| 摘要: | 背景：隨著醫療環境複雜化，醫師擔任醫療機構管理者的機會相對增加，傳統的醫學教育並未包含管理，主管職醫師多在擔任主管的歷程中自行摸索學習。
目標：了解主管職醫師同時兼顧臨床及行政管理工作的實況，以探討主管職醫師職涯路徑發展歷程以及其中所付出的努力為研究目的。
方法：採質性研究，以半結構式來確認受訪者職位的變動歷程與一對一訪談的方式來探詢其職位變動的個人準備、經驗與成熟歷程。樣本的選取係以配額抽樣方式選出15位擔任醫療機構院長或副院長之醫師，其中醫學中心3位，區域醫院4位，地區醫院4位，診所4位；完成資料蒐集後，以開放性編碼方式進行資料整理與分析。
結果：主管職醫師的職涯歷程分為五個階段「Pre-preparation」、「Role taking」、「Experience」、「Maturation」、「Inheritance」。職涯路徑分為「受雇於醫院→受雇於醫院」、「受雇於醫院→開業」及「開業→受雇於醫院」三種類型。在其歷程中所付出的努力則以「對人」、「對制度」、「對自我」及「對外部」四個面向為主，包括解決員工的問題、員工權益的維護及創造、建立完善的制度與教育訓練、自我分析檢討、穩固與外界的連結。
結論：不同醫院層級的主管在五個階段的呈現有多寡之差異，而三種類型的主管職醫師皆依循五個階段的職涯歷程。
Background : As the complexity of the medical environment, there have more chance for doctor to be a physician director in medical institutions. Medical education does not include management, they learn how to be a manager by himself.
Purpose : The study tried to understand the situation that physician director juggle between clinical and administration, in order to investigate the physician director’s career path and the efforts.
Method: The study is a qualitative design. The data were collected by semistructured interview. The study samples consisted 15 president or vice president of medical institutions; include 3physicians at medical center, 4 physicians at regional hospital, 4 physicians at local community hospital, 4 physicians at Clinics by quota sampling. Transcribed them and analyzed based on the code and coding.
Found: We found that there were five phases in physician director’s journey: “Pre-preparation”, ” Role taking”, ”Experience”, ” Maturation”, ” Inheritance”. Career paths include "employed by hospitals → employed in hospitals", "employed by the hospital → open" and "opening → employed Hospital" three types. The journey of the effort places "for people", "institutional", "self" and "external" four terms, including solving problems of employees, maintenance and creation of employee''s rights, the establishment of a sound system and education and training, self-analysis, firm with the outside world.
Conclusion: Different levels of hospital directors presented the difference in the amount of five stages, and the hospital directors follow the course of the five stages of career paths. |
