The Factors Influencing Visiting Staff Turnover in A Private Municipal Hospital：Case study

• Main Authors: Kuan-Chun Chang, 張冠群
• Other Authors: Hung-Hui Li
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/14152772583779394385

碩士 === 元智大學 === 管理研究所 === 95 === Resignation of visiting staff will have a direct impact on patient''s rights. It will certainly induce some detrimental effects on medical qualities and medical treatment processes. Moreover, resignation will also make bad influence on doctor’s personal professionalism, organization efficiency, hospital’s business performance as well as institution’s reputation. The implementation of National Health Care Insurance policy in Taiwan has significantly changed the environment of medical industries, particularly in private hospitals. As the result, the discrepancy between administrator’s philosophy and attending doctor’s attitude towards changing will seriously affect doctor’s decision in resignation. The hospital conducted in this study has experienced relocation, expanding, and reformation. During the course, its top managements have been changed several times. In addition, the salary system of the hospital has been adjusted due to variations in health care insurance payments. All these reasons have caused many attending doctors to resign, approximately 30% at most. Among those resigned, some have been worked in the hospital for more than 10 years, but most of them have more than 5 years of experience. The main purpose of this study is to investigate the reason of resignation for doctors in private hospitals. The study uses semistructured interviews and participant observation method to visit the cases directly in order to understand their thoughts about resignation. The results have been compared to the hospital’s management strategies. The analyses have indicated that the mistrust between doctors and hospital is the main reason for resignation. The mistrust was induced by a series of reformations employed by the hospital owing to the alteration in heath care insurance system. Among those reformations, the policies as well as the leadership of the new administrator have been criticized the most. Resigned doctors have doubts about the integrity and respectfulness of the administrator. They feel pessimistic about the medical environment and the health care insurance system. Most of them also feel that the rewarding systems among different groups are unfair. On the other hand, the administrator does not agree the way top managements place their personal benefits over the organizational benefits. As the result of these conflicts, resignation is inevitable. After introducing new personnel into the hospital, the new administrator stabilizes the conflict; consequently, the business gradually returns to normal. In summary, we believe the doctors should think mostly about their patients. They must pay attention to medical quality as well as lifetime learning. For hospitals, however, they must take integrity, fairness, internal management, quality improvement, as well as forming self-culture into consideration in order to have a sustainable business. As for the health care insurance system, we must establish clear definitions for its employment and enhance the medical quality monitoring in order to bring benefits to our entire nation.