Doctors in the People's Republic of China : a research of profession and professionalization

Abstract

Since 1985, China's healthcare system has experienced more than thirty years' reforms. To reach the goals of the reforms, doctors, ever defined as workers of the state in the post-Mao era, have also gone through three decades of professionalization. The objective of this research is to investigate the extent to which doctors have been professionalized and the current progress of professionalization of doctor in the People's Republic of China. Following Friedson's ideal model of profession, the doctor profession in this research is examined from an institutional perspective, and the research integrates one quantitative study and one qualitative study. Under the background of professionalization of doctor profession, the objectives of the quantitative study are to assess and understand the doctor profession from fifteen key categories (professional commitment, intention to leave profession, prosocial motivation, etc.) and explore the mechanisms through which doctors' intention to leave profession is affected. A survey method was adopted to collect data. Under the support of Chinese Hospital Association, 24 general hospitals allover China were selected, and around 80 doctors at different professional ranks in each hospital were randomly selected to fill the questionnaire of the survey. SPSS 22.0 and SmartPLS 3 were used to analyze the data. Regarding the qualitative study, the main objectives are to comprehensively and deeply understand the professionalization of doctor profession from four themes, including profession selection, profession's work, profession's status, and profession development. Based on Grounded Theory (GT), three rounds' semi-structured face-to-face interviews were conducted for the purpose of data collection. The round one interview was conducted in five "third grade-class A" public general hospitals in Beijing covered with 112 doctors in four different professional ranks. The second-round interview was held in the same five hospitals and their stakeholders-presidents and vice presidents were interviewed. The third-round interviews were implemented in two medical colleges in Beijing targeting at five college stakeholders. The software NVivo was used to assist in the management of the collected data. This research opens a door that let the world understand the doctor profession in China from diverse categories. It not only identities the common ground and differences of doctor profession between China and western developed countries, but also it provides the China's governments, medical colleges, hospitals with rich and reliable data for the future development of professionalization of the doctor profession.