醫師對網路爆料醫療爭議的態度與因應策略之探討

研究目的　　「社群網站」蓬勃發展把爆料風氣推到最高點，社會上各行各業都被以放大鏡來檢視，包括醫療業。醫療爭議恐怕在還沒獲得真相還原前，就已經迅速延燒成為風暴。面對猶如空襲炸彈般的網路爆料醫療爭議，醫師到底該如何因應？研究方法　　本研究探討醫師對於網路爆料醫療爭議的態度與因應策略，面對如何做決定，是一個複雜的歷程。為了探討醫師的想法，本研究是以質性研究的方式進行，透過深度訪談來收集第一手資料。研究結果 1. 本研究發現醫師科別和任職醫院層級，顯著影響他們對網路爆料醫療爭議的態度和因應策略。共通性是遇到不實指控，都認為一定要及時出面回應，而醫學中心的醫師，偏向由院方出面按照程序解決，地區醫院和診所醫師，則傾向能私下跟病患溝通，在事件沒有擴大延燒前，先釋出善意解決爭議。 2. 網路爆料醫療爭議嚴重衝擊醫病關係！讓醫病間充滿猜忌與對立，因此衍生出防禦性醫療，如此骨牌效應，不但降低醫療品質，浪費醫療資源，更造成醫護、患者、社會的三輸。結論與建議　　本研究訪談的20位醫師都認為網路爆料醫療爭議確實造成困擾，甚至有不少醫師為求自保，另外花時間研讀法律，顯然醫療機構在處理醫療爭議時，還是讓醫師覺得不足。因此醫療機構因應網路時代來臨，應建立新的危機處理SOP，對於相關爭議的因應策略，也應增列為員工訓練計劃，提醒醫事人員在法律界限內做好自我保護。

關鍵字

網路爆料；醫病關係；醫療糾紛；社群媒體

並列摘要

Objectives 　　Social media blooms while users are accustomed to unveiling scandals or inside stories. Virtually all practices from all professions could be scrutinized under magnifying glasses. This phenomenon is especially commonplace in the field of medicine, where medical disputes on the internet very often explode into devastating wildfire even before justified investigations are initiated. In the face of such calamitous yet unstoppable strikes, how should health care providers cope? Methods 　　The qualitative study investigates the opinions and coping strategies of healthcare providers towards exposed medical disputes on social media, particularly factors affecting their decision making. In-depth interviews were conducted for twenty certified physicians to collect first-handed information. Ten parameters that delineate the physician’s demographic characteristics, years of practice, specialty, seniority of employment, levels of hospitals in practice, whether or not with management experiences were compiled and analyzed. Results 　　First, specialty and seniority of employment are two factors that significantly influence the interviewees’opinions and coping strategies towards exposed medical disputes on the internet. Regardless of levels of hospital practiced, all doctors agree that prompt response and clarification of untrue accusations are of prime importance. Legal actions should be implanted if necessary. Doctors from regional hospitals or medical centers usually comply to standard procedures led by the hospital’s legal departments. Doctors from local clinics tend to reconcile with the accusers in private before the event become catastrophic. 　　Secondly, internet medical scandals tremendously sever doctor-patient relationships, which are now full of skepticism and conflicts. Physicians would rather devote their time and energy on treating patients in true medical needs. In contrast, a vicious cycle results from defensive medical practice that lowers patient care quality and increases medical resource wastage. No healthcare providers, patients or the society in general benefit from such scenarios. Conclusion 　　This study showed that exposing medical disputes on the internet is unstoppable and medical scandals on social media have caused great distress. Apparently, physicians still fell short in medical dispute coping abilities. Hospitals are advised to build new standard operative procedures(SOP) managed by a specialized multidisciplinary team to solve medical crisis on the internet. To cope, physicians need a renovated multidisciplinary team that incorporates lawyers, social workers and publicists specialized in media manipulations. Doctors could consult with lawyers at the beginning if legal issues exist; social workers could aid in understanding the accusers’ motives and appeals; while publicists straighten untrue accusations through available media in time to protect healthcare providers’ dignity and the hospital’s reputation.