美容醫學醫師放棄原專科之因素探討

Abstract

研究背景 : 近年來健保的總額給付制度造成醫師收入下降及民眾對於醫療服務的要求越來越嚴苛，使得部分科別醫師發生醫療糾紛發生頻繁造成醫師選擇「專科轉換」。而美容醫學產業所需技術門檻不高、屬於新興市場，政府相關單位對於此類醫療服務規範尚不完善、醫療糾紛較其他專科低、收入來源增加、工作時間彈性等特性導致醫師紛紛放棄原「專科選擇」投入美容醫學產業。美容醫學產業蓬勃發展的現象導致部分專科(內科、外科、婦產科、兒科與急診)醫師人力匱乏。政府也意識到此一現象，因此行政院衛生署在民國102年發表「美容醫學市場之擴張對我國醫療體系、醫療制度發展及民眾健康權之衝擊影響」。本研究將試圖探討醫師轉入美容醫學產業的因素分析及轉入美容醫學醫師是否保留原執業專科及其因素為何，期待能為為來醫療政策發展之參考。 研究目的 : 以台灣目前從事美容醫學專科醫師做為調查對象，分析美容醫學專科醫師之 ( 1) 從事美容醫學醫療服務之醫師做出專科轉換（career change）之影響因素。( 2) 美容醫學醫療服務之醫師繼續從事原執業專科的情形與影響因素。(3) 驗證薪資、生活品質與工作轉換之間的關係，俾政府能夠了解五大專科醫師流動至美容醫學專科的原因，進而調整相關政策。(4) 瞭解醫師從事美容醫學的因素與醫師是否放棄原執業專科是否有關。 研究方法 : 本研究乃採不記名問卷調查的方式進行，由受訪者自行填寫問卷，參與本研究之受訪者為目前有執業美容醫學業務之醫師，問卷為研究者親自發放給受訪醫師，待填寫完畢再前往將問卷收回。共發放了300份問卷，回收問卷共119份。利用SAS 統計軟體進行描述性統計、推論性統計與回歸分析。利用IBM SPSS Amos version 20版軟體進行驗證性因素分析。 結果：影響醫師從事美容醫學的六大因素中，除了職場關係之外，其它五大因素（生活品質、原有工作之工作內容、職涯發展途徑、自我評價與受到身旁的人影響）中的大部份子選項皆有一半以上的醫師同意該因素。在邏輯斯迴歸的部分，醫師個人背景與影響醫師從事美容醫學的因素對於醫師是否放棄原執業專科之影響，僅有職涯發展對於醫師是否放棄原執業專科之影響達統計顯著。 結論 : 此研究瞭解了醫師從事美容醫學醫療業務的原因；醫師從事美容醫學後的薪資水準有大幅提升的現象，而促使醫師從事美容醫學醫療服務的原因眾多，根據邏輯斯迴歸，在影響醫師從事美容醫學醫療服務的因素中，醫師對於職涯發展途徑的同意程度越高，則醫師轉入美容醫學專科而放棄原執業專科的機率也越高。

Background: In past years, some physicians made the decision of “career change” due to the income level of physicians were influenced by the constraint of government budget and the medical malpractices are getting worse. More and more physicians revise their original “career choice” and joined the aesthetics medicine industry due to the following reasons: lower barriers to entry in related techniques; incomplete or less regulatory by government; less medical malpractices; higher income and flexibility in working hours. The prosperity of aesthetics medicine industry also make some specialties like, internal medicine department, surgical department, OB/GYN department, pediatrics department and emergency medicine department lack of manpower. Government is also aware of this phenomenon. Therefore department of health issued “the impacts of expansion of aesthetics medicine to healthcare system, development of medical system and citizen’s health right”. This study will try to identify the factors associated with “career change” of aesthetics physicians and why they retain their original specialty. Hope this study can make some contribution to future healthcare related policy development. Objectives: The target group of this study is the physicians are currently practicing aesthetics medicine and our objectives are as following: 1.The factors associated with career change of aesthetics physicians. 2. Current situation and factors to aesthetics physicians who are still practicing their original specialty. 3. To prove the positive correlation between “salary compensation”、“quality of life”and “career change”. From the result, we can provide some insight to government regarding the reasons why physicians in five major departments choose to make the decision of “career change”. 4. To understand the relationshop between the factors of physicians decide to make the decision of “chareer chang” and if the physician abden their original specialty. Method: the survey form was developed and delivered in person to 300 aesthetics physicians. 119 out of 300 physicians completed the survey. The result was proceeding in descriptive statistics, inferential statistics and regression by SAS and CFA analysis by Amos version 20. Result: Besides the office politics, the rest 5 factors (including quality of life; original job content; career development; self appraisal and influence by others) more than 50% of the aesthetics physicians agree with the factors associate with making the choice of “career change”. In the part of logic regression, only the factor of “career development” shows statistically signigficant. Conclusion: This study shows the factors why doctor make decision of “career change” to aesthetics medicine. Aesthetics physicians have siginicant increamental in salary compensation. According to the logistic regression, the factor of “career development” has positive correlation with physicians who abdan their original specialty.