Analysis of contractual relations and profile of dentists at dental specialty centers of low and high performance in Brazil

Introduction: In the 1990s, flexible contractual relations were implemented in the realm of public administration in Brazil, which have led to job insecurity among health professionals working in the public sector. Objective: The aim of the present study was to investigate the profile of dentists at Dental Specialty Centers of the Brazilian public healthcare system and to analyze the nature of work relations stipulated in contracts between dentists and municipalities. Methods: An exploratory study was carried out involving semi-structured interviews with 289 dentists at 59 Dental Specialty Centers representative of the five macro-regions of Brazil and selected among the 10% best and worst performance in the production of procedures. Results: Among the professionals surveyed, more than half were women (55.0%). As regards professional qualifications, 72.7% of total respondents said they had attended or were attending postgraduate school at the time of the interview. The most important issues raised during the interviews regarded unstable work ties and job insecurity. Moreover, differences were found among the country's macro-regions. Conclusions: The findings of the present study underscore the existence of job insecurity stemming from the Brazilian National Oral Health Policy implemented by states and municipalities.