大型醫院主管職的生涯路徑與醫師職場結構
Pathways to Large-scale Hospital Director and Physician Labor Markets
作者:陳端容(Duan-Rung Chen) | 首次發表於 2020-07-01 | 第 33 期 December 2004
DOI:https://dx.doi.org/10.6786/TJS.200412_(33).0003
研究論文(Research Articles)
論文資訊 | Article information
摘要 Abstract
台灣醫師人力多集中在大型醫療機構,醫師想在大型機構如醫學中心或區域醫院中取得醫療主管職相當困難。什麼因素構成醫師取得主管職的機會結構未有具體研究。本研究旨在探討在控制個人背景因素後,醫學系背景、進階學位、或醫師生涯選擇(優勢科別與生涯路徑選擇),以及工作經歷(轉換不同任職機構次數)對醫師取得正副院長職是否有關。以台灣90家醫學中心與區域教學醫院歷、現任內科、外科、婦產科、小兒科、骨科之科部主任及正副(醫療)院長為對象,以衛生署所提供之「醫事人員執業異動資料檔」,取得醫師生涯路徑流動資料。
研究結果顯示,在大型醫院擔任科部主任與正副院長職醫師以男性為主,平均年齡約50歲。醫師取得大型醫院正副院長職與下列因素有關:年齡、名校文憑、進階學位、外科背景,以及選擇公立醫院體系為生涯路徑。醫師擁有名校文憑具有明顯競爭優勢,然其部分導因於名校與勞動職場的製度性連結。醫師勞動職場呈現區隔化與集結化特性。在不同的醫院市場區塊中,醫師由科部主任升任正副院長職的條件不同,顯示組織的市場位置會與組織內人員升遷機會有關。

關鍵字:醫師職場、主管職、生涯路徑 

 
About two-thirds of all Taiwanese physicians are employed in large hospitals, making it increasingly difficult for general physicians to move into a limited number of high-level managerial positions, including hospital CEO positions. The author examines factors associated with getting managerial positions in large-scale hospitals, based on data gathered from 90 such institutions throughout Taiwan. A dataset on physician job history is examined and matched to determine the career patterns of managerial physicians at these institutions. The results show that these physicians are primarily males in their late 40s and early 50s with degrees from highly selective medical schools. Other factors associated with physicians in managerial positions include surgical backgrounds and career patterns focused on public hospitals. Some of these results can be explained by the signaling effect of prestigious medical schools, while others can be attributed to strong institutional links between prestigious school-based hospitals and other hospitals. The physician labor market is characterized by segmentation and clustering. Success factors associated with physicians in managerial positions are different for different market segments, indicating that an organization's market stance exerts an influence on internal employee promotion mechanisms.

Keywords: physician labor market, hospital directors, career lines