臺灣中醫傷科人才養成及業務發展之調查分析

Investigation of personnel training and occupational activities in Chinese Traumatology in Taiwan

傷科業務約佔中醫門診的三成，但專力投入傷科之中醫師相對不足，為了解傷科人才養成及業務相關問題，本研究以問卷訪談146 名中醫系實習醫學生及160 位中醫師，結果如下：有意願從事傷科的學生佔了8.9%，興趣為最重要之因素；無意願者之考量包括：體力、性別、志趣不合及對傷科業務不熟悉等；改善教學有助於提高選擇意願。本文定義之傷科醫師（佔28.8%）與非傷科醫師之不同在於：執業前以師徒傳承及由研討會學習較多；而執業後較多以與傷科同儕切磋、專家指導及讀書會等繼續進修。傷科醫師推拿比重大於50% 者有39.2%，而非傷科醫師僅10.5%。中醫師普遍認同傷科之優勢為：病患需求高（72.8%）、代表中醫特色及臨床療效佳（各55.7%）；但治療時間長（41.3%）、技術難度高（41.9%）、醫療風險高（43.8%）及收入低（66.9%）則為其劣勢。過半中醫師認同：增加收入、培訓師資及增開進修課程等有利於傷科業務發展。本研究由教育及業務面探討傷科相關發展，獲致結論如下：改善教育訓練，可能提高學生執業傷科意願；提高給付、培育師資及增開進修課程等，可能有利於傷科業務發展。The proportion of outpatient services about traumatology is approximately 30 percent in outpatient services of Traditional Chinese Medicine (TCM). However, there are few TCM doctors specializing in traumatology. To comprehend the problems for training traditional Chinese traumatology physicians (CTPs) in Taiwan, this study interviewed 146 students of the department of TCM and 160 TCM physicians by questionnaires, and the result is as following: 8.9 percent of these students took traumatology into consideration as their future career. Interest is an important factor for selection. The comprehensive factors of excluding traumatology include physical vigor, gender, conflicting inclination, and unfamiliarity with the clinical condition of traumatology. Improving the education and training programs may encourage more students to become a CTP. CTPs defined in this study occupied 28% of all TCM physicians. Before graduated, the CTPs spent lots of time to learn traumatology from masters or joining in meeting. There were 39.2 percent of CTPs always practiced manipulations (tui-na); however, only 10.5 percent of non-CTPs did. TCM doctors overall agreed with the advantages of Chinese traumatology such as: highly demand (72.8%), specifically featured of TCM(55.7%) and well curative effects(55.7%); while the disadvantages included time-consuming treatments(41.3%), difficult techniques(41.9%), high risk with lower income(43.8). More than half of TCM doctors agreed that increasing revenue, training of teachers and additional education are conducive to business development in traumatology. This study discussed the development of traumatology in the aspect of teaching and business and the conclusion is as follows: improving the education and training programs might encourage students to select Chinese Traumatology as their profession. Higher income, cultivating more qualified teachers and setting up further education may be useful to promote Chinese traumatology.