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Abstract(s)
No atual enquadramento regulatório das políticas públicas de saúde verifica-se um maior escrutínio público sobre a medicina, pelo que os atores institucionais se têm empenhado na implementação de medidas que procuram reduzir a variação das práticas médicas, concretamente através das chamadas normas de orientação clínica (NOC). Considerando o processo formal da sua implementação em Portugal, o objetivo específico deste artigo é explorar as razões que explicam a adesão a esta lógica de padronização por parte da medicina geral e familiar (MGF). No quadro de uma metodologia qualitativa-intensiva mais ampla, são aqui mobilizados os resultados empíricos decorrentes da aplicação de um conjunto de entrevistas semiestruturadas junto de um número restrito de informantes privilegiados acerca do envolvimento da MGF neste processo, bem como um suporte documental específico enquadrador da sua implementação em Portugal. Constata-se que a vulnerabilidade deste segmento profissional às interferências regulatórias que foram desencadeadas acabou por ser contingente, dado que a concretização do processo de implementação das NOC implicou uma lógica de negociação que assegurou a participação dos profissionais na própria modulação desta iniciativa e constituiu-se como uma oportunidade de reforço da afirmação profissional desta especialidade médica.
ABSTRACT - In the current regulatory framework of public health policies there is greater public scrutiny upon medicine, and institutional actors have been engaged in the implementation of measures that seek to link professional interventions to the demonstration of their effectiveness and efficiency, namely through the so-called clinical guidelines. Considering the formal process of its implementation in Portugal, the aim of this article is to explore the reasons why general practice adheres to this standardization logic. Within the framework of a broader qualitative-intensive methodology, we present the empirical results obtained from the application of a set of semi-structured interviews with a limited number of privileged informants about the involvement of general practice in this process, as well as specific documentary support about its implementation in Portugal. The vulnerability of this professional segment to regulatory interference that has been triggered proved to be contingent, since the implementation of the clinical guidelines process implied a negotiation logic that ensured the participation of professionals in the modulation of this initiative itself and constituted an opportunity to reinforce the professionalization of this medical specialty.
ABSTRACT - In the current regulatory framework of public health policies there is greater public scrutiny upon medicine, and institutional actors have been engaged in the implementation of measures that seek to link professional interventions to the demonstration of their effectiveness and efficiency, namely through the so-called clinical guidelines. Considering the formal process of its implementation in Portugal, the aim of this article is to explore the reasons why general practice adheres to this standardization logic. Within the framework of a broader qualitative-intensive methodology, we present the empirical results obtained from the application of a set of semi-structured interviews with a limited number of privileged informants about the involvement of general practice in this process, as well as specific documentary support about its implementation in Portugal. The vulnerability of this professional segment to regulatory interference that has been triggered proved to be contingent, since the implementation of the clinical guidelines process implied a negotiation logic that ensured the participation of professionals in the modulation of this initiative itself and constituted an opportunity to reinforce the professionalization of this medical specialty.
Description
Keywords
Padronização Profissão médica Normas de orientação clínica Medicina geral e familiar Standardization Medical profession Clinical guidelines General practice
Citation
Raposo H. Reconfigurações profissionais em contextos de mudança: o papel da medicina geral e familiar. Sociol Probl Praticas. 2019;(91):77-96.