外科醫生過勞

Burnout among Surgeons

賴昭翰(Chao-Han Lai) ； 李政昌(Jenq-Chang Lee)

《台灣醫學》 19卷5期 (2015/09) Pp. 479-485

https://doi.org/10.6320/FJM.2015.19(5).05

摘要

台灣外科醫師過勞已經是普遍現象。這個問題在接受訓練的住院醫師尤其嚴重，也因此畢業後醫學生不願意進入外科。最近衛生福利部開始限制住院醫師工作時間。在這篇報告中，我們想要利用回顧文獻與其他國家經驗來更清楚了解這個政策的衝擊。我們試圖分析限制外科住院醫師工作時間的好壞處，並提出我們對於執行這項政策的提醒。我們也提出募集年輕主治醫師與專科護理師的計畫來解決教學醫院醫師短缺。這些方法也許能夠對降低台灣外科醫師過勞有些幫助。

關鍵字

外科醫師 ； 工作時間 ； 外科住院醫師 ； 畢業後醫學教育 ； 外科主治醫師 ； 專科護理師 ； 台灣醫療制度

並列摘要

Overwork due to long work hours has been a common feature of surgeons in Taiwan. This problem is particularly severe for residents-in-training, and thus post-graduate medical students become unwilling to enter surgery residency training programs. Recently, the Ministry of Health and Welfare began to restrict resident work hours. In this reports, we aim to gain perspective on the impact of this policy based on review of the literature and experiences in other countries. We attempt to analyze the advantages and pitfalls of limiting surgical resident work hours. We also propose schemes with recruitment of young attending surgeons and nurse practitioners to resolve doctor shortages in teaching hospitals. These actions might help attenuate over-fatigue among surgeons in Taiwan.

並列關鍵字

surgeon ； work hour ； surgical resident ； post-graduate medical education ； attending surgeon ； nurse practitioner ； healthcare system in Taiwan

參考文獻

Osborne MP: William Stewart Halsted: his life and contributions to surgery. Lancet Oncol 2007;8:256-65."

Friedman RC, Bigger JT, Kornfeld DS: The intern and sleep loss. N Engl J Med 1971; 285:201-3."

Fabricant PD, Dy CJ, Dare DM, et al: A narrative review of surgical resident duty hour limits: where do we go from here? J Grad Med Educ 2013;5:19-24."

Landrigan CP, Rothschild JM, Cronin JW, et al: Effect of reducing interns' work hours on serious medical errors in intensive care units. N Engl J Med 2004;351:1838-48."

Petersen LA, Brennan TA, O'Neil AC, et al: Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med 1994;121:866-72."