Carlos Atencio

Ashoka Fellow


This profile was prepared when Carlos Atencio was elected to the Ashoka Fellowship in 2014.
The New Idea
In Venezuela and across Latin America, healthcare is more and more geared toward curing the sick, and is increasingly hospital-based. In a related trend, for the last century, doctors have become more and more specialized instead of having a broad base of medical knowledge. In Venezuela, the healthcare system is particularly fractured for those two reasons but also due to a waning population of doctors and two separate health systems -- public and private -- neither of which adequately cover care for the population. In this context, Carlos Atencio and his Fundación Medicina Familiar (Family Medicine Foundation, (FMF)) are offering a new model to flip the hospital and sickness-focused paradigm to one of home and wellness.

To do this, FMF is reviving a family medicine/general practitioner approach with preventive and primary care that is based on proximity to the patients and integrated medical knowledge. The FMF model separates the financer (whether state or private), from the practitioner (the health center), and quality monitor (the community), increasing trust and community participation. FMF has small community outpatient centers that serve as a place close to home where families can go for preventative and emergency healthcare. The same team of doctors and nurses always care for the same families, even treating them at their homes if necessary. While the FMF staff of 70 medical professionals are practicing medicine at the health centers, Carlos is moving to focus FMF’s efforts on training, research, and replication.

The four FMF health centers serve as test sites for different financing options and evaluation practices. While each is based on four pillars (integration, training, sustainability, and citizen participation), each center runs on a different financing model and adapts their community health outreach to each particular community. Meanwhile, Carlos has partnered with two universities to train new doctors in family medicine, and offer continuing education courses to current physicians who want to specialize in the practice. The FMF general practitioners are able to treat 85% of health issues they see, and only those 15% that are not resolved are referred to specialists or larger hospitals. Carlos estimates that this method, by focusing on prevention, early detection, and personalized care incurs only 20% of current private healthcare costs. Nearly 500,000 patients have come through FMF health centers in the last five years, and 11 universities have begun offering courses in family medicine. Carlos is dedicated to taking this model across the country and beyond.
The Problem
The Strategy
The Person

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