RSI/WMSD in the context of the symbolic meeting between patients and medical experts at the INSS/SP

Abstract

This paper discusses aspects of the physician-patient relationship in the context of the symbolic meeting between patients with RSI/WMSD and medical experts at the Brazilian National Institute for Social Security of São Paulo (INSS/SP). The empirical research which grounded the discussion had a qualitative approach and it used as instrument for obtaining data the in-depth interview, with different scripts for medical experts and patients. We conducted 9 interviews, 6 with patients and 3 with medical experts. Content analysis was applied to the empirical material according to the conceptual framework of social representations. The narratives of patients about RSI/WMSD, the narratives of medical experts about medical evaluation, and the narratives of both about INSS/SP medical consultations allowed exploring the symbolic meeting that occurred between than. The physician-patient relationship established in this symbolic meeting is extremely peculiar, since it is aimed at assessing the health-disease process of the patient, based on the premises of social insurance law, factor that mischaracterize this kind of relationship, established on the social imaginary as a space for care and trust. As a consequence, patients with RSI/WMSD and medical experts, at the meeting time, are in different power scales: the former are assessed and the latter assess the validity of complaint according to the standards of the INSS/SP. Hence, they present narratives about the consultations permeated by the tension related to the expectations and needs with regard to the results.