Flexible work hours at the SUS: labor legislation at a specialized outpatient facility in Brazil

The geographical shortage and poor distribution of physicians, their traditional autonomy with multiple jobs, and low salaries they are paid in the public sector have created a reality of widespread failure to comply with the work hours defined in the Brazil Unified Health System legislation, causing legal uncertainty for managers and physicians.

This report aims to analyze the perception of managers, health personnel, and users of the Unified Health System about the corporate experience of a new labor legislation that preserves statutory labor rights and sets flexible work hours for medical specialists in Praia Grande, São Paulo, Brazil.

This is a qualitative study with a phenomenological basis, using ethnographic research. A total of 42 social actors were interviewed in person or remotely with a digital recorder, including managers, physicians, and clients of the Unified Health System at a specialized outpatient facility (mean interview length 24.1 minutes [95%CI 17.7-30.6]), and official documentation.

Emic and ethical perspectives from 489 units of meaning were compiled into 10 categories for analysis and presented in an ethnographic report for regrouping through nomothetic analysis, and records from an ideographic perspective for validity through integrative synthesis.

The new legislation provided professional satisfaction, atracting and retaining specialist practitioners, providing legal certainty with external audit bodies and improving access to diagnostic and therapeutic procedures, microregulation between specialists and Primary Health Care, standing out as a successful experience for external audit bodies and atracting managerial interest from all over Brazil.