台灣中醫師人力規劃的初探

Taiwan Current Condition and Programming on Manpower of Chinese Medicine Doctor

劉麗偉(Li-Wei Liu)

《臺灣中醫醫學雜誌》 2卷1期 (2003/03) Pp. 62-70

摘要

目前台灣中醫師專門技術人員高等及特種考試中醫師考試每年產生許多中醫師。為避免台灣中醫師人力供給過利，中醫師人力成長情形必須妥善規劃，以免造成醫事人力浪費。根據衛生署之醫師人力規劃，理想中醫師數為每十萬人口為22名中醫師，但近年來在台灣，實際中醫師人數已迅速增加，且根據中醫師人力研究結果顯示，中醫師成長情形已比預期時間超前。中醫於2000年7月1日試辦總額支付制度後，若中醫師人力過利，將對健保總額支付費用產生稀釋作用；由於面對醫療全球化的衝擊，目前台灣中醫程教材及考試科目將逐漸不符新時代需求；尤其，台灣臨床教學醫院明顯不足，醫政治規嚴格限制中醫師使用現代化醫療設備，並限制中西醫擇一執業，影響中西醫療之結合，中醫師「教」、「考」、「訓」、「用」無法配合。針對在未來中醫師規劃方面，必須重新評估中醫師人力之供給與需求，推動增設中醫臨床見習、實習教學醫院場所、鬆綁中西醫雙登錄執業、開辦中醫健保住院給付，積極推動中醫臨床療效評估、醫政法規應開放中醫師使用現代化醫療設備、加強中醫師接受繼續教育與考核，加強教（教育部）、考（考選部）、用（衛生署）單位之結合，以共同規劃培育全理醫師人力，全面提昇中醫醫療服務品質，提供民眾更優質的健康照護。

關鍵字

中醫師 ； 人力規劃 ； 考試制度

並列摘要

At present, numbers of Chinese Medicine Doctor qualified and trained from many sources including the Approval/Evaluation Examination of Chinese Medicine Doctor, National High Examination For Professionals & Technicians, and Specialist Examination, etc. Therefore, the growth of manpower of Chinese Medicine Doctor must be controlled to avoid the increase in the physician-to-patient ratio. According to the programming of National Health Administration, the ideal number of Chinese Medicine Doctor is 22 doctors for the population of every one hundred thousand. But, in recent years, the number of Chinese Medicine Doctor is increased rapidly. According to the research on manpower of Chinese Medicine Doctor, it appears that the growth of Chinese Medicine Doctor is earlier ahead than the expectation. On July 1,2000, National Health Insurance Bureau formally gave an evaluation for implementation of the “total amount pay” system for Chinese Medicine. If the manpower of Chinese Medicine Doctors over surplus, then the payment carried out by National Health Insurance Bureau will be reduced for the individual physician. “Teaching”, “Examining”, ”Training” and “Application” for local Chinese Medicine Doctor are unable to cooperate. In addition, other problems may also appears, such as teaching materials for Chinese Medicine courses and subjects for examination are not in conformity with the requirement of modern time; clinical teaching hospitals are insufficient; the medical Business Law restricts Chinese Medicine Doctors to use modernized medical equipment; and limitation of alternative operation on both Western Medicine and Chinese Medicine affects the combination of Western Medicine and Chinese Medicine for therapy. Aiming at future programming on Chinese Medicine Doctor, we must re-as-sess on the supply and demand of manpower of Chinese Medicine Doctor, specify clearly increase experience of clinical practice on Chinese Medicine and practice in the teaching hospitals, admit the double practice license for both Western and Chinese Medicine, implement the hospitalization cost paid by National Health Insurance, promote progressively the clinic therapy assessment of Chinese Medicine, let Medical Business Law allow Chinese Medicine Doctor to use modernized medical equipment, normalize the training of manpower in Chinese Medicine Doctor based upon the regular education system, and stress on the united linking of teaching (Ministry of Education), testing (Ministry of Examination), applying (National Health Administration) to program together for the manpower.

並列關鍵字

Chinese Medicine Doctor ； Manpower Programming ； Examination System