Satisfações e insatisfações no trabalho de médicos do Programa Mais Médicos alocados no interior do estado de São Paulo
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Data
2019-06-27
Autores
Rodrigues, Louise Lopes [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A Organização Mundial de Saúde recomenda uma razão de um médico para cada mil habitantes para que a população tenha um adequado acesso à saúde. Apesar de o Brasil possuir um número absoluto satisfatório de médicos, há no país uma distribuição desigual destes profissionais, com carência de médicos em comunidades remotas e vulneráveis, causando um grande impacto no bem-estar da população que ali se encontra e dificultando a universalização da saúde, como prevê os princípios do Sistema Único de Saúde. Diante disso, o Governo Federal criou, em 2013, o Programa Mais Médicos (PMM), com o intuito de suprir de forma emergencial a carência de médicos em regiões de difícil fixação dos mesmos. A literatura considera que o principal fator que leva um trabalhador a deixar uma organização é seu nível de insatisfação com a função que desempenha, o que também se faz verdadeiro na área da saúde. Sendo assim, podemos inferir que a insatisfação laboral do médico da Atenção Básica é um dos motivos da dificuldade de recrutá-los e fixá-los por um período mais longo. Objetivo: Este estudo se propõe a avaliar as satisfações e insatisfações no trabalho de médicos integrantes do PMM no município de Botucatu – SP, cidade universitária com elevado IDH e com razão médico-paciente de 6,25. Metodologia: Trata-se de pesquisa qualitativa, na qual foram feitas oito entrevistas semiestruturadas com médicos do PMM e uma entrevista com gestores da AB no município, as quais foram analisadas e categorizadas. Resultados: foram construídas as seguintes categorias:1. A visão da ESF; 2. A valorização de uma ESF desvalorizada; 3. Uma rede sem rede; 4. Entre os agendados e os pacientes com queixas agudas: a dificuldade de organizar o trabalho; 5. Bem-vindos porém passageiros; e 6. Nossos momentos de maior satisfação no trabalho. Destacou-se como fontes de insatisfação no trabalho a falta de prestígio do Médico de Família frente aos colegas médicos e pacientes; o grande volume de consultas de queixas agudas, que sequestram tempo de ações preventivas e consultas de rotina; dificuldades de encaminhamento de pacientes e a comunicação precária entre setores primário, secundário e terciário e a falta de perspectiva de crescimento profissional. Em contrapartida a boa receptividade das equipes e dos pacientes aos médicos do PMM; a construção da boa relação médico-paciente e a constatação de bons resultados diagnósticos e terapêuticos destacaram-se como fontes de satisfação no trabalho. Considerações finais: Observamos que a maioria dos médicos entrevistados foi surpreendida pelos desafios que a Atenção Básica traz, encontrando satisfação na relação médico-paciente porém sem o desejo de continuar trabalhando no setor primário.
Introduction: The World Health Organization recommends a ratio of one doctor per thousand inhabitants so that the population has adequate access to health. Although Brazil has a satisfactory absolute number of doctors, there is an unequal distribution of these professionals in the country, with a shortage of physicians in remote and vulnerable communities, causing a great impact on the well-being of the population that lives there and making it difficult to make health accessible for everyone, as foreseen by the principles of the Sistema Único de Saúde. Due to that, the Federal Government created in 2013 the More Doctors Program (PMM), with the aim of urgently supplying the shortage of doctors in regions that are difficult to set them down. The literature considers that the main factor that leads a worker to leave an organization is their level of dissatisfaction with the role they play, which is also true in the health field. Thus, we can infer that the dissatisfaction at work of the primary care physician is one of the reasons for the difficulty of recruiting them and fixing them for a longer period. Objective: This study aims to evaluate the satisfactions and dissatisfactions in the work of physicians of the PMM in the city of Botucatu - SP, a city with a renowned University, a high HDI and a physician-patient ratio of 6.25. Methodology: This is a qualitative research, in which eight semi-structured interviews were conducted with PMM physicians and one interview with health managers in the city, which were analyzed and categorized. Results: the following categories were constructed: 1. The vision of the Family Health Strategy; 2. The valuation of a depreciated Family Health Strategy; 3. A network without a network; 4. Among scheduled and patients with acute complaints: the difficulty of organizing the work; 5. Welcome but transient; and 6. Our moments of greater satisfaction at work. It was highlighted as sources of job dissatisfaction the lack of prestige of the Family Doctor before his medical colleagues and patients; the large volume of acute complaints, which hijacks preventive actions and routine appointments; difficulties in patient referral and poor communication between the primary, secondary and tertiary sectors and the lack of perspective of professional growth. On the other hand, the good reception of the teams and the patients to the PMM physicians; the construction of a good doctor-patient relationship and the confirmation of accurate diagnosis and therapeutic results were highlighted as sources of job satisfaction. Final considerations: We observed that most physicians interviewed were astonished by the challenges that Basic Care brings, finding satisfaction in the doctor-patient relationship but without the desire to continue working in the primary health sector.
Introduction: The World Health Organization recommends a ratio of one doctor per thousand inhabitants so that the population has adequate access to health. Although Brazil has a satisfactory absolute number of doctors, there is an unequal distribution of these professionals in the country, with a shortage of physicians in remote and vulnerable communities, causing a great impact on the well-being of the population that lives there and making it difficult to make health accessible for everyone, as foreseen by the principles of the Sistema Único de Saúde. Due to that, the Federal Government created in 2013 the More Doctors Program (PMM), with the aim of urgently supplying the shortage of doctors in regions that are difficult to set them down. The literature considers that the main factor that leads a worker to leave an organization is their level of dissatisfaction with the role they play, which is also true in the health field. Thus, we can infer that the dissatisfaction at work of the primary care physician is one of the reasons for the difficulty of recruiting them and fixing them for a longer period. Objective: This study aims to evaluate the satisfactions and dissatisfactions in the work of physicians of the PMM in the city of Botucatu - SP, a city with a renowned University, a high HDI and a physician-patient ratio of 6.25. Methodology: This is a qualitative research, in which eight semi-structured interviews were conducted with PMM physicians and one interview with health managers in the city, which were analyzed and categorized. Results: the following categories were constructed: 1. The vision of the Family Health Strategy; 2. The valuation of a depreciated Family Health Strategy; 3. A network without a network; 4. Among scheduled and patients with acute complaints: the difficulty of organizing the work; 5. Welcome but transient; and 6. Our moments of greater satisfaction at work. It was highlighted as sources of job dissatisfaction the lack of prestige of the Family Doctor before his medical colleagues and patients; the large volume of acute complaints, which hijacks preventive actions and routine appointments; difficulties in patient referral and poor communication between the primary, secondary and tertiary sectors and the lack of perspective of professional growth. On the other hand, the good reception of the teams and the patients to the PMM physicians; the construction of a good doctor-patient relationship and the confirmation of accurate diagnosis and therapeutic results were highlighted as sources of job satisfaction. Final considerations: We observed that most physicians interviewed were astonished by the challenges that Basic Care brings, finding satisfaction in the doctor-patient relationship but without the desire to continue working in the primary health sector.
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Palavras-chave
Satisfação no trabalho, Insatisfação no trabalho, Atenção Básica, Médicos de Família, Programa Mais Médicos, Job Satisfaction, Job dissatisfaction, Basic attention, Family Physicians, More Doctors Program