The study was performed with the objective to understand the ethical challenges of implementing the Program, using a qualitative approach and focal group discussion. The study included members from different FHP teams in the city of Campo Bom (Rio Grande do Sul, Brazil): three physicians, three nurses, two technicians, and four community health agents. Eight situations were created to discuss different aspects of the FHP. This article is an excerpt of the study, addressing the bottleneck effects in the FHP work process. The theoretical framework included concepts of crossing and transverse and the amplified clinic proposition. The results were categorized according to the individuals involved in the work processes: users of the health system, community health agents, professionals, administrators, and health system. The bottleneck effect in these processes originates in the repetition of primary care procedures and hospital practices, disregarding the subjective and social dimensions of the health/disease process. The amplified clinic proposition could be an answer since it holds that the therapeutic plans should result from an agreement between the health system user and the professional.
Family Health Program; Personnel management; Job satisfaction; Primary health care; Public health