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History, Present Status, and Existing Straits of Physical Therapy in Taiwan

台灣物理治療之歷史、現況與困境

摘要


本文回顧台灣物理治療的發展,並闡述其現況,且對現存的困境加以探討。物理治療發展史可分為啟蒙期(1950's-1966)、奠基期(1967-1981)、建構期(1982-1998)、穩固期(1999至今)等四期。台灣物理治療雖濫觴於1950年代且在1967年即在臺灣大學設系,但直到1995年方通過物理治療師法來保障其權益。該法對物理治療師的養成教育與醫療環境極具衝擊,進而改變其執業生態。截至2010年7月底以前,台灣的百萬人口有146.8名物理治療師,大多來至大學層級之培育。目前共有9所一般大學與2所科技大學提供學士級物理治療師養成教育課程,每年招生約570名。至於高階教育,共有5所大學設有物理治療碩士課程及4所設有博士課程。中華民國物理治療學會與其他各層級物理治療師公會每年提供超過50個繼續教育課程給臨床治療飾研習。從2007年起,物理治療師每六年需維持一定的繼續教育學分方能換照。而剛畢業者須在教學醫院進行二年期物理治療師訓練。目前台灣物理治療面臨的困境是缺乏工作自主權、不公平的健保支付制度、以及病患無法直接就診,導致潛在人力過剩的危機。在現行環境下的解決之道包括改革養成教育、倡導實證執業、建立自主的物理治療部門等等。物理治療師如能擁有工作自主權與病患直接就診權則有助於物理治療服務品質的維繫。

關鍵字

物理治療 歷史 人力 教育 法律 執業

並列摘要


This article reviewed the development and present status of physical therapy (PT) in Taiwan as well as outlined the current encountered straits in PT practice and their possible solutions. The PT development in Taiwan was divided into four periods: the initiation period (1950's-1966), the foundation building period (1967-1981), the construction period (1982-1998), and the consolidation period (1999-present). Although it was developed in the 1950's and the first entry-level PT program was founded in 1967, the Physical Therapist Act was not promulgated until 1995. The amelioration of education and health care environments following promulgation of the Act substantially impacts development of this profession, further alters ecology of PT practice. By the end of July of 2010, there were 146.8 practicing physical therapists per million of population in Taiwan. Nine general universities and two universities of technology offer entry-level baccalaureate PT programs currently and enroll approximately 570 students per year There are five master and four doctorate PT programs providing advanced PT education to date More than 50 professional continuing education courses are held per year. For quality assurance of PT practice, requests of credits of continuing education for license renewing every six year and attendance of two-year PT residency training program in the teaching hospital for new licensed physical therapists commenced in 2007. Lack of autonomous practice, unavailable direct access, and unfavorable imbursement system are three existing straits that result in potential oversupply of PT manpower. The possible solutions under the present health care system and environment are suggested, including the reform of entry-level professional programs, the utilization of evidence-based practice, and the foundation of an autonomous PT department in the hospital. To be entitled to autonomous practice and direct access is highly suggested since an appropriate model of PT practice may enable the client to obtain a high-quality health care.

並列關鍵字

Physical Therapy History Manpower Education Law Practice

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