新興的醫療工作角色與權限？醫師眼中的醫師助理(Physician Assistant)角色

New Medical Work Role and Jurisdiction?- Physicians' View of Physician Assistant

陳端容(Duan-Rung Chen)

《醫護科技學刊》 3卷1期 (2001/01) Pp. 84-110

https://doi.org/10.6563/TJHS.2001.3(1).6

摘要

本論文探討醫師對醫師助理工作角色與工作權限的認知，以及其對醫師助理制度的評估。我們以88年5月醫師公會全國聯合會記之執業醫師名冊中，服務於地區教學醫院以上醫院內、外、婦、兒、泌尿科、神經外科、整型外科、骨科、神經科的醫師，以分層隨機抽樣方式選取受訪醫師，採郵寄問卷收集資料，共發4016份問卷，回收558份，回收率13.9%為。在本研究樣本中，有近七成的醫師（68%）支持成立醫師助理制度，亦有近6成（59.7%）的醫師曾與醫師助理共事，大部分醫師對於醫師助理工作權限有相當的共識。「醫師助理」可以分擔醫師醫療工作中較為常規性的工作，可經由法制化培訓，在沒有醫師親臨監督下，執行部分醫療工作，並成為專業工作角色。與醫師助理有共事經驗的醫師或醫師知道其他醫院設置醫師助理一職對醫師助理制度有較正面看法，亦較支持醫師助理發展成一個「專業」的工作角色。任職於醫學中心等大型的醫院醫師傾向設置專業化的「醫師助理」制度，而年輕的醫師亦較為支持醫師助理制度。醫師憂慮醫療糾紛責任界定不易。醫師對醫師助理工作權限應由醫師來主導與控管，與專科護理師的培訓有所不同。

關鍵字

醫師助理 ； 工作權限 ； 醫師

並列摘要

This study aims to1) understand physicians’ attitudes toward the practices of physicians’ assistants; 2) explore factors which determine those attitudes. A self-administered questionnaire is mailed to general internal medical physicians, neurologists, general surgeons, neurosurgeons, orthopedic surgeons, urologists, gynecologists, obstetricians and pediatricians. The response rate is 13.9%. Statistical methods employed include descriptive analysis, and analysis, and multivariate regression analysis. Important findings are as follows. 1) Most physicians surveyed present a consensus on the appropriate medical practices that physician assistants should be allowed to perform. Those practices include inserting Ⅳ set, looking after catheter tubes, tending wounds, inserting urethral catheters, preoperative and postoperative care, gathering data during patient hospitalization, writing patients’ records under the supervision of attending physicians, and serving as assistants in the operating room, and etc. 2) Physicians experienced in working with physicians’ assistants or who are knowledgeable of physician assistants’ practices tend to prefer to have them professionalized and legally certified.

並列關鍵字

physician assistant ； job jurisdiction ； physician