Willingness of Government-Sponsored Physicians to Continue Practicing at Outer-Island Hospitals after Obligatory Service- A Case Study of Kinmen Hospital
Date Issued
2015
Date
2015
Author(s)
Fu, Yang-Hsien
Abstract
Medical resources are scarcer in the outer islands compared with the island of Taiwan. Of these, medical professionals are especially hard to come by, and many outer-island residents feel that there are health care disparities; government authorities have attempted to raise the willingness of government-sponsored physicians to practice in the outer islands through government-sponsored training of physicians and policies giving preferential lengths of obligatory service in rural areas, in order to improve the proximity of outer-island residents to medical care, to achieve equality in health care, and care for vulnerable groups. Retaining physicians that meet the region’s needs allow outer-island hospitals to reduce patient referral rates and increase patient satisfaction, which ultimately enhances overall revenues. Therefore, retaining physicians is an important issue for outer-island hospitals. With the increase of tourism on the outer islands, transportation has improved, tourists come from both sides of the strait, economic development has flourished, and under government policies of “localized medical care”, outer-island hospitals have continuously purchased medical hardware, there is relative security of benefit payment points (values) from the National Health Insurance, and there is great growth potential for the medical industry; by contrast, hospitals on the island of Taiwan are dealing with issues of physician saturation and competition, promotion is difficult for physicians, and compensation received for the amount of work done is declining annually, a situation which is conducive to physicians’ willingness to continue practicing in the outer islands. Since its transition to an Executive Yuan, Department of Health hospital in 2005, Kinmen Hospital has relied heavily on government-sponsored physicians as its source of physicians. In recent years its physicians have generated substantial revenue growth; therefore, in order to sustain the management and development of Kinmen Hospital, there is a necessity to investigate the willingness of physicians to continue practicing at outer-island hospitals and thus form a retention strategy for the hospital. This a qualitative study conducted using in-depth interviews with government-sponsored physicians. The results of the study indicated that traditional individual factors such as personal attributes, career plans, organizational factors (for example, management systems, empowerment in management, promotional and compensatory policies), social support factors, and especially familial support and job satisfaction all affected the willingness of government-sponsored physicians to continue practicing on the outer islands; other than that, the “localized experience” of the outer islands was also an important disturbance variable, which could resolve the problems or obstacles of the aforementioned traditional factors, and by itself provide positive effects on physicians’ willingness to stay on the outer islands.
Subjects
government-sponsored physicians
outer-island hospitals
willingness to continue practice
Type
thesis
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