of the population and each financed differently.2 The subsystem that is linked to the high- and middle-income sector attracts more physicians and gives greater financial rewards to those who are specialists.
As in Brazil, there are forces at work to promote family medicine and to expose students to the satisfactions of humanistic care, although it is an uphill battle. Each of Argentina’s 26 medical schools is, to a greater or lesser degree, struggling to find ways to provide more humanistic training for its students. Some Argentinean professionals participate in the Latin American Association of Family Medicine Professors. And, since 2000, there has been an Argentinean Federation of General and Family Medicine.
Undoubtedly, compatibility between the health care system and the medical education system, simultaneously backed by governmental decisions and actions and by professional associations and federations, seems to be the best option. Brazil has understood the challenge whilst Argentina is still on the way.
Alberto Enrique D’Ottavio, PhD
Research professor of histology and embryology, Medical School and Research Council, Rosario National University, Argentina, Santa Fe 3100, 2000 Rosario (Argentina); ([email protected]).
1 Blasco PB, Levites MR, Janaudis MA, et al. Family medicine education in Brazil: Challenges, opportunities, and innovations. Acad Med. 2008;83:684–690.
2 Belmartino S. Reorganizing the health care system in Argentina. Reshaping health care in Latin America: A comparative analysis of health care reform in Argentina, Brazil, and Mexico. In: Fleury S, Belmartino S, Baris E, eds. The International Development Research Centre, Canada, 2000. Available at: (http://www.idrc.ca/es/ev-9421-201–1-DO_TOPIC.html
). Accessed April 4, 2008.