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医生与社会:泰国北部的一项研究。

Doctors and society: a Northern Thailand study.

作者信息

Smith H E

出版信息

Soc Sci Med. 1982;16(5):515-26. doi: 10.1016/0277-9536(82)90305-7.

Abstract

This paper presents findings from a survey together with other observations to characterize the medical profession in Northern Thailand. Data were obtained in early 1976 using a self-administered questionnaire which was completed by 132 physicians in three Northern Thai provinces. Officially approved Thai medicine is 'Western' in nature and is predominantly an urban phenomenon. Practitioners of indigenous medicine are widespread and although illegal, they are tolerated. Training of doctors conforms very largely to Western standards. This plus the limited demand for private medical care results in a high proportion of the graduates of Thai medical schools migrating abroad. Results of the survey indicate that doctors in Northern Thailand were predominantly government employees or staff of a private hospital. Less than 5% were solely in self-employment. However, most 'employee' doctors had a private 'after hours' practice. Two types of medical professionals were identified: the 'cosmopolitan' and the 'local' doctor. Difficulties in communicating with patients were indicated by about 30% of the respondent doctors. The level of dissatisfaction expressed by the doctors surveyed was relatively high--43%. Items most often mentioned were: over-work, low compensation and lack of cooperation of patients. Satisfaction most often mentioned were: service to others, independent occupation and prestige with which doctors are regarded. In the analysis, the influence of several independent variables on type of professionalism and on satisfaction-dissatisfaction was determined.

摘要

本文呈现了一项调查的结果以及其他观察结果,以描述泰国北部的医学职业状况。数据于1976年初通过一份自填式问卷收集,该问卷由泰国北部三个省份的132名医生填写。官方认可的泰国医学本质上是“西方”医学,主要是一种城市现象。本土医学从业者分布广泛,尽管他们是非法的,但却被容忍。医生的培训在很大程度上符合西方标准。这加上对私人医疗护理的需求有限,导致泰国医学院校的毕业生中有很大比例移民到国外。调查结果表明,泰国北部的医生主要是政府雇员或私立医院的工作人员。只有不到5%的人是个体从业者。然而,大多数“雇员”医生在下班后有私人执业。确定了两种类型的医学专业人员:“国际化”医生和“本地”医生。约30%的受访医生表示在与患者沟通方面存在困难。接受调查的医生所表达的不满程度相对较高——为43%。最常提到的项目有:工作过度、薪酬低和患者缺乏合作。最常提到的满意因素有:为他人服务、独立职业以及医生所享有的威望。在分析中,确定了几个自变量对专业类型以及满意-不满意程度的影响。

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