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J Korean Med Assoc > Volume 55(1); 2012 > Article
Seo, Lim, Park, Key, and Park: A study on the current state of public health doctors

Abstract

As the healthcare environment has changed both socially and politically importance of public health doctors' roles has increased and ongoing revision of their roles is also needed in Korea. However, many problems have decreased the job satisfaction of public health doctors. This study aims to determine the factors that influence public health doctors' satisfaction. The survey was conducted over the course of 2 months by questionnaire methodology. A total of 881 respondents (response rate, 90.1%) participated and 778 valid responses were analyzed using SAS version 9.1. Items about arranged organization, work task, employee welfare and services, education, public health doctor's system, and the role of public health doctors were included in the questionnaire. It was found that the satisfaction of many respondents was not high and they had negative perceptions of arranged organization, work, environment, employee welfare and services, education, system, and their own role. Although the public health doctors have professional knowledge of healthcare, they were not satisfied with their role because they were required to do inappropriate work, improperly arranged and found performing work difficult when treated unfairly or not paid fairly. Therefore, policies focused on financial compensation or system improvement must be established to increase the satisfaction of public health doctors. This study's limitation was that the survey was done through two modalities. However, it is meaningful that issues related to the public health doctors were dealt with more comprehen-sively in this study than other studies.

References

1. Article 1-2, Act No. 10653. Act on special measures for the health and medical service in the areas including farming and fishing villages 2011;05. 19.

2. Yoon SJ. A study on the branch of public health center's status and approaches for reorganization 1998;The 20th anniversary symposium of Korean Association for Public Health Doctor. Seoul: Korean Association for Public Health Doctor.

3. Yi JR. Study on public health doctors: job satisfaction rate and demand for changes [dissertation] 2000;Seoul: Yonsei University.

4. Song HS. The system of public health doctors and family doctor. J Korean Acad Fam Med 2000;21:S296-S299.

5. Jeong HJ, Jo HS, Bae SS. A study on job satisfaction and strategies to improve the system of public health doctors in charge of community health programmes. Korean J Health Policy Adm 2004;14:1-23.

6. Kim SY, Kang YH, Lee SJ, Hwang JY, Kang HT, Han IH. Establishment of disposition standards for the appropriate disposition of public health doctors 2009;Cheongwon: Korea Health Industry Development Institute.

7. Kang HS. A study on improvement methods of public doctor system in public health institution [dissertation] 2004;Anseong: Hankyong National University.

8. Kim ES, Han GC, Lee DH. A study on the current utility and policy task of public health doctors' manpower in branch of public health center 1996;Seoul: Korea Institute for Health and Social Affairs.

9. Moon JJ, Kim CW, Lee JH, Seo JW, Kim DH, Song EC, Lee JW. A study on development of assessment tool and strategies to improve the arrange system for public health doctors 2005;Cheongwon: Korea Health Industry Development Institute.

10. Moon JJ, Seo JW, Seon JH, Nam HJ, Park HG. A study on the utilization of manpower for efficient management of public health services 2007;Cheongwon: Korea Health Industry Development Institute.

11. Kim YI, Kim CB, Yoon SJ, Kim JY, Choi BY. A study on the strategies to improve system for public health doctor system 2002;Seoul: Presidential Commission on Policy Planning.

Figure 1
The elements required to work. 1. Specialty knowledge. 2. Experience of and knowledge about performing health services. 3. Personal relations. 4. Administrative experiences and knowledge. 5. No other skills or knowledge required. 6. Other. The cases not answered in questions are rejected in analysis.
jkma-55-56-g001-l.jpg
Figure 2
Institutional measure for improvement of satisfaction. 1. Financial compensation. 2. Empowerment and reinforcement of autonomy. 3. Expansion of medical facilities. 4. Deregulation related to public health doctors. 5. Education/research support. 6. Reduction of number of tasks. 7. Others. The cases not answered in questions are rejected in analysis.
jkma-55-56-g002-l.jpg
Figure 3
Satisfaction on the specific details of salary. 1. The level of pay is reasonable for the performance expected. 2. It is proper relative to other related work like public-service advocates. 3. I'm satisfied overall with current pay level. The cases not answered in questions are rejected in analysis. Likert 5-point scale is used to measure.
jkma-55-56-g003-l.jpg
Figure 4
Satisfaction on the specific details of bonuses. 1. The level of pay is reasonable for the performance expected. 2. I'm satisfied overall with current bonus level. The cases not answered in questions are rejected in analysis. Likert 5-point scale is used to measure.
jkma-55-56-g004-l.jpg
Figure 5
Area for improvement among the public health doctor's system. 1. Working conditions (salary, bonuses, status etc.). 2. Selection and arrangement related matters. 3. Breaks from a treatment-oriented role: shift to the role focused on health service of research. 4. Improvement of working conditions. 5. Issues about service regulation of public health doctor. 6. Educational program. 7. Other. The cases not answered in questions are rejected in analysis.
jkma-55-56-g005-l.jpg
Figure 6
Challenges public health doctors face. 1. Lack of pay and unfair treatment. 2. Lack of clinical knowledge and skills. 3. Lack of experience and knowledge in health service. 4. Conflict with other workers. 5. Medical malpractice. 6. Conflict with the local residents. 7. Excessive workload. 8. Conflict with other public health doctors. 9. None. 10. Other. The cases not answered in questions are rejected in analysis.
jkma-55-56-g006-l.jpg
Figure 7
Factors related to job satisfaction.
jkma-55-56-g007-l.jpg
Table 1
Respondents' characteristics
jkma-55-56-i001-l.jpg

