戰後台灣醫療檢驗業之發展摘要

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題名:
戰後台灣醫療檢驗業之發展摘要
著者: 陳慧君; Hui-Chun, Chen
蔡篤堅; Duu Jian, Tsai; 台灣文化研究所
主題: 臨床檢驗; 專業化; 檢驗技術; 口述歷史; 醫檢師法; clinical examine; professional; medical technology; oral history; MT''s law
描述: 戰後台灣醫療檢驗業之發展，因社會分工逐漸走向專業化，成為目前不可或缺的醫療專門職業之過程。該業發展歷程分別由台大醫學院成立醫事技術系、落實證照制度以及2000年立法成功三個事件作為斷限，分為臨床檢驗技術訓練班時期、醫技人才大量培育時期、法定專業時期。醫檢業發展歷程符合種種「專業化」的條件，然而其專業地位與專業自主性的表現，及專業領域的種種矛盾現象，卻受到其他專業排他性的影響未能受到重視。檢驗技術訓練班時期始於國民政府為了能夠有效遏止疾病的蔓延，達到傳染疾病的有效控制及預防醫學的公共衛生任務，大量培養了檢疫技術人才，栽培檢出感染源的技術操作者。因此招攬當時高中畢業生，透過地區醫院代為訓練檢驗技術，並於1953年至1971年開辦18期的「實驗診斷技術訓練班」，培訓出許多當時對臨床醫學檢驗十分重要的檢驗技術員。因為檢驗技術員的培育與傳染病防治密切相關，這些資深的醫檢前輩基於當時的檢驗技術可以應用於地方防疫經驗在地方上開設的檢驗所，並配合施行地方防疫工作。 1956年台大醫學院成立醫事技術系，是為檢驗技術訓練轉型的關鍵點。美援時期美國海軍第二研究所（NAMRU - 2）對台灣現代醫學的研究與發展、檢驗技術的引進方面貢獻甚鉅，檢驗技術隨著工業科技的發展，手工檢驗技術開始邁向簡單儀器自動化。檢驗人員的訓練，自台大醫事技術系成立之後，學院、專科學校也跟隨著腳步以進行人才培育，早期幾屆台大醫技系畢業生從NAMRU－2的現代醫學研究吸收成長之後，紛紛投入醫技專科教育，奠定了醫技人訓練醫技人的專業化訓練模式，是為醫檢分家之濫觴。1970年代後醫檢師以落實證照制度，曾經一度基於臨床人力市場的需求，各醫技專科學校大量增班培訓，開啟了台灣醫技人才大量培育的顛峰時期，但在沒有總量管制下，形成就業市場排擠效應。近年來又因檢驗自動化節省人工作業，健保制度下促使醫院精簡醫檢人力，加上美國臨床病理實驗室的模式影響，許多原來醫檢師執業範圍逐漸流失。由於缺乏合理的人力調節方案，若考量醫檢業的未來發展，醫技教育必須減招，衛生主管單位及教育卻未重視此問題，至今仍然未有解決之道，導致醫檢人力問題更顯雪上加霜。鑑於台灣未有個別專業人員法律來規範醫事技術人員的各項業務，醫檢師（生）期盼可以透過證照考試核定專業身份，並希望透過法條的約束與管理，能夠保障自身的工作權利。因此醫檢師們透過公會及全國聯合會積極請願爭取，為了圖一線生存之地。前後奮鬥了十八年，最後終於在兩千年通過《醫檢師法》。立法過程漫長，從立法動機到爭取的行動中，許多台灣醫療場域中許多不公平的權力和利益問題一一被彰顯出來，這部《醫檢師法》也為台灣的醫療制度開創國際舞台之新紀元。前述醫療檢驗業之現況，除了人力市場飽和問題，醫檢開業市場也逐漸萎縮或紛紛轉型，近年來生物技術的衝擊，是對醫檢界的另一波挑戰，但醫檢教育改革將從生物技術著手，是否真能讓醫檢業得到救贖，許多業界、學界仍抱持著歧異的觀點各自為政。由整個發展歷程來看，醫檢業的種種問題與現況所呈現的專業化發展，將走向黃昏事業亦或面臨專業轉型，仍有待進一步探討。
Since World War II, Medical technology (MT) in Taiwan has gradually developed into one of the medical professions, due to the specialization trend. The establishment of MT department of the Medical college of National Taiwan university (NTU), the issue of Medical Technologist’s license, and the authorization through legalization in 2000, are three phases of this development. They were a phase of clinical technology training class, a phase of medical technologist culture a great quantity and a phase of statutory profession. Medical technology has progressed to with the conformation for specialization. But medical technologist’s professional position and autonomy, and some contradictory phenomenon in this field were still ignored from the other profession exclusiveness. The phase of clinical technology training class began when KMT government tried to arrest the spread of the disease, which wanted to achieve the mission for controlling infectious disease and sanitarian, to train a great quantity quarantine technologists, and cultured some of technical operators who can examine infectious organism. Therefore, the government recruited senior high school students and sent them to local hospitals for medical technology. NTU College of medicine hold 18 stages of experiment diagnostic training class from 1953 to 1971. And it cultivated a lot of important technologists for clinical medical examine at that time. As medical technologist training associated plays an important role in preventing diseases. In view of the proper application of technique for preventive jobs, those predecessors performed the mission through local MT laboratory (MT LAB). In 1956, NTU set up the MT department, which was the key point of transforming the MT training course. During the U.S aid age, NAMRU-2 had a great contribution to the research and development of present Taiwan medical science and technique transfer. MT progressed with the development of the industry science, and manual MT began stepping into simple auto-analyzing instruments. With the establishment of MT Department in NTU, the training of MT began to be followed by all the colleges and universities in Taiwan. In the early age, the graduates who studied the modern medical research at NAMRU-2 were poured into the training and education, and set the foundation stone for the specialization training in colleges. That is the initiation of separation of Medicine and MT. After 1970, MT carried out the license system. In want of the professionals of MT, colleges increased the quantity of both students and class, which was the climax of MT staff education. But without proper control, MT staff overflowed. In recent years, because of automation, health insurance system, and the influence of American clinic pathology laboratory, the number of all the MT staff has been reduced to the minimum. Lacking adjustment programs, we must reduce the number staff training to channel the bottleneck, but our health authorities put little emphasis on the difficulties, which add injury in MT manpower. Without proper rules to stipulate the scope of field in MT, Medical technologists are anxious to be acknowledged as professional, and rights through the rule of laws; therefore, M technologists have been struggling for their work for 18 years by the aid of MT Association and National Union of MT. MT’s law has finally been passed in the year 2000.During the long lawmaking process, the problems of power and benefits in the medical field of Taiwan have been gradually shown, but it also puts Taiwan into a new era to step onto the international stage. According to the above statement, MT profession nowadays meet the problems of both manpower saturation and the decreasing practices of MT LAB, which should find other outlets. Under the influence of Bio-technology, MT face another challenge. Whether the reform of MT education can be transformed through bio-tech, both practicers and academy hold divergent opinions and have their own way. Viewed from the progress, MT profession has been facing a series of difficulties, and wanting more specific improvement. But, much has been left to be discussed about MT’s future into an unknown dilemma.
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建立日期: 2005
格式: 121 bytes
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語言: 中文
識別號: http://nutnr.lib.nutn.edu.tw/handle/987654321/4403
資源來源: NUTN IR

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戰後台灣醫療檢驗業之發展摘要

陳慧君; Hui-Chun, Chen 蔡篤堅; Duu Jian, Tsai; 台灣文化研究所 2005

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