Perícia médica previdenciária: o que estudantes e médicos sabem sobre o tema?

Abstract

The topic Social Security Disability Examinations is scarcely covered during the medical course, despite doctors being frequently required to conduct them in their clinical practice. Social Security expenses with disability benefits and the number of medical examinations are high in Brazil, becoming routine issuing of health certificates in medical practice. Given the importance of these factors, the objective of the study was to assess the knowledge of medical interns, residents and preceptors at UFRN about the social security disability examination and propose an appropriate teaching strategy to the topic. An on-line self-assessment questionnaire was sent to 568 subjects (interns, residents and preceptors). The nine questions involved the following items: knowledge of the main types of disability benefits awarded by the INSS (Social Security Institute), confidence in preparing a health certificate for sick benefit purposes, confidence in assessing the working capacity of patients in their of field of work and knowledge of items deemed indispensable in preparing a health certificate for the INSS. A total of 95 interns, 81 residents and 82 preceptors responded to the questionnaire (45%). Students reported having poor and very poor knowledge of all disability benefits, 80.2% for sick benefits and 73.4% for disability pension. Among the doctors (residents and preceptors), 46.1% reported average knowledge of sick benefits, and between poor and very poor knowledge of the other benefits. With respect to confidence in issuing sick benefit certificates, 74% of the students revealed being insecure or very insecure, only 33% of preceptors considered themselves secure or very secure and half considered themselves somewhat secure. In the assessment of patients’ working capacity, nearly 40% of doctors (residents and preceptors) considered themselves between secure and very secure and half somewhat secure. In relation to the most relevant items of the health certificate for the INSS, the current status of the disease and the International Classification of Disease (ICD-10) were considered the most relevant by doctors and interns. These results demonstrate the doctors’ insecurity in dealing with these demands and show the need for including effective and continuous discussions on Social Security Disability Examinations in the curricula of medical courses, due to their importance in medical practice. A mini-course was designed and applied in workshop format, using active methodologies and will be inserted in some periods of the degree course in Medicine at UFRN, as part of the curriculum realignment to the National Curriculum Guidelines underway in the institution.