Objectives: To analyze the freedom of the medical profession in Brazil to create medical specialties, the effect these specialties exert on practice, and the integration of the specialties into the SUS.
Methodology: Analytical and interpretive.
Results: The authors analyze the relative freedom with which physicians in Brazil create new medical specialties, which results in the progressive fragmentation of work in healthcare. This process also produces an increasing reduction in the importance and capacity for action of basic specialties: clinical medicine, pediatrics, general surgery, and obstetrics-gynecology.
The authors propose two operative concepts to redefine the characteristics of a specialty: breadth of medical competency and core of medical competency. The first includes the principal knowledge and competencies of a basic specialty, on which are superimposed other specialties, thereby creating a field of interaction. The second is more specific and includes the exclusive attributes of a medical specialty, justified on the basis of its comprising a new area.
Conclusions: The analysis concludes with proposals for the reform of policies underlying the formation of medical specialties and their incorporation into the SUS.
Copyright 2007 University of New Mexico