The cases not answered in questions are rejected in analysis.

Table 2
Appropriateness of the number of public health doctors assigned to public health-related organizaions
jkma-55-56-i002-l.jpg

Unit: n (%), score.

The cases not answered in questions are rejected in analysis.

Likert 5-point scale is used to measure.

Table 3
Appropriateness of arrangement by organization
jkma-55-56-i003-l.jpg

Unit: score.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 4
Nature of current work
jkma-55-56-i004-l.jpg

Unit: n (%).

The cases not answered in questions are rejected in analysis.

a)First-aid Counseling & Hospital Transfer Service conducted by the 1339 Emergency Medical Service Information Center.

b)Dispatched medical service at other organizations including a mobile clinic unit.

c)Family health programs for health management of infants & pregnant women, and health promotion program for non-smoking/obesity/temperance, mental health program, etc.

Table 5
Validity of public health doctors' work
jkma-55-56-i005-l.jpg

Unit: score.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 6
The length of working time
jkma-55-56-i006-l.jpg

Unit: n (%), hour.

The cases not answered in questions are rejected in analysis.

Table 7
The number of patients treated per 1 week
jkma-55-56-i007-l.jpg

The cases not answered in questions are rejected in analysis.

Likert 5-point scale is used to measure.

SD, standard deviation.

Table 8
The perception of the work itself
jkma-55-56-i008-l.jpg

Unit: score.

1. It's boring and get me fed up. 2. It makes me frustrated. 3. There is no specific difference whether doing hard on it or doing sloppily. 4. It gives me stress. 5. It requires a lot of time in clerical (administrative) transactions. 6. It's pleasant and rewarding. 7. It gives me an intellectual stimulus and a sense of achievement. 8. It's a acknowledged and socially respected job. 9. It affords a lot of opportunity to display one's own ability. 10. It gives a lot of opportunity to acquire new knowledges or techniques.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 9
The perception of the work environment
jkma-55-56-i009-l.jpg

Unit: score.

1. There is sufficient time for business activities. 2. There is a sufficient space for business activities. 3. There is a sufficient workforce for business activities. 4. Immediately after I was assigned to an organization, I received the education & orientation from the relevant organization. 5. Working conditions such as noise, lighting, and indoor temperature are pleasant. 6. The opinions suggested by public health doctors are nicely embraced by the arranged organization. 7. Medical appliances or medical equipment are sufficient enough to do medical service.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 10
Relationship and experience of conflict between public health doctors' arranged organization and private health care institution
jkma-55-56-i010-l.jpg

Unit: n (%), score.

The cases not answered in questions are rejected in analysis.

Likert 5-point scale is used to measure.

Table 11
Satisfaction comcerning working conditions (employee welfare and services)
jkma-55-56-i011-l.jpg

Unit: score.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 12
Availability of and satisfaction with official residence
jkma-55-56-i012-l.jpg

Unit: n (%), score.

The cases not answered in questions are rejected in analysis.

Likert 5-point scale is used to measure the satisfaction.

Table 13
Availability of and usefulness of job training program
jkma-55-56-i013-l.jpg

Unit: score.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 14
Satisfaction with job training program
jkma-55-56-i014-l.jpg

Unit: score.

1. Appropriateness of period of time for education. 2. Suitability of educational purpose and contents. 3. Educational environment (lecture room etc.). 4. Educational contents. 5. Length of training period and lecture time. 6. Accessibility of the educational facility. 7. Room and board during education.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 15
Necessity for public health doctor' system change
jkma-55-56-i015-l.jpg

Unit: score.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.

Table 16
Public health doctors' awareness of their own role
jkma-55-56-i016-l.jpg

Unit: score.

The cases not answered in questions are rejected in analysis.

The standard deviation is given in parentheses.

Likert 5-point scale is used to measure.



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