- 學位論文
不同勞動身分醫師退休規劃之研究
A Study of Retirement Planning of Physicians with Different Labor Status
摘要
背景：我國於2018 年進入高齡社會加上全球生育率倒數第一，使得人口老化、勞動力對於國家社會、醫療等各個層面都造成衝擊。醫師的退休計劃對醫療保健系統具有重大影響，且台灣的醫療資源分布不均，流失一位醫師可能對偏遠地區的醫療可近性造成嚴重影響。然而我國擁有不同勞動身分之醫師，開業醫師屬於僱主身分、而受僱醫師又可依受雇單位不同非為公保、軍保及勞保醫師，不同勞動身份的醫師擁有不同的退休金制度，身分責任及退休年齡皆有所不同。台灣面臨著人口老化和醫療資源不均等挑戰，醫師的退休計劃對於個人、病人和醫療體系都至關重要，本研究將針對各類勞動身份之醫師探討其對退休的看法和規劃。 目的：本研究探討不同身分別的主治醫師，是否會因為退休制度的不同及所擁有的身分限制而對退休有不同的看法及規劃，藉此來探討各身分別醫師退休的影響因子。 方法：本研究透過立意取樣及滾雪球方式進行10 位醫師之訪談，包含不同身份之退休及未退休醫師，並將訪談內容進行比對及歸納，找出影響各身份醫師退休規劃及影響因子。 結果：透過訪談得知，退休醫師對於退休皆有規劃與想像，不會貿然退休。共同點為害怕退休後失去重心、退化快速，皆願意擔任醫療志工。軍職醫師對於是否取得月退俸資格最為在意，在個人心理調適上也較其他身分醫師重要。開業醫師選擇退休的時間較其他身分醫師自由；而未退休醫師因年資及經濟等因素未有過多的規劃。影響各身份別醫師退休的因素共同因素為經濟、健康、家庭，並對退休金制度瞭解皆不深。軍職醫師在身分轉換上較為明顯、在意社會觀感、對制度不滿。勞保醫師較不在意退休金，職務變動較明顯。開業醫師不在意退休金，且多數未加入退休金制度。對於合理的退休年齡無統一共識，主治科別會影響退休年齡的選擇。 結論：根據本研究的結果，得知各身份別醫師的退休影響因子與多數人相同：健康、經濟及家庭因素。針對可改善的面向進行檢討改進，如減少醫師的工作壓力及工作帶來的身體傷害、改善醫師的金錢觀念、協助醫師在工作及家庭間取得平衡及妥善進行退休後身份轉化及心理調適，針對可改善的面向進行檢討改進，提供醫師退休規劃的方向。
並列摘要
Background: Taiwan entered an aged society in 2018, coupled with a global birth rate ranking at the bottom. This has led to population aging, and the impact of the labor force on various aspects of the nation, including society and healthcare. The retirement plans of physicians have a significant impact on the healthcare system, and in Taiwan, the uneven distribution of medical resources is evident. The loss of a physician could severely affect the accessibility of medical services in remote areas. Taiwan has physicians with different labor statuses; practicing physicians have an employer status, while employed physicians may be covered by different insurance schemes, including public insurance, military insurance, and labor insurance. Physicians with different labor statuses have different retirement pension systems, responsibilities, and retirement ages. Taiwan is facing challenges such as an aging population and unequal distribution of medical resources. The retirement plans of physicians are crucial for individuals, patients, and the healthcare system. This study aims to explore the views and plans for retirement among physicians with various employment statuses. Objective: This study investigates whether attending physicians with different labor status have varied perspectives and plans for retirement due to differences in retirement systems and identity-related restrictions. The aim is to identify influencing factors on retirement planning for physicians with different labor status. Methods: Through purposive sampling and snowball sampling, interviews were conducted with ten physicians, including those of different retirement statuses and categories. The interview content was compared and summarized to identify influencing factors on retirement planning for physicians of different categories. Results: The interviews revealed that retiring physicians generally have plans and expectations for retirement and do not retire hastily. Common concerns include fear of losing purpose and rapid deterioration post-retirement, and a willingness to engage in medical volunteering. Military physicians are particularly concerned about qualifying for a monthly retirement allowance and find psychological adjustment more critical than other categories. Solo practitioners have more freedom in choosing retirement time, while non-retired physicians have limited planning due to factors such as seniority and financial considerations. Common influencing factors on retirement planning for physicians of different categories include economic, health, and family considerations, with limited understanding of retirement pension systems. Military physicians show more noticeable identity transitions, societal perception concerns, and dissatisfaction with the system. Labor insurance physicians are less concerned about retirement pensions and experience significant job role changes. Solo practitioners show little concern for retirement pensions, with most not participating in retirement pension systems. There is no unified consensus on a reasonable retirement age, and the chosen retirement age is influenced by the specialty. Conclusion: Based on the study results, influencing factors on retirement planning for physicians with different labor status are similar to those for the general population: health, economic, and family factors. Addressing aspects that can be improved, such as reducing physician work stress and associated health risks, improving financial perspectives, assisting physicians in achieving work-life balance, and facilitating successful identity transitions and psychological adjustments after retirement. A review and improvement of areas that can be enhanced are suggested to provide a direction for physician retirement planning.