| Summary: | 碩士 === 國立中正大學 === 勞工研究所 === 99 === This research aims to bring to understanding the control of resident surgeons from external market, social values, and internal organizational structures. This research uses qualitative interviews to get an in-depth understanding of resident surgeons. The objects are the resident surgeons in one of the medical centers in southern Taiwan.
It is found that there are five ways of labor control over resident surgeons. First of all, from the perspective of external market, the payment system of National Heath Insurance guarantees Bureau of National Health Insurance’s monopsony power over healthcare market. Doctors become, therefore, the employees working for Bureau of National Health Insurance, leading to five changes: ways of medication as well as diagnosis & treatment, people’s habit of seeking medical treatment, doctors’ major in medical fields, doctors’ choice of the hospital for internship, and doctors’ choice of the hospital to work for. Second, the increasing number of medical disputes mars doctors’ devotion to healthcare and aggravates their worries about medical environment. Third, from the perspective of social values, the worsening relation between doctors and patients demonizes doctors. Moreover, healthcare has its limit, but people anticipate only success of doctors, with no failures allowed. Social interaction involves familial interaction among groups, orderlies working as great help to doctors, and a career of saving people. Fourth, in terms of internal organizational structures, time control has the following four forms: 24-hour working network, the arrangement of system of job responsibility disorderly working hours, and virtual working hours. Fifth, their work involves clinical diagnosis and treatment, administrative work irrelevant to clinical diagnosis and treatment, participation of seminars, application for work-related learning opportunities, and implicit courses in work.
Nevertheless, during the labor process, resident surgeons are not under absolute yoke. Labor subjectivity can present itself in the following strategies: more examination, sense of achievement through saving patients and protection from organizations. In healthcare system, while no internal states exist, there are always “making out” and internal labor market in hospitals.
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