Multiple job contracts of physicians in Ceará, Northeastern Brazil

Abstract

OBJECTIVE: To analyze the multiple job contracts of physicians in the Brazilian National Health System in the State of Ceará. METHODS: Documental research was performed about the work contracts of the physicians, based on data of health professional contracts in the municipalities of Ceará state, Northeastern Brazil, in 2008. Indices were created for the quantity of contracts of each physician, as well as the municipalities where each physician maintained work contracts. The distances between the municipalities where they worked was calculated in order to estimate the total weekly hours of work. RESULTS: Of the 7,008 physicians employed by the Ceará state, 3,751 (53.5%) maintain between two and four job contracts and 39 (0.6%) between 11 and 20 contracts. One professional maintained 20 contracts. More than half (51.9%) of the physicians had work contracts that when summed totaled more than 40 weekly working hours and 27.0% (1,894) maintained job contracts with more than one municipality. CONCLUSIONS: In order to increase their work income, physicians undertake various jobs, practicing their profession in different locations and various municipalities, involving constant travel and contributing to the precarious conditions of their own lives and, therefore, of the public health system.