EVOLUTION OF FAMILY AND COMMUNITY MEDICINE IN BRAZIL: CHALLENGES, PERSPECTIVES, AND THE IMPORTANCE OF THE LONGITUDINAL PHYSICIAN-PATIENT RELATIONSHIP

Abstract

This article aimed to portray the evolution of Family and Community Medicine (FCM) from the Alma-Ata Declaration in 1978 to the challenges faced today. It highlights the longitudinal nature of the doctor-patient relationship, which is essential for building lasting bonds, improving therapeutic adherence, and promoting health. Additionally, some of the challenges faced by Primary Health Care (PHC) in Brazil, such as the unequal distribution of qualified professionals across the vast territory, insufficient funding, and the impact of global health crises—such as the 2019 pandemic caused by SARS-CoV-2—directly affect the improvement of the healthcare system. Another difficulty in FCM is the shortage of specialists and the need for high-quality training. Thus, the article highlights initiatives such as increasing the number of positions in Medical Residency Programs (MRPs) and valuing the multidisciplinary team as essential measures to address these challenges. Finally, the study underscores the importance of PHC in structuring the healthcare system and proposes strategies to strengthen longitudinal care and overcome global and national challenges.