The Rural Health Experience: Expectations, Reality, and Results. Reports from District General Practitioners and Teams. 1963–1975

Abstract

Between 1967 and 1978, 19 accounts of the experiences of district general practitioners and rural health teams who had completed their internships between 1963 and 1975 were published in the Cuadernos Médico Sociales (Medical Social Notebooks). This was the result of an award established that year by the Medical Association: first, for the best district general practitioner; and then, beginning in 1969, for the best rural health care team. This recognition included the dissemination of these experiences through this journal. As Dr. Carlos Montoya stated years later, "they constitute a detailed, irreplaceable testimony to the creative and determined work of young Chilean doctors in building our health system." (Montoya-Aguilar, C., 2009). The Rural Health Program and the Regional General Practitioners Program were initiatives launched by the National Health Service in the mid-1950s, shortly after its establishment. The service was still in the process of organizing its new healthcare system when it faced the decision to expand its presence and coverage to isolated areas in peripheral centers, where the ratio of physicians and healthcare resources per inhabitant was well below the already insufficient national average.
On this occasion, we revisited these narratives to learn about the implementation of these two programs, Rural Health and Regional General Practitioners, at a time when social medicine predominated as a healthcare model and sought to address the unequal distribution of health outcomes and healthcare resources, expanding the healthcare response to those social sectors particularly marginalized by the country's development. By analyzing the main content of these stories, we sought to understand the expectations of those recruited to join these programs, identify the sociodemographic, epidemiological, and cultural profiles, and identify the resources available to provide healthcare to the population in the territory assigned to the healthcare center where they were assigned. Finally, we highlight the performance of these professionals and teams through their achievements in comprehensive medicine, which is a particularly important outcome to understand, in order to uncover the valuable meaning of these experiences and their conditions.