Medical Professionalism of Occupational and Environmental Physicians in Korea

우리나라 산업의학과 의사의 직업전문성

  • Shin, Seung-Hwan (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Lee, Jong-Tae (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Kim, Min (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Kim, Jeong-Ho (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Kim, Dae-Hwan (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Son, Byung-Chul (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Lee, Chae-Kwan (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Suh, Chun-Huii (Department of Occupational and Environmental Medicine, Institute of Environmental and Occupational Medicine) ;
  • Kang, Shin-Ik (Department of Medical Humanities, Inje University College of Medicine)
  • 신성환 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 이종태 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 김 민 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 김정호 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 김대환 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 손병철 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 이채관 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 서춘희 (인제대학교 의과대학 산업의학교실, 환경.산업의학연구소) ;
  • 강신익 (인제대학교 의과대학 인문의학교실)
  • Published : 2011.06.30

Abstract

Objectives: This study evaluated cognition, core values and attributes of medical professionalism in occupational and environmental physicians, and was conducted to have basic data for suggesting proper role models of occupational and environmental physicians. Methods: Perceptions of reality and the priority of professionalism virtues in occupational and environmental medicine were evaluated by using a self-administered questionnaire, completed by 109 occupational and environmental physicians in Korea. The physicians were divided into two sub-groups: the resident group and the board certified specialist group. There are 4 questions about perceptions of reality and survey respondents gave 5-scale scores to each of 10 professionalism virtues in the questionnaire. The statistical significance of the perception difference between two groups was given by a cross tabulation analysis. Priority difference between each 10 professionalism virtue between the two groups was analyzed through Student T-test by using the SPSS 17.0K program. Afterwards, the type of medical professionalism in occupational and environmental medicine was analyzed based on the results of the questionnaire. Results: This study provided us with the information that specialists had more optimistic views about reality of occupational and environmental medicine than residents. 10 virtues of medical professionalism were listed in the order of priority, highest to lowest. Occupational and environmental physicians valued 'technical competence', 'professional dominance', and 'morality', but 'altruism' had the lowest score. Conclusions: This study demonstrated that the occupational and environmental physicians's type of medical professionalism didn't match any of the seven types of medical professionalism from Castellani & Hafferty, although 'empirical type', 'nostalgic type' were partially similar to the occupational and environmental physician's type of medical professionalism. This is assumed because the occupational and environmental medicine field is different from other clinical medicine in terms of the physician's role. Further studies and discussions are necessary for establishing a suitable model of medical professionalism for occupational and environmental physicians.

목적: 우리나라 산업의학과 의사들의 직업전문성에 대한 인식, 핵심가치 및 유형을 파악하고, 향후 우리나라 산업의학 직업전문성에 대한 역할모델을 찾기 위한 기초 자료를 제공하고자 한다. 방법: 산업의학 전문의(341명)와 전공의(73명) 전체(414명)를 대상으로 우편설문조사를 시행하여 응답한 설문자 109명(26.3%)을 최종 대상자(전문의 65명(59.6%), 전공의 44명(40.4%))로 하였다. 설문조사는 산업의학 직업전문성에 관한 인식정도 4문항과 직업전문성 가치항목 10문항으로 구성하였다. 산업의학 직업전문성의 인식정도에 관한 설문은 영국왕립내과의학회의 설문 내용을 수정하여 구성하였고, 10가지 가치항목은 Castellani 등(2006)이 제시한 의학 직업전문성 10가지 항목을 서술형으로 재구성한 뒤 5점 척도로 중요도를 평가하였다. 이를 토대로 Castellani 등이 제시한 7가지 의학 직업전문성의 유형과 비교하였다. 결과: 산업의학 직업전문성 인식정도에 관한 설문 결과 산업의학 전문가로서의 미래가 희망적이라는 긍정적인 비율(70.4%)이 부정적인 비율(29.6%)에 비해 더 높았다. 산업의학 직업전문성 가치항목의 중요도 평가에서는 '기술적 역량(4.28점)', '전문직의 권위(4.18점)', '도덕성(4.04점)', '사회계약의 성실한 수행(3.92점)' 을 중요한 가치로 평가하였고, '이타성(3.17점)' '상업성(3.61점)', ' 원만한 인간성(3.61점)' 을 낮게 평가하였다. 산업의학과 의사들은 Castellani 등이 제시한 직업전문성 7가지 유형 중 어느 유형에도 적합하지 않았지만, 의사과학자의 특성을 가진 '경험형' 또는 전통적인 의사 유형인 '향수형' 과 유사하였다. 전공의 고년차는 '생활양식형', 저년차는 기업가형의 특성을 보였다. 결론: 우리나라 산업의학과 의사들은 산업의학의 향후 전망에 대해서 비교적 긍정적인 태도를 취하고 있으나, 전문가로서 전문성 위협과 신뢰도 하락에 대해서는 우려하고 있다. 산업의학 직업전문성에 대해서는 전문가적인 지식과 기술을 강조하여 수월성을 핵심가치로 생각하고 있는 반면 의학 직업전문성의 전통적 핵심가치 중 하나인 이타성이 가장 낮게 평가되었다. 의학 직업전문성의 유형은 어느 유형에도 적합하지 않았으나, 선호하는 유형이 계층 또는 세대 간에 차이가 있음을 알 수 있으며, 젊은세대에서 자신과 가족의 생활양식을 중시하는 경향을 보였다. 산업의학과 의사들에게 전문가로서 필요한 역량을 함양하기 위하여 직업전문성 교육과 훈련이 학회차원에서 마련되어야 한다. 특히 전공의들에게 의학 직업전문성의 원 리에 따라 산업보건서비스를 제공할 수 있는 자질과 능력을 키우기 위한 수련교육 프로그램을 도입하여야 한다. 산업의학과 의사들이 전문가로서의 역할과 기능을 충실히 수행할 수 있도록 적합한 직업전문성 역할모델이 확립되어야 한다.

Keywords

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