Labarda Meredith P
School of Health Sciences, University of the Philippines-Manila in Palo, Leyte, the Philippines.
Asia Pac Fam Med. 2011 Oct 6;10(1):13. doi: 10.1186/1447-056X-10-13.
At the height of the global demand for nurses in the 1990s, a phenomenon of grave concern arose. A significant number of medical doctors in the Philippines shifted careers in order to seek work as nurses overseas. The obvious implications of such a trend require inquiry as to the reasons for it; hence, this cross-sectional study. The data in the study compared factors such as personal circumstances, job satisfaction/dissatisfaction, perceived benefits versus costs of the alternative job, and the role of social networks/linkages among doctors classified as career shifters and non-shifters.
A combined qualitative and quantitative method was utilized in the study. Data gathered came from sixty medical doctors practicing in three major hospitals in Tacloban City, Philippines, and from a special nursing school also located in the same city. Respondents were chosen through a non-probability sampling, specifically through a chain referral sampling owing to the controversial nature of the research. A set of pre-set criteria was used to qualify doctors as shifters and non-shifters. Cross-tabulation was carried out to highlight the differences between the two groups. Finally, the Wilcoxon-Mann-Whitney test was utilized to assess if these differences were significant.
Among the different factors investigated, results of the study indicated that the level of job satisfaction or dissatisfaction and certain socio-demographic factors such as age, length of medical practice, and having children to support, were significantly different among shifters and non-shifters at p ≤ 0.05. This suggested that such factors had a bearing on the intention to shift to a nursing career among physicians.
Taken in the context of the medical profession, it was the level of job satisfaction/dissatisfaction that was the immediate antecedent in the intention to shift careers among medical doctors. Personal factors, specifically age, support of children, and the length of medical practice gained explanatory power when they were linked to job satisfaction or dissatisfaction. On the other hand, factors such as perceived benefits and costs of the alternative job and the impact of social networks did not differ between shifters and non-shifters. It would then indicate that efforts to address the issue of physician retention need to go beyond economic incentives and deal with other sources of satisfaction or dissatisfaction among practicing physicians. Since this was an exploratory study in a particular locale in central Philippines, similar studies in other parts of the country need to be done to gain better understanding of this phenomenon at a national level.
在20世纪90年代全球对护士需求达到顶峰时，出现了一个令人严重关切的现象。菲律宾大量医生转行去海外寻求护士工作。这种趋势的明显影响需要探究其背后的原因；因此开展了这项横断面研究。该研究中的数据比较了个人情况、工作满意度/不满意度、对替代工作的感知收益与成本，以及在转行医生和未转行医生中社会网络/联系的作用等因素。
该研究采用了定性与定量相结合的方法。收集的数据来自菲律宾塔克洛班市三家主要医院的60名执业医生，以及该市的一所特殊护理学校。由于研究具有争议性，通过非概率抽样，具体是链式推荐抽样来选择受访者。使用一组预先设定的标准将医生分为转行和未转行两类。进行交叉制表以突出两组之间的差异。最后，使用威尔科克森 - 曼 - 惠特尼检验来评估这些差异是否显著。
在调查的不同因素中，研究结果表明，工作满意度或不满意度水平以及某些社会人口统计学因素，如年龄、医疗执业时长和需抚养子女情况，在转行医生和未转行医生之间存在显著差异（p≤0.05）。这表明这些因素与医生转行从事护理职业的意愿有关。
从医学专业的背景来看，工作满意度/不满意度水平是医生转行意愿的直接前因。个人因素，特别是年龄、子女抚养情况和医疗执业时长，在与工作满意度或不满意度相关联时具有解释力。另一方面，转行医生和未转行医生在对替代工作的感知收益和成本以及社会网络的影响等因素上没有差异。这表明解决医生留用问题的努力需要超越经济激励，还要处理执业医生其他的满意度或不满意度来源。由于这是在菲律宾中部一个特定地区进行的探索性研究，需要在该国其他地区开展类似研究，以便在国家层面更好地理解这一现象。
