牙科專業人才選擇執業環境的研究

Abstract

牙科醫學雖然也是醫學的一個分支，但是其治療範疇與工作型態卻迥異於其他醫學的分科，特別適合小團隊的工作模式，因此大部分的牙科醫師在接受完專業訓練後對執業環境的選擇多捨棄大型醫療機構的服務機會，影響所及已造成國內許多教學醫院甚至醫學中心的牙科部門出現人才斷層的問題，這對國內牙醫學的未來發展不利。同樣的如果大部分牙醫畢業生的執業選項為投入中小型私人診所，那麼學校在課程的安排上是否需要加以調整。因此本研究的目的在於研究正在接受牙科次專科訓練的年輕牙科醫師對未來執業規劃的選擇以及可能影響其選擇的因素。 我們以問卷調查的形式調查了目前正在台大醫院牙科部接受次專科訓練的資深住院醫師、研究生，與代訓醫師。結果發現絕大多數的受訪牙科醫師計畫將來受雇於私人牙醫診所，只有非常少數的醫師有在教學醫院執業的打算，而目前已有自行開業計畫者亦不多。大部分受訪醫師對在教學醫院工作負面的印象在於“醫療本業外之業務與行政雜事多”與“收入少”。 進一步分析可以發現不同次專科背景對執業環境的選擇上可能扮演重要角色，例如口腔外科醫師有明顯較高留在教學醫院執業的意願，贋復牙科醫師則有較高自行開業的趨勢，而矯正科醫師則似乎最沒有自行開業的需求。此外我們也發現不同次專科背景的醫師在工作時數與預期收入上億有明顯差距，而這些差距除了可以反映各次專科不同的工作特質之外，似乎更可反映現行牙科醫療市場的現實狀況。這些資訊可以提供當政者或訓練機構找出改變制度的一些方向，以便讓醫療機構更容易找到適當的人才，同時也能調整各次分科之間勞逸分布不均的現象。

Dentistry is a branch of medicine, but its scope and art of work are quite different to other medical specialties, namely it’s especially suit for small team work. Therefore, the great majority of the dentists won’t choose hospital to practice, after finishing their professional trainings. As a consequence, dental clinics of many teaching hospitals or medical centers in Taiwan have faced problem of shortage of man power. It would bring negative impacts on the development of dentistry here. Meanwhile, if most of the dental graduates would devote themselves into private clinical services, should the curriculums of the dental school be modified accordingly? The aim of this study is thus to investigate the choosing of the practice environments of young dentists who are under dental sub-specialty training; and factors affecting their choices. Questionnaires were used to interview those who are under dental sub-specialty training in dental department of the National Taiwan University Hospital, including senior residents, graduate students in the master program, and training residents from outside. We found that the great majority of the interviewed dentists are planning to be hired in private dental clinics. Only very few of them intend to practice in the teaching hospitals. Not much of them wants to run their own practice, either. Most of the negative opinions towards working in the teaching hospitals include “too much trivial non-medical business” and “poor income”. Further investigations have indicated that different sub-specialty background might play import role in choosing practice environments. For instance, the oral surgeons are most likely to practice in the teaching hospital. Prosthdontists are inclined to run their own office. Orthodontists seem to have least intension to run their own clinics. Besides we also find that dentists with different sub-specialty backgrounds showed varied working loads and expected incomes. These differences can not only reflect different characteristics of different sub-specialties, but also some realities of dental markets. The results of this study can provide useful information to policy makers or training providers to adapt themselves to attract more appropriate man powers.