Evaluation of Job-Related Anxiety Symptoms Among Brazilian Social Security Medical Experts

OBJECTIVES: The function of a medical expert within the scope of the Brazilian social security system consists of medically evaluating the examinee to draw a conclusive opinion on the person's working ability capacity and to characterize the disability for social security and assistance purposes. Forensic decisions inevitably converge on two opposite outcomes: concession or refusal. Rejection is against the interests of the candidates, who can direct their disappointment and dissatisfaction at the professional, exposing the latter to potentially stressful situations. The present study aimed to determine whether the prevalence of stress and anxiety symptoms is higher among social security medical experts than among medical experts in other public service careers. The study was also intended to propose organizational changes aimed at the preservation and recovery of the mental health of medical experts. METHODS: The evaluation was conducted using a specific, previously validated job-related stress questionnaire and a series of questions about subjective perceptions of work performance, labor stressors and emotional status. RESULTS: We found an overwhelming and alarming prevalence of stress and dissatisfaction related to occupational aspects among social security experts, often culminating in emotional exhaustion, a characteristic feature of burnout syndrome. CONCLUSION: There is a high prevalence of job-related stress among social security doctors in Brazil, warranting implementation of specific measures to ensure the adequate provision of social security services to the population, thus avoiding social injustice and financial damage.

Pectoralis minor muscle. An unusual insertion

Variations in the insertion of the pectoralis minor muscle have been described. Although much of them were considered to be functionally normal, others may be associated in certain with disconfort related to shoulder movement. Here we described a bilateral, symmetric insertional variation of the pectoralis minor muscle that was found during a routine dissection of upper limbs. In this variation, the tendon crossed the superior surface of the coracoid process to insert on the major tubercle of the humerus head, where it fused with the tendon of the supraspinatus muscle. This variation could be the cause of pain during certain shoulder movements as a result of neurovascular compression, and may lead to mechanical alterations in the muscular dynamics of the shoulder.