行醫年資與轉科意願

Medical Doctors’ Practicing Years and Switching Intention

本研究於民國94年以中部某區域醫院為調查對象，探討受訪醫師對健保制度的看法，以及他們的轉科意願。資料分析引進「年資變項」，比較資淺（行醫年資≦12年）與資深（行醫年資＞12年）的差異。發現樣本裡的資深外科醫師，僅有31.58％願意留在外科，卻有高達42.11％想轉到眼、耳、皮膚科。即使資淺的外科醫師，也僅有53.33％願意繼續留在外科。除了外科醫師外，本研究亦討論內科醫師的轉科意願，並比較資淺與資深醫師的差異，發現「若有機會願選其他科系」或「若有機會願選眼、耳、皮膚科系」，顯著的差異來自資深vs.資淺，遠甚於來自內科vs.外科。資深醫師比資淺者更想選其他科，而無論內科或外科，資深者都比資淺者更想轉到眼、耳、皮膚科。轉科意謂「用腳投票」，源自工作極不滿足，我們引用激勵原理的「公平理論」加以詮釋，並介紹工作評價之相對價值、可酬因素等觀念。

This study intends to investigate medical doctors’ perception on NHI and witching intentionamong various departments. Questionnaires were distributed to doctors from a regional hospital in 2005.Practicing years were classified into junior (≦ 12 yrs) vs. senior (＞ 12 yrs) groups. Only 31.58% of thesenior surgeons intended to remain in surgical department; 42.11% of them wished to switch to thedermatology, ophthalmology or ENT. Only 53.33% of the junior surgeons intended to remain in surgicaldepartment. The switching intention of internal physicians was also investigated. It was found thatseniority (senior or junior) explains switching intention better than departmentation (surgeon orphysician). Intention to switch reflects job dissatisfaction. Equity theory of motivation behavior canbe used to explain the high switching intention. Comparable worth and compensable factors from jobevaluation were also discussed.