我国公立医院医生鼓励子女从医的现状与趋势分析

Current status and trend of doctors encouraging children to pursue a medical career in Chinese public hospitals

目的:了解近年来我国主要三级公立医院医生鼓励子女从医的现状及其动态变化情况。方法:2016-2019年,"进一步改善医疗服务行动计划"第三方评估("第三方评估")项目组在全国31个省(自治区、直辖市)和新疆生产建设兵团的136家三级公立医院中,对医生是否会鼓励其子女从医进行了年度问卷调查。结果:医生们期望自己的子女从医的比例在2016-2019年四年间略有上升但仍处于很低水平,其比例分别为13.4%、12.6%、13.7%和14.6%。而四年间医生们不鼓励子女从医的比例虽呈下降趋势但整体比例仍旧很高,分别为71%、69%、62%和57%。急诊科医生鼓励子女从医的比例提升最快,由2016-2018年的14.3%、12.8%、13.1%提升到2019年的19.6%,比整体高5%左右;他们不鼓励子女从医的比例也下降最快:四年间的比例分别为71.5%、74.1%、67.2%和51.6%,比整体低5%左右。儿科、内科和妇产科医生以及中年资和中级职称的医生不鼓励子女从医的比例较高且四年间变化不大。医生们所在医院的地理区域之间没有差别。结论:从近四年来我国主要三级公立医院医生们鼓励或不鼓励其子女从医的比例变化趋势来看,医生们对自身职业的信心虽有所提高,但尚有很大的提升空间。

Objective: To explore the current situation and trend of Chinese doctors in encouraging children to pursue a medical career in major tertiary public hospitals in China. Methods: From 2016 to 2019, the China Healthcare Improvement Evaluation Survey(CHIES) was conducted among the 136 tertiary public hospitals in 31 provinces, autonomous regions, municipalities. The survey included a cell-phone based questionnaire filled out by the sampled doctors to investigate doctors’ attitude toward encouraging their children to pursue a medical career. Results: From 2016 to 2019, the proportion of doctors encouraging their children to pursue a medical career were 13.4%, 12.6%, 13.7%, and 14.6%, respectively. The proportion of doctors who discourage their children to pursue a medical career during the four years showed a downward trend but the overall rate remained high at 71%, 69%, 62% and 57% respectively. A higher proportion of pediatricians, physicians and obstetricians-and-gynecologist discourage their children to pursue a medical career. And the proportion of emergency doctors encouraging their children to pursue a medical career shows rapid upward trend, from 14.3%,12.8% and 13.1% in 2016-2018 to 19.6% in 2019, about 5% above the overall rate. The proportion of emergency doctors who discourage their children from engaging in medical work also declined the fastest: the proportions over the four years were 71.5%, 74.1%, 67.2%, and 51.6%, about 5% lower than the overall. There is no difference between the geographic areas of the doctors’ hospitals. Doctors with medium years of service and intermediate title tend to discourage their children to pursue a medical career. Conclusions: In view of the changing trend of doctors encouraging or discouraging their children to pursue a medical career, doctors’ confidence in their profession has improved, but there is still much room for improvement.