專業團體分化的困境與出路－以口腔衛生人員為例

Challenges and Opportunities of Division of Work in Professional Groups: A Case Study of Oral Hygiene Care Personnel

郭淑珍(Shu-Chen Kuo)

《人文社會與醫療學刊》 8期 (2021/05) Pp. 85-101

https://doi.org/10.6279/JHSSM.202105_(8).0005

摘要

現代社會專業團體之所以興盛，主要是因知識和科技的快速進展、工作內容的分化、以及市場需求增加有關。在台灣，口腔照護領域相關職業中，牙醫師是第一個發展出專業地位的職業，當其他新興團體如要出現，就要與牙醫師團體做權力競爭。口腔照護輔助人員的出現，第一個是牙體技術人員，相關法案－－「牙體技術師法」是2009年三讀通過，將牙體技術人員從勞工轉為醫療人員，正式開啟台灣口腔醫療照護體系的專業分工，確立牙醫師是此領域內的管理者，如今「口腔衛生人員法」代表口腔照護領域又要有新的輔助團體產生。「口腔衛生人員法」法案於2017年12月18日在立法院初審通過，原本預定2017年12月29日就要三讀通過，然而法案推動過程牙醫界對此法案沒有共識，目前進入政黨協商。在專業團體進行分化的過程中，新的專業團體從原本專業團體的工作領域劃分部分業務範圍，不可避免會產生利益衝突，牙醫界對此法案的疑慮與爭議包括有：口腔衛生師之工作是否會與牙醫師工作有部分重疊，導致「密醫」出現，原本在診所協助牙醫師工作的牙醫助理和口腔衛生師的工作又該如何界定、劃分，以及原本牙醫助理工作權益是否受到影響等。本文將從民眾口腔健康需求、牙科臨床輔助人員的重要性、以及牙醫專業分化的歷史面向，探討口腔照護體系是否需要新的專業團體－－口腔衛生人員。從專業化的角度與過往的經驗，牙醫師與相關團體競爭主導「口腔衛生人員法」，是牙醫師專業化的一部分，也是再次確定牙醫師對於口腔照護領域的管理與支配。

關鍵字

牙醫師 ； 牙醫助理 ； 口腔衛生人員 ； 口腔衛生人員法 ； 專業

並列摘要

Professional groups are prevalent in modern society mainly because of the rapid development of knowledge and technology, diversification of work content, and increase in market demands. In Taiwan, in jobs related to oral hygiene care, dentists are the first group to consolidate their professional status in the industry. When other groups emerge, they need to compete with the dentist group. Oral health care assistance personnel emerged first in the form of dental technicians. The third reading of a relevant act, Dental Technicians Act, was passed in 2009. This act converted dental technicians from laborers to medical personnel, declaring the start of professional division of work in the oral hygiene care system in Taiwan and identifying dentists as the management level of the field. The emerging Oral Hygiene Care Personnel Act suggests that another new assistance group in the oral care field will emerge. The Oral Hygiene Care Personnel Act passed the first reading on December 18, 2017. The act was scheduled to pass the third reading on December 29, 2017; however, the dentist sector did not reach a consensus over the Act implementation process and the Act is currently in the party negotiation process. In the division of labor in professional groups, new professional groups will cover part of the original operation scope of existing professional groups, inevitably causing conflicts of interests. Dentists' concerns and disputes over the Act include: (1) whether the scope of work of oral hygiene care personnel overlaps that of the dentists, thereby causing the emergence of ＂uncertified dentists＂; (2) how to define and separate the work of dental assistants, who originally assist dentist works in clinics, and the work of oral hygiene care personnel; and (3) whether the work rights of dental assistants are affected. This study explored whether the new professional group, namely oral hygiene care personnel, is required in the oral care system from the perspectives of the public's oral health needs, clinical dental assistants' importance, and historic division of work in dentists. From professional perspectives and previous experience, the competition between dentists and relevant groups over the dominance in Oral Hygiene Care Personnel Act highlights a segment of professionalism in dentists and further confirms the management and dominance of dentists in the oral care field.

並列關鍵字

dentist ； dental assistant ； oral hygiene care personnel ； the Oral Hygiene Care Personnel Act ； profession