台灣整形外科醫師的執業滿意度

Abstract

健保制度實施以及美容醫學的興起，使得台灣整形外科醫師在選擇執業場所時有了不同的考慮。所謂執業場所即衛生部定義的醫療機構，包括大型醫院、中型醫院、大型診所、中型診所、小型診所、及單人診所。這些醫療機構都希望能夠找到好的人才並留任之。要達成這個目標首先我們必須了解整形外科醫師對他們執業的滿意度，然後找出影響滿意度的變數有那些，這樣才能夠改善自身的缺點並放大優點來吸引人才。首先我們設計一份有20個問題的問卷，包括受訪者的基本資料、服務的醫療機構、滿意度、是否曾經換過醫療機構、如果有的話原因為何、專長的手術項目與比例、專長的美容醫學項目、嚮往的醫療機構、以及留任原職的原因。由整形外科醫學會協助發放問卷，從2022年8月30日開始通知會員填寫，至2022年10月31日截止共收到148份有效問卷，回覆率為19%。統計的方法包含單項變數與滿意度之間使用單因子變異數；留任原職的原因以及嚮往的醫療機構是用卡方檢定；最後使用多元邏輯斯回歸計算各個變數與滿意度的關聯，統計顯著性差異的閾值為p< .05。結果發現年齡和服務的醫療機構是影響滿意度最重要的因素，而性別、執業地點、和手術專長則沒有顯著影響。留任原職位的原因在不同醫療機構間有顯著性差異。而醫師最嚮往的醫療機構則是2～5位醫師所組成的小型診所。

After the implementation of the National Health Insurance system and the rise of aesthetic medicine, plastic surgeons in Taiwan have different considerations when choosing their workplace. The term"workplace" refers to medical institutions defined by the Ministry of Health and Welfare, including large hospitals, medium-sized hospitals, large clinics, medium-sized clinics, small clinics, and solo clinics. All these medical institutions hope to find and retain talented individuals. To achieve this goal, we must first understand the satisfaction of plastic surgeons with their work and then identify the variables that affect their satisfaction, so that we can improve our own shortcomings andamplify existing strengths to attract them. We designed a questionnaire consisting of 20 questions, including respondents' basic information, the medical institution they serve, satisfaction level, whether they have changed medical institutions, reasons for changing if applicable, proportion of specialized surgeries, areas of expertise in aesthetic medicine, desired medical institutions, and reasons for staying in their current positions. The Taiwan Society of Plastic Surgery (TSPS) notified its members that they had to complete the questionnaire from August 30, 2022 to October 31, 2022. A total of 148 valid questionnaires were received, resulting in a response rate of 19%. Statistical methods used included one-way ANOVA to analyze single variables and satisfaction, chi-square test for reasons for staying in current positions and desired medical institutions, and finally, multivariate logistic regression to assess the association between various variables and satisfaction, with a significance threshold of p< .05. The results revealed that age and the medical institution served were the most significant factors affecting satisfaction level, while gender, practice location, and surgical specialization had no significant impact. The reasons for staying in current positions varied significantly among different practice institutions, and the most desired medical institution was a small clinic composed of 2-5 physicians.