Nov. 28, 2016

Miguel Palacios Celi


Miguel Palacios Celi

National Dean, Colegio Medico del Peru

TBY talks to Miguel Palacios Celi, National Dean of Colegio Medico del Peru, on changes in the healthcare sector, the country's challenges with healthcare workers, and investing in preventative care.


Miguel Palacios Celi is a surgeon specialized in gynecology and obstetrics. He started in the College of Physicians of Peru in 2012-2013 as a member of the board, responsible for public health policies. He became National Dean after an election process open to all members of the college at the national level. He remains active in the medical area and also actively participates in research as well as in academia.

How would you characterize the development of the health sector in Peru in the last few years?

In the last few years, we have seen positive and important changes in the sector that contributed to its rapid development. For example, a few years ago the private health sector was made up of a small number of clinics run by few professionals. There was a concentration of clinics and two or three oligopolies. This changed to change in 2011, and we now see a consolidation. The banking sector has a strong presence here too through insurance companies as well as a nationwide clinic network. This is one of the realities of the health sector in Peru. Additionally, there has been a rapid development of integral health insurance in the country. Today, there are 16.5 million insured people, which represent two-thirds of the total population. In this context, we see a positive development of the public insurance and the universal health coverage. The public health sector has deteriorated due to poor budgets from the state as well as the lack of political interest to address the situation. The situation in the private sector is different. It is in a much stronger position. Overall, the development of universal coverage and health insurance, together with the presence of oligopolies and the increase in certain investments, have been the key to the development and progress of the health sector in Peru. For example, we saw the development of 103 new hospitals from 2011, with 54 to be completed. This is a good indicator of the development of the sector.

How would you characterize the sector's human resources?

This is one of the main challenges we face right now; there are not enough doctors in the country. Currently, the estimated cost for the state to train a doctor is around USD350,000. However, once they complete their studies they see no vacancies here to continue their specializations. There are no vacancies for all the graduates Peru has every year. The country does not have the economic muscle to guarantee a position for all of them. Another challenge we face has to do with the specialization of these doctors due to the lack of vacancies in the country. Currently, a third of the doctors become specialists; the other two-thirds end up with more generic training and no specialization. Most of these general doctors end up moving abroad in search of brighter opportunities—Europe, the US, and neighboring countries. The government needs to tackle this and provide the necessary positions and vacancies for young doctors to specialize, encouraging them to stay from a professional and economic point of view.

How has the prevention culture in Peru developed in recent years?

We currently have a rehabilitative health sector and culture, and it is important to invest in prevention as it considerably reduces costs in the long term. We aim to shift this culture to a more preventive culture and greater health awareness. We need to invest in education and promote health as basis of prevention. We need to reach schools and other organizations to educate people because we currently have the tools to achieve the desired change: healthier eating habits, more physical activity, and so on. In this context, we need to continue to fight extreme poverty and invest in providing drinking water to all the regions.

What is your main objective for 2016?

We have a legal responsibility toward public health. In this regard, the college is ready to work on the future of the sector to restructure the national health system. Our term finishes in 2018, and we will work hand in hand with the new government to achieve the abovementioned change in culture, as well as strengthen primary health services. We need to further contribute to the specialization of our doctors in order to improve the quality of the services the sector offers the population.