The family health program: motivation, training and work according to physicians acting at three districts of the city of Duque de Caxias, Rio de Janeiro, Brazil

Analisou-se como o m??dico do Programa de Sa??de da Fam??lia (PSF) de Duque de Caxias percebe sua atua????o. Foram feitas entrevistas semiestruturadas com 15 m??dicos que trabalham no primeiro, terceiro e quarto distritos, sendo o primeiro urbano e os demais rurais. Aplicou-se aos dados a an??lise de conte??do, na modalidade tem??tica. Os n??cleos de sentidos referiram-se ?? motiva????o e ao preparo para ingressar na equipe, e a oportunidade que o PSF oferece para estabelecer v??nculos com o paciente, refor??ando o acolhimento, a escuta e a responsabilidade. Estabeleceram- se: a) a maioria se ressente da opini??o que os colegas fazem dela; b) a prepara????o ofertada ?? eminentemente te??rica; c) v??nculo, escuta e responsabilidade s??o avan??os conquistados na realiza????o profissional, e d) as bases da racionalidade m??dica formatam a organiza????o das pr??ticas, traduzindo uma concep????o de sa??de que se define pela aus??ncia das doen??as. Consubstancia-se uma lacuna entre a realidade e a proposta do governo de fazer do PSF uma via de reorganiza????o da aten????o b??sica.The study analyzed how physicians working in Programa Sa??de da Fam??lia (PSF - Family Health Program) perceive their professional practice in the municipality of Duque de Caxias, state of Rio de Janeiro, Brazil. Semi-structured interviews were conducted with fifteen physicians working in the first, third and fourth districts. The first district is urban and the others, rural. Data was analyzed by content analysis, and the nuclear senses found were associated with motivation and training to carry out the job, and the opportunity the Program offers to establish close personal bonds between physicians and patients, reinforcing the capacity to listen and accountability. The results showed that: a) the great majority resent what their colleagues think about them; b) the offered training is essentially theoretical; c) bonding, capacity to listen and accountability are advances and professional achievements; d) the modern occidental medical rationality is the base of the practice, health being the absence of disease. It can be said that there is a gap between reality and the government???s intention of making PSF become a path to reorient the Brazilian health system