西進台灣醫師慌不慌？談台灣跨海執業醫師在中國醫療環境的發展與調適

Will Taiwanese Physicians Feel Panic？The Career Development and Professional Adaptation of Taiwanese Physicians Who Practice in Mainland China

王彥喬(Yen-Chiao Wang)

指導教授 ： 李淑娟 ； 陳端容

國立臺灣大學/社會科學院/新聞研究所/碩士(2015年)

https://doi.org/10.6342/NTU.2015.02363

摘要

台灣的醫療執業環境惡化，對醫護人員形成推力，媒體陸續報導中國以高薪向台灣醫師挖角；由於醫療人才的養成，除了個人，國家、社會也須付出高成本，這些醫療人才到同文同種、制度迥異的大陸執業，究竟發展如何? 卻少見報導完整揭露台灣醫師西進後的職業調適情形。

本篇深度報導目的即基於上述謎題，想進一步追蹤報導台灣醫師西進後，在大陸執業和發展情形；當時以十三億人口醫療市場為發展腹地的動機，是否真如所願？還是看得到、未必吃得到? 本文為了探詢答案，以台灣醫師西進發展情形，反映兩地醫療制度、醫病關係各方面的差異比較，在兩地深入採訪三十餘位醫師及相關受訪人，以第一手訪談資料，從事深度報導，探討台灣醫師在中國大陸執業困境，並針對困境分析及提出建議改善方向。

台灣醫師西進中國大陸發展，面臨的調適問題包括：兩岸醫師職稱不對等，法令規範各醫師職級能施展的醫療技術，連帶也影響了台灣資深醫師赴大陸所能施治項目；另外，台醫晉升困難、對岸醫師社會地位不如台灣、民營醫療單位經營困難、高端自費病人人脈培養不易、與對岸醫護團隊工作思維不同，時有磨擦，加上醫病關係與台灣有別等，都使得台灣醫師在中國大陸發展受阻，甚而興起「不如歸去」念頭或放棄當時至對岸施展的雄心壯志，直接返台。

當前中國大陸的醫療資源比起民眾需求，仍遠遠不足，西進的台灣醫師要在異地生根，歸結這些曾在當地發展的醫師經驗，有「三本」條件，即本人深蹲該地市場、本錢打造軟硬體、本事吸引病人，是台醫在對岸生存的條件；一般預測大陸人才濟濟，儘管目前對岸整體醫護水準仍難與台灣匹敵，但在三到五年內，將快速超越台灣的醫療專業、管理與服務優勢，屆時西進台醫若沒有開創自我生存之道，將難以立足。

關鍵字

台灣醫師 ； 民營醫療 ； 醫病關係 ； 醫療市場 ； 深度報導

並列摘要

As Taiwan’s medical work environment begins to worsen, it is starting to push its medical worker to leave the country in search of better work opportunities and environment. Media reports that there has been a trend of corporate hospitals from Mainland China poaching the skilled Taiwan’s physician with competitive high salaries. As the progression and development of a health care worker takes much more than just an individual contribution and cost factor, it also takes the combined efforts from the country and society. With the leaving of these Taiwanese trained physicians to Mainland China, they may appear to be working under a similar culture and same language system. However, they are in a different institutional system, their occupational life is bound to be impacted. How should these professionals adapt to the differences? Unfortunately, with regards to this matter, media is rarely reporting it.

This in-depth report is base on the above question. It would focus on the development after the big move to China. Upon the lure to move on to a country with the possibility of profiting from this mega population of 1.3 billion people. Did these Taiwanese physicians finally succeeded in getting a share in this booming industry? Or has it been just a dream after all? In order to find the answer, this thesis presents finding from Taiwan’s physician who practice in Mainland China. It will be focusing on the comparison of medical system, physician-patient relationship etc. For this report, I had interviewed around thirty physicians and related respondents. Through face-to face interview, I would be asking them to share with me on the difficulties that they faced throughout this move. With substantial findings and data, I had analyzed and provided suggestions.

Taiwanese physicians may have a hard time adapting when they practice in Mainland China. This would includes: The unequal of physician title in both cross-strait medical environment, according to the law governing Taiwan’s physicians, they are not allowed to do surgeries if they do not hold the related title. Taiwanese physicians may also face difficulty when it comes to Job progression or promotion. There is also the issue that China’s physician social status is inferior as compared to Taiwan. Furthermore, it is hard to operate a privatized hospital and come in contact with high-end private patient. Moreover, different working method would create friction. Also, the physician-patient relationship is different from that in Taiwan. The above are the common obstacles that Taiwanese physicians faced while they practiced in China, resulting in them giving up their career in China, and returning home to Taiwan.

Nevertheless medical demand is still bigger than supply in China. Taiwanese physicians survive in China are based on three elements: manage the medical business on your own, invest money to build up on hardware and software, and build up contacts and to ensure that they have the ability to attract more patients. At this present moment, Taiwan may still be at an advantage in the medical profession, but with the huge number of talents from China, Many has predicted that China would surpass Taiwan within the next three to five years. Therefore, if Taiwanese physicians don’t create a self-survival rule, it will be difficult for them to gain a foothold.

並列關鍵字

Taiwanese physicians ； privatized hospital ； physician-patient relationship ； medical market ； in-depth report

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