Conflicts in the Relationship Between Dentists and Health Insurance Providers

Detalhes bibliográficos
Autor(a) principal: Feitosa, Larissa Barradas Lima
Data de Publicação: 2020
Outros Autores: Santos, Denise Ribeiro, Santos, Rai Matheus Carvalho
Tipo de documento: Artigo
Idioma: por
Título da fonte: Saúde, Ética & Justiça (Online)
Texto Completo: https://www.revistas.usp.br/sej/article/view/168551
Resumo: This article aimed to find, in the national literature, the reasons for the conflictive relationship between health insurance providers and dental surgeons. The study describes the history of insurance companies in the Brazilian market and the professional profile of dental surgeons. Issues related to the autonomy, remuneration and job satisfaction of the health care professional were found. This might encourage critical thought among these professionals regarding work relations in the field of supplementary dental care. The analysis showed that the supplementary health system developed for over thirty years without government interference, culminating in an alarming, disorderly and unregulated growth, influenced by the excess supply of dentists and the reduction in the number of patients who pay for private services. Professionals who contract with health insurance companies in the hopes of expanding their practice must yield to their demands. These companies often limit the provider to less costly treatment, interfere with their treatment plan and use outdated price lists to pay for clinical procedures, leading to a negative perception and dissatisfaction with the insurance companies’ performance. The studied relationship was found to be truly conflictive, affecting the healthcare provider not only at the financial but also personal level. This conflict is related to the growth of the supplementary health system, which affects dental practice at its core, without the due control and supervision measures, necessary to correct asymmetries in corporate relations and avoid precarious working conditions, being taken.
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spelling Conflicts in the Relationship Between Dentists and Health Insurance ProvidersConflitos na relação entre Cirurgiões-dentistas e operadoras de Odontologia suplementarSupplemental HealthDental CarePrepaid Health PlansSaúde SuplementarAssistência OdontológicaPlanos de Pré-Pagamento em SaúdeThis article aimed to find, in the national literature, the reasons for the conflictive relationship between health insurance providers and dental surgeons. The study describes the history of insurance companies in the Brazilian market and the professional profile of dental surgeons. Issues related to the autonomy, remuneration and job satisfaction of the health care professional were found. This might encourage critical thought among these professionals regarding work relations in the field of supplementary dental care. The analysis showed that the supplementary health system developed for over thirty years without government interference, culminating in an alarming, disorderly and unregulated growth, influenced by the excess supply of dentists and the reduction in the number of patients who pay for private services. Professionals who contract with health insurance companies in the hopes of expanding their practice must yield to their demands. These companies often limit the provider to less costly treatment, interfere with their treatment plan and use outdated price lists to pay for clinical procedures, leading to a negative perception and dissatisfaction with the insurance companies’ performance. The studied relationship was found to be truly conflictive, affecting the healthcare provider not only at the financial but also personal level. This conflict is related to the growth of the supplementary health system, which affects dental practice at its core, without the due control and supervision measures, necessary to correct asymmetries in corporate relations and avoid precarious working conditions, being taken.Este artigo buscou levantar na literatura nacional os motivos pelos quais a relação entre as operadoras de planos de saúde e os cirurgiões-dentistas é conflituosa, traçando um histórico do mercado brasileiro na área, bem como o perfil do profissional deste segmento,  destacando as implicações observadas quanto à autonomia profissional, remuneração e satisfação com o trabalho, a fim de fomentar uma reflexão crítica na categoria quanto às relações de trabalho no âmbito da assistência odontológica suplementar. A análise realizada evidenciou que o sistema de saúde suplementar se desenvolveu por mais de trinta anos sem interferência governamental, culminando em um crescimento alarmante, desordenado e desregulado, influenciado pelo excesso de oferta de dentistas e redução de pacientes que pagam por serviços privados. Dessa forma, grande parcela dos profissionais que têm se associado a planos de saúde na expectativa de expansão dos seus serviços são submetidos às demandas das operadoras que limitam seu trabalho àquele menos oneroso, interferem no plano de tratamento e utilizam tabelas de preços desatualizadas para o pagamento de procedimentos clínicos, levando a uma percepção negativa e descontentamento em relação ao desempenho das operadoras. Concluiu-se que de fato a relação é conflituosa, atingindo o profissional em diversas esferas, não apenas econômicas como pessoais, e está associada à expansão do sistema suplementar. Sendo assim, a prática odontológica é afetada na sua essência, sem que medidas de controle e supervisão, tão necessárias, sejam implementadas para corrigir assimetrias nas relações corporativas e evitar condições precárias da profissão.Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Legal, Ética Médica e Medicina do Trabalho.2020-07-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionART.application/pdfhttps://www.revistas.usp.br/sej/article/view/16855110.11606/issn.2317-2770.v25i1p15-22Saúde Ética & Justiça ; v. 25 n. 1 (2020); 15-222317-2770reponame:Saúde, Ética & Justiça (Online)instname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/sej/article/view/168551/163511Copyright (c) 2020 Rai Matheus Carvalho Santoshttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessFeitosa, Larissa Barradas LimaSantos, Denise RibeiroSantos, Rai Matheus Carvalho2020-09-30T23:48:05Zoai:revistas.usp.br:article/168551Revistahttps://www.revistas.usp.br/sej/indexPUBhttps://www.revistas.usp.br/sej/oairevistasej@fm.usp.br||2317-27701414-218Xopendoar:2020-09-30T23:48:05Saúde, Ética & Justiça (Online) - Universidade de São Paulo (USP)false
dc.title.none.fl_str_mv Conflicts in the Relationship Between Dentists and Health Insurance Providers
Conflitos na relação entre Cirurgiões-dentistas e operadoras de Odontologia suplementar
title Conflicts in the Relationship Between Dentists and Health Insurance Providers
spellingShingle Conflicts in the Relationship Between Dentists and Health Insurance Providers
Feitosa, Larissa Barradas Lima
Supplemental Health
Dental Care
Prepaid Health Plans
Saúde Suplementar
Assistência Odontológica
Planos de Pré-Pagamento em Saúde
title_short Conflicts in the Relationship Between Dentists and Health Insurance Providers
title_full Conflicts in the Relationship Between Dentists and Health Insurance Providers
title_fullStr Conflicts in the Relationship Between Dentists and Health Insurance Providers
title_full_unstemmed Conflicts in the Relationship Between Dentists and Health Insurance Providers
title_sort Conflicts in the Relationship Between Dentists and Health Insurance Providers
author Feitosa, Larissa Barradas Lima
author_facet Feitosa, Larissa Barradas Lima
Santos, Denise Ribeiro
Santos, Rai Matheus Carvalho
author_role author
author2 Santos, Denise Ribeiro
Santos, Rai Matheus Carvalho
author2_role author
author
dc.contributor.author.fl_str_mv Feitosa, Larissa Barradas Lima
Santos, Denise Ribeiro
Santos, Rai Matheus Carvalho
dc.subject.por.fl_str_mv Supplemental Health
Dental Care
Prepaid Health Plans
Saúde Suplementar
Assistência Odontológica
Planos de Pré-Pagamento em Saúde
topic Supplemental Health
Dental Care
Prepaid Health Plans
Saúde Suplementar
Assistência Odontológica
Planos de Pré-Pagamento em Saúde
description This article aimed to find, in the national literature, the reasons for the conflictive relationship between health insurance providers and dental surgeons. The study describes the history of insurance companies in the Brazilian market and the professional profile of dental surgeons. Issues related to the autonomy, remuneration and job satisfaction of the health care professional were found. This might encourage critical thought among these professionals regarding work relations in the field of supplementary dental care. The analysis showed that the supplementary health system developed for over thirty years without government interference, culminating in an alarming, disorderly and unregulated growth, influenced by the excess supply of dentists and the reduction in the number of patients who pay for private services. Professionals who contract with health insurance companies in the hopes of expanding their practice must yield to their demands. These companies often limit the provider to less costly treatment, interfere with their treatment plan and use outdated price lists to pay for clinical procedures, leading to a negative perception and dissatisfaction with the insurance companies’ performance. The studied relationship was found to be truly conflictive, affecting the healthcare provider not only at the financial but also personal level. This conflict is related to the growth of the supplementary health system, which affects dental practice at its core, without the due control and supervision measures, necessary to correct asymmetries in corporate relations and avoid precarious working conditions, being taken.
publishDate 2020
dc.date.none.fl_str_mv 2020-07-03
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
ART.
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status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/sej/article/view/168551
10.11606/issn.2317-2770.v25i1p15-22
url https://www.revistas.usp.br/sej/article/view/168551
identifier_str_mv 10.11606/issn.2317-2770.v25i1p15-22
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://www.revistas.usp.br/sej/article/view/168551/163511
dc.rights.driver.fl_str_mv Copyright (c) 2020 Rai Matheus Carvalho Santos
http://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2020 Rai Matheus Carvalho Santos
http://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Legal, Ética Médica e Medicina do Trabalho.
publisher.none.fl_str_mv Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Legal, Ética Médica e Medicina do Trabalho.
dc.source.none.fl_str_mv Saúde Ética & Justiça ; v. 25 n. 1 (2020); 15-22
2317-2770
reponame:Saúde, Ética & Justiça (Online)
instname:Universidade de São Paulo (USP)
instacron:USP
instname_str Universidade de São Paulo (USP)
instacron_str USP
institution USP
reponame_str Saúde, Ética & Justiça (Online)
collection Saúde, Ética & Justiça (Online)
repository.name.fl_str_mv Saúde, Ética & Justiça (Online) - Universidade de São Paulo (USP)
repository.mail.fl_str_mv revistasej@fm.usp.br||
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