Family and community physicians: their role and impact on healthcare

The family and community physician is more than the professional who treats the flu and renews prescriptions. They are the link between the patient and the health system, the one who follows the patient’s history over the years, identifies risks before they become emergencies and coordinates referrals for further care.

This model of care has a direct impact on hospital management. A strong primary care network reduces avoidable hospital stays, reorganizes the flow of care and changes the hospital’s demand profile. For those who plan capacity, negotiate contracts with health plans or manage the revenue cycle, understanding the role of this professional is part of the job.

What Family and Community Medicine is

Family and Community Medicine (MFC) is the medical specialty focused on primary care. Its focus is comprehensive, continuous and longitudinal care for people of all ages, genders and health conditions, within the family and community context in which they live.

In Brazil, the specialty has been recognized by the Federal Council of Medicine (CFM) since CFM Resolution No. 2,330/2023, which consolidated its status among the official medical specialties. Even so, training family and community physicians is still a challenge: the number of professionals with specific residency training in the field is far below what the health system needs.

The family physician is often confused with the general practitioner. The difference lies in training and in the model of practice: the general practitioner has a broader, less in-depth approach to primary care, while the family and community physician is specifically trained to coordinate the patient’s care over time, based on an ongoing relationship and continuity.

What the family and community physician does

The family and community physician is the professional responsible for the entry point to the health system. Their work involves seeing people of all age groups, following chronic diseases such as hypertension and diabetes, coordinating referrals to specialists when necessary and working on prevention before a problem requires hospital intervention.

What sets this professional apart is not the volume of visits, but the relationship. The same physician follows the same patient over the years and knows their history, their family and their risk factors. This continuity of care helps identify early on conditions that, without attention, would progress to high-complexity hospital stays.

In primary care, the family and community physician also coordinates the multidisciplinary team: nurses, community health workers, nursing technicians and other professionals who work in an integrated way in the area they serve.

The impact on reducing hospital stays and costs

The relationship between family and community physicians and lower hospital costs is well documented. A master’s thesis from UFMG (Federal University of Minas Gerais), by Gregório Victor Rodrigues, analyzed about 600,000 hospital admission records in Belo Horizonte between 2017 and 2021. The study showed that the higher the proportion of family and community physicians with specific residency training on health teams, the fewer the hospitalizations for primary care-sensitive conditions (ICSAP): diseases that, when well managed at the base, do not progress to hospitalization.

The results are striking: an overall reduction of 11.89% in hospital stays for conditions such as diabetes, hypertension, asthma and pneumonia; a 10.6% drop in care costs; and a reduction of almost 33% in hospitalizations for diabetes specifically.

ICSAP are a relevant indicator for hospital managers because they represent hospital stays that could have been avoided. When a hospital receives many cases of this kind, it signals weakness in the area’s primary care network.

Family Health Strategy: 32 years and national coverage

The Family Health Strategy (ESF) turns 32 in 2026 as Brazil’s main primary care policy. Covering 92.5% of the national population, the ESF today brings together more than 40,000 multidisciplinary teams across the country.

In November 2024, the Ministry of Health accredited 2,363 new teams in 561 municipalities, with an investment of R$ 854 million through the end of 2025. The initiative comes with a new federal funding model established by Ordinance GM/MS No. 3,493/2024, which restructures federal co-financing of the Primary Care Floor with a focus on efficiency and equity in the distribution of resources.

For hospital managers who serve SUS (Brazil’s public health system) patients, the expansion of the ESF has a direct implication: a stronger primary care network reduces pressure on emergency rooms and medium-complexity hospital stays, and reorganizes the flow of care in the area.

Frequently asked questions about the family and community physician

What is the difference between a family physician and a general practitioner?

The general practitioner has broad training across several areas of medicine, with no specific specialization in primary care. The family and community physician is a specialist trained to work in primary care with a focus on the ongoing relationship and care coordination. In practice, the family physician knows the patient’s history over time and coordinates their journey through the health system in a more structured way.

Do family physicians work only in SUS?

No. Although the Family Health Strategy is the main primary care policy in Brazil and employs most of these professionals, family and community physicians also work in private healthcare.

How does primary care reduce hospital costs?

Strong primary care reduces hospitalizations for sensitive conditions, that is, diseases that could have been controlled before progressing to hospitalization. Fewer avoidable hospital stays mean less pressure on beds, a lower cost per member for health plans and a hospital demand profile more concentrated on higher-complexity, higher-value cases. The impact is financial and operational for the entire chain.