Mishima MS, Villa ST, Silva E, Pinto C, de Almeida PM. O velho trabalho em equipe pode ganhar cara nova? Uma perspectiva do trabalho gerencial. [Can team work in its older form acquire a new face? A perspective on managerial work.] Saúde em Debate [Health in Debate] (Río de Janeiro, Brazil) 2000; 24 (54): 66-74.

Objectives: To identify the structure of managerial work within the process of “municipalizing” healthcare, the relationships that are established in community health centers, and the possibilities for instituting new teamwork dynamics.

Methodology: Qualitative, via semi-structured interviews of managers at the community health centers in Riberão Preto, São Paulo , Brazil .

Results: The statements of managers clarify that the relationships established between members of the healthcare team are tense, charged with conflict and confrontation.

One possibility for transforming these problems within the teams is to create a more horizontal relationship among all people involved in the chain of work. The process of democratization is based on the concrete facts of daily life and on establishing direct dialogue among the different members who make up the healthcare team. The managers interviewed pointed out the need to win the confidence of the team in order to forge a more cohesive work ethic and environment.

The manager must operationalize the concept of taking responsibility through a conscious effort that entails teaching this principle to the team.

Conclusion: The interviewees were in agreement that, despite the difficulties of democratizing healthcare work, it is possible to forge more participative processes. These processes depend on the creation of a multidisciplinary team in which the manager assumes an important coordinative role.

Copyright 2007 University of New Mexico