IESS launches “primary care” concept to patients

Sonia Arévalo waited around 45 minutes yesterday to be seen at the José Carrasco Arteaga hospital. He had a stomachache and mentioned that he went to the hospital to justify his not going to work. He didn’t realize there are other places he could go that treat these kind of minor complaints.  And rather than investigate his options, he went to the hospital so she could be sure to get a written excuse for his employer.

Just like Arévalo, 80 percent of patients that go to this Ecuadorian Institute of Social Security (IESS) hospital are coming for minor conditions. That equates to between 450 and 500 daily visits for non-emergency care.

To address this issue, and to promote the idea of preventive health, the IESS, will present a plan under the concept of “primary doctor,” equivalent to the idea of a “primary care physician” in North America..

“Health is always related to having or not diseases, however, other components such as health promotion and prevention are required,” explained Mauricio Espinel, director of the Individual and Family Health Insurance of IESS.

The pilot plan to strengthen preventive health will start in Cuenca and aims to appoint a doctor to each person to ensure proper health control.

Espinel explained that over a time period of 15 days, doctors will start to make calls to all IESS members to inform them of the assigned doctor concept and to give them a first appointment to make exams relevant to their age group.

The idea is that the assigned doctor is close to the members and gives immediate attention to problems such as colds and common diseases that represent the highest percentage of emergencies. In this case, Arévalo would no longer have to go to a hospital for a minor emergency; his sickness would be attended to by his assigned doctor.

The health needs of the members will be channeled through the family doctor to reduce the time of attention and decongest the specialty hospitals.

“Members will no longer be able to go to hospital emergency unless they require emergency care,” the official explained.


Once the plan is implemented in Cuenca, it will be extended to the approximately 185,000 members of Azuay and progressively throughout the country.

This service will also offer online scheduling and a call center where care will be with the doctor already assigned.

The IESS carried out a mapping of the health centers that provide services to members to assign between 2,000 and 5,000 members per medical team, which initially will consist of a doctor and nurse. Depending on the need, a dentist and a psychologist will be assigned.

In addition, there are 26 providers of first level services for the attention of minor emergencies that do not merit attention in hospitals or specialty centers that are available to members through the IESS website.