Soc Sci Med. 1982 ; 16(5): 515-26.

Doctors and society: a Northern Thailand study.

Smith HE.

This paper presents findings from a survey together with other observations to characterize the medical profession in Northern Thailand. Data were obtained in early 1976 using a self-administered questionnaire which was completed by 132 physicians in three Northern Thai provinces. Officially approved Thai medicine is 'Western' in nature and is predominantly an urban phenomenon. Practitioners of indigenous medicine are widespread and although illegal, they are tolerated. Training of doctors conforms very largely to Western standards. This plus the limited demand for private medical care results in a high proportion of the graduates of Thai medical schools migrating abroad. Results of the survey indicate that doctors in Northern Thailand were predominantly government employees or staff of a private hospital. Less than 5% were solely in self-employment. However, most 'employee' doctors had a private 'after hours' practice. Two types of medical professionals were identified: the 'cosmopolitan' and the 'local' doctor. Difficulties in communicating with patients were indicated by about 30% of the respondent doctors. The level of dissatisfaction expressed by the doctors surveyed was relatively high--43%. Items most often mentioned were: over-work, low compensation and lack of cooperation of patients. Satisfaction most often mentioned were: service to others, independent occupation and prestige with which doctors are regarded. In the analysis, the influence of several independent variables on type of professionalism and on satisfaction-dissatisfaction was determined.