Díaz-Portillo Sandra P, Reyes-Morales Hortensia, Cuadra-Hernández Silvia Magali, Idrovo Álvaro J, Nigenda Gustavo, Dreser Anahí
Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
Hospital Infantil de México Federico Gómez, Ciudad de México, México.
Gac Sanit. 2017 Nov-Dec;31(6):459-465. doi: 10.1016/j.gaceta.2016.10.016. Epub 2017 May 1.
To analyse the working conditions of physicians in outpatient clinics adjacent to pharmacies (CAFs) and their organizational elements from their own perspective.
We carried out an exploratory qualitative study. Semi-structured interviews were conducted with 32 CAF physicians in Mexico City. A directed content analysis technique was used based on previously built and emerging codes which were related to the experience of the subjects in their work.
Respondents perceive that work in CAFs does not meet professional expectations due to low pay, informality in the recruitment process and the absence of minimum labour guarantees. This prevents them from enjoying the benefits associated with formal employment, and sustains their desire to work in CAF only temporarily. They believe that economic incentives related to number of consultations, procedures and sales attained by the pharmacy allow them to increase their income without influencing their prescriptive behaviour. They express that the monitoring systems and pressure exerted on CAFs seek to affect their autonomy, pushing them to enhance the sales of medicines in the pharmacy.
Physicians working in CAFs face a difficult employment situation. The managerial elements used to induce prescription and enhance pharmacy sales create a work environment that generates challenges for regulation and underlines the need to monitor the services provided at these clinics and the possible risk for users.
从自身角度分析毗邻药房的门诊医生（CAF）的工作条件及其组织要素。
我们开展了一项探索性定性研究。对墨西哥城的32名CAF医生进行了半结构化访谈。采用基于先前构建和新出现的与受试者工作经历相关代码的定向内容分析技术。
受访者认为，由于薪酬低、招聘过程不正规以及缺乏最低劳动保障，在CAF工作无法满足职业期望。这使他们无法享受正规就业带来的福利，并使他们只想在CAF临时工作。他们认为，与药房的会诊次数、诊疗程序和销售额相关的经济激励措施使他们能够增加收入，而不会影响他们的处方行为。他们表示，对CAF的监测系统和施加的压力旨在影响他们的自主权，促使他们增加药房药品的销售额。
在CAF工作的医生面临艰难的就业形势。用于诱导处方和提高药房销售额的管理要素营造了一个对监管构成挑战的工作环境，并凸显了监测这些诊所提供的服务以及对用户可能存在的风险的必要性。
