Research On The Working Status Of Doctors Under The Background Of Medical Reform

Since the latest Public Hospital Reform was carried out in 2009 in Shanghai, it has gained some achievements in the aspects of public hospital health system, public hospital compensation mechanism and improvement of health service quality.public welfare is the same goal of almost all countries’ reform, but little attention was paid on main body of the reform, doctors. After 5-year reform, in December,2014, the government of Shanghai plans to start public hospital payment reform next year.Study the status quo of doctors’ work and finding the exist problem of their work can offer more effective,convenient and safe basic medical service to the people, at the same time, it also can mobilize the enthusiasm and initiative of the doctor in hospital reform so as to offer essential help to promote the public welfare in hospital reform.ObjectivesThe study aims to research on the working status quo of public hospital doctors in shanghai, especially in the background of public hospital reform. We start in the large public hospitals, on the basis of appraisal of doctors themselves, expect to find the exist problems and solutions, and then find the solution to increase the enthusiasm of doctors to participate in the reform.MethodsThe research has used literature review, questionnaire survey and specialist interview, we chose 15 large public hospital clinical doctors in Shanghai as investigation object, through random sample of 852 clinical doctors, we want to study:(1) literature analysis method:health statistics yearbook and local yearbook can provide some data and theoretical basis for project.(2) the socialist interview:through exert consultation method, we get indexes reflecting doctors’ work, such as the number of working hours per week, frequency of free medical consultation per month, weekly community lecture frequency, the types of patients, the patient type expected, job satisfaction and its influencing factors, life stress, working pressure influence factor and so on.(3) quantitative research: based on the above indexes, formulate questionnaire, by using statistical software we can get the result of data analysis.(4) qualitative research:by using interview method, we can understand doctors’ thoughts on certain issues, combined with the result of quantitative research, the results of quantitative research is inconsistent with the real situation, we can give the real answers to sensitive questions which cannot gain the true answers in the questionnaire.Results(1) The overall satisfaction rate is low:Doctors’ job satisfaction rate of large public hospital in Shanghai is relatively low,35.4% doctors are satisfied with their job. On the job satisfaction of doctors, top three reasons for satisfied with the job are as follows:the value of their own achievements, work sense and stable income; top three reasons for not satisfied with the job are as follow:intensity work, relatively low income and high job risks. Title, whether are satisfied with type of patients, changed of work pressure, self assess level of patients influence job satisfaction.(2) Doctors work overtime:average weekly working time of large public hospital doctors is 56.80 hours.37.4% doctors have organized community health lecture, and lecture will require a total of 8.43 hours to prepare.56.6% doctors have participated in the community free consultation, and the consultation requires 3.22 hours.84.9% of doctors can reach department assessment.(3) The type of patients is not reasonable, in the survey of large public hospital, doctors of the actual treatment patient types were the top three common diseases and chronic disease and daily medicine; when asked about the large public hospital patients should be how to form, they answer the first three bits should be incurable diseases, major diseases and rare diseases; doctors hope to hospital patients to the first three types of common disease is incurable diseases, and major diseases. Large comprehensive hospital patients constitute an unreasonable.(4) The doctors are under high pressure:76.9% doctors agree that their life pressure, gender, position and nearly a year of work pressure changes affect the life pressure.86.5% doctors agree that their greater pressure of work, education, work time, whether to achieve the Department Assessment and nearly a year of work pressure changes affect the working pressure.(5)The doctor’s job satisfaction and expectation of income:when the doctor average daily working time is 10 hours, their satisfaction will be greatly reduced, from 7.68 to 6.22, then their expected salary is 21221 yuan/month; when the doctor daily average time is 11.5 hours, he began to be dissatisfied, at this time they expected salary is 26307 yuan/ month.SuggestionRaise work satisfaction rate of doctors; guide the residents first treat in community medical center; alleviate the pressure of the doctor; improve doctors’ income reasonably.