Care in Dispute: Medical Work Between Moral and Market Logics.

Abstract

This article examines how the platformization of medical work has been reconfiguring the ethical, relational, and subjective dimensions of healthcare in the Brazilian context. Drawing on contributions from economic sociology, it argues that the growing mediation of medical practice by digital platforms, managerial protocols, and market-oriented rationalities exceeds strictly technological or organizational changes, constituting a sociotechnical reorganization of care. Based on the concepts of disembedding, contested markets, and emotional labor, the article examines how the fragmentation of labor ties, the intensification of emotional demands, and contractual instability affect professional autonomy, therapeutic continuity, and the construction of trust between physicians and patients. In Brazil, these transformations become particularly relevant given the accelerated expansion of the medical workforce, regional inequalities, and the increasing incorporation of managerial mechanisms and digitally mediated infrastructures in both the private sector and the Unified Health System (SUS). It is argued that the contemporary precarization of medical work affects not only labor conditions but also weakens the ethical and relational foundations that guide healthcare. Finally, the article argues for strengthening stable institutional ties, conditions for attentive listening, and forms of work organization capable of preserving the relational, collective, and ethical character of medical practice.