Ensaio sobre ethos profissional médico em saúde pública

Abstract

This essay sought to problematize the professional ethos of physicians in the public health network in Belo Horizonte. The focus on doctors is related to their implication with curative services, which represent the highest maintenance cost among the others offered by public health. The health care model adopted by the State to provide the right to health has principles and guidelines that guide the conduct of both managers and workers. The provision of public services must occur, considering individuals, universally, equitably and integrally, which indicates an ideal that guides the whole system. It happens that between the formulation of public policies and the effectiveness of their implementation there is a gulf of possibilities, which is part of the autonomy, customs and beliefs of professionals and which guide their decisions and practices at work. The theoretical analysis shows that medicine is a unique profession for several reasons, and has a privileged place compared to other professions working in the health field. The professional ethos of doctors is the result of a social construction, in a dual relationship in which doctors claim for themselves power and domination and the society that legitimizes this domination. These professionals share certain beliefs, customs, some that perpetuate themselves over the years and influence how they dress, how they share information. All of these elements together help doctors to recognize each other while differentiating themselves from other professionals, even those in the health field in activities close to medicine. The medical ethos, therefore, does not concern an ethical standard, understood as a code considered the ideal of practice and used as a guide for decision making. First, however, ethos concerns the real aspects rather than the ideals. The confusion between these two dimensions, ethics and ethos, can lead to romanticization of professional practice at the price of analytical myopia. Observing the historical process of medical education highlights some strong characteristics, such as traditionalism, power and domination relations, social prestige, vocational appeal as a humanitarian desire, and the profile of professionals presenting elitist traits. Understanding the professional ethos can contribute to the analysis of the implications of changes in both the health field and the medical curriculum. In general, professional ethos is an important means of understanding shared beliefs, customs, and behaviors within professions.