Abstract
The present study highlighted the labour process of the dental surgeon (DS) in the private healthcare sector from the healthcare professional's perspective based on intervention bioethics. An observational, cross-sectional survey study was performed within the Federal District (Distrito Federal) region. Data were collected from 108 questionnaires completed by DSs affiliated with two types of private health insurers, self-insurance and group insurance, to assess job perception and the degree of job satisfaction in the dentistry market. The main source of dissatisfaction for healthcare professionals was related to the pay for dental procedures by insurers. For self-insurer 1, 38.1% healthcare professionals replied that the pay was satisfactory, whereas in self-insurance 2 and in the group insurance, 100% of healthcare professionals were dissatisfied. Another finding was that the group insurer considerably restricted elective treatments. In conclusion, loss of professional autonomy, depreciation of insurance claims and precarisation of dentistry occurs in the private healthcare sector, thus demonstrating the ethical conflicts in this relationship.
Highlights
Dentistry, as a profession, has gained prominence over time due to the increased demand for dental services resulting from the advent of caries as well as technical developments and from its consolidation as a specialised activity with a scientific field of knowledge and practices[1]
Most healthcare professionals interviewed answered that private dental care, provided within the direct reimbursement modality, was almost non-existent and that dental care under health plans prevailed
The analysis of the results from this study indicate an improved understanding of the operation of the private healthcare sector from the perspective of healthcare professionals regarding the precarisation, vulnerability and autonomy of their labour process, as well as of the role of the State’s responsibilities in the intervention bioethics (IB) perspective
Summary
As a profession, has gained prominence over time due to the increased demand for dental services resulting from the advent of caries as well as technical developments and from its consolidation as a specialised activity with a scientific field of knowledge and practices[1]. Dentistry has established itself in the process of production of goods and services and reaffirmed its role as core of the material base of the productive process, thereby revitalising other labour forces[4,5] in the logic of liberalism and privatism associated with professional autonomy. This model was abused in dentistry, with limited prospects of ensuring professional fulfilment economically[6], due to wage labour and restriction in autonomy[5,6], which is similar to what has occurred in medicine[2]. Contracts and affiliations became a strategy against the crisis of decreased income, the insurers expressed control of treatment provided and payment in the context of the relationship between the healthcare professional and the patient[7,8,10,12,13,14,15]
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