| Summary: | 博士 === 國立中正大學 === 社會福利學系暨研究所 === 99 === This study investigated potential factors that had impact on the physician-patient interactions in Taiwan’s medical environment dominated by western-medicine system. The researcher explored several aspects including patients’ expectations in seeking medical treatment, insurance systems, medical disputes, and also cross reference between the viewpoints of clinical physicians and the general public. The study utilized a mix of methods. Firstly, quantitative approach was applied on the targeted physicians in the mainstream medical system. Sampling techniques included probability proportionate to size (PPS) and systematic random sampling for the purpose of identifying potential research subjects. Questionnaires were mailed, and participants’ responses were analyzed using SPSS in order to identify trends and factors for the follow-up qualitative research. Sampling techniques involved in the qualitative study included purposive sampling, snowballing, and voluntary sampling for obtaining study participants from both pools of physicians and patients. Interviews were conducted, and content analysis was performed with Nvivo7 for coding and analysis.
The result of quantitative research indicated that 98.8% of the physicians’ families and friends or 99.2% of the physicians’ patients had experienced estern medical treatment, and 86.3% of the physicians’ families and friends or 93% of the physicians’ patients had tried alternative therapy. However, only less than 6% of the physicians indicated acceptance of their families and friends toward eastern medical treatment, and only 2.1% indicated acceptance of their patients toward alternative therapy. The result of qualitative study revealed that a physician’s compassion toward patients and worries about medical disputes could impact a physician’s view on the multiple medical seeking. This study identified five critical factors including medical expense, physician’s attitude, medical negligence, news media, and communication between physicians and patients, which could impact the probability of medical disputes.
Finally, six similarities and differences in viewpoints that characterized physician- patient interactions were also identified, and the researcher recommended a localized physician-patient interaction approach that combined paternalistic relationship model, consultative relationship model, and commercial relationship model. This approach may contribute to current literature by clarifying the confusion between the physician-induced demands and the patient-induced demands, and will be of benefit to clinical practice as well.
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