A Study On Physicians' Professional Identity And Its Influential Factors In 136 Public Tertiary Hospitals In China

Objectives:Talents are the core competitiveness of society and organizations,and medical professionals are important resources and wealth in the health care field.The quality,behavior,ability and professional identity of public hospital staff not only directly affect the patient's medical experience and treatment effect,but also reflect the culture of their hospitals and social civilization of the area.Therefore,improving the environment for their practice and their professional identity are the basic elements of hospital management,the important prerequisite to improve the health care quality in all levels health management institution and the basic guarantee of social civilization.This study aims to understand the status quo of physicians in 136 tertiary public hospitals in our country,so as to further discuss the influential factors of demographic variables of physicians' identity,as well as to make evidence-based recommendations for improving the professional identity of physicians.Contents&Methods:This study based on the questionnaire survey of 19,774 physicians in 136 tertiary hospitals in 31 provinces in China from the end of 2016 to the beginning of 2017,which hold on by the school of Public Health,Peking Union Medical College.It aims to understand the status quo of professional identity and the social demographic factors influencing the identity.Basic surveyed information includes gender,age,education,marital status,child,working year(s),hospital type,hospital location,department,job title,administrative duty,actual monthly income,expected monthly income,and medical liability insurance coverage.Professional identity measures include two questions:1)"I gained social recognition and respect by engaging in this profession" and 2)"I agree and/or encourage my children to engage in medical work".The questionnaire adopts the Likert five-scale form.The survey finished by the electronic questionnaire on the smart phones and the data directly uploaded to the "Healthy China" platform.We used SPSS 21.0 software for data analysis.Wilcoxon test was used for univariate analysis;Spearman correlation was conducted to correlation analysis.Binary logistic regression was performed for univariate and multivariate analysis.P<0.05 was considered as statistically significant.Results:All in all,on question "I gained social recognition and respect by engaging in this profession",the agreement rate(include strongly agree and agree)is 33.82%and the disagreement rate(include strongly disagree and disagree)is 29.56%.On question" I agree and/or encourage my children to engage in medical work",the agreement rate is 13.09%and the disagreement rate is 67.91%.Multivariate statistical analysis results show that gender,child,hospital type,department,working year(s),title,administrative duty,medical liability insurance coverage,actual income,expected income and salary difference(expected income minus actual income)are influential factors on the physicians' professional identity.The most important influential factors are remuneration and medical liability insurance coverage.In terms of professional identity,physicians who work in specialized hospitals and Traditional Chinese Medicine hospitals,surgeons,who have been working less than 5 years,who know that they are covered by medical liability insurance,and whose monthly income is more than 10,000 yuan,have higher sense of professional identity.Recommendations:it is suggested that physicians' remuneration need to be elevated,and the coverage of medical liability insurance must be fully realized as soon as possible;meanwhile it is urgent to increase the number of pediatricians,as well as to decrease the working pressure of physicians and workload of physicians.