目的：本研究在探討醫院市場導向對醫病關係的影響、探索醫師—病人和管理階層—醫師之知覺市場導向缺口及其對醫病關係的影響，以及確認內部行銷在醫院發展市場導向的重要角色。方法：本研究採用理論抽樣方式，以中部某醫學中心4位高階管理團隊成員、第一線醫師和護士各2位為深度訪談的受訪對象，之後針對文本資料進行內容分析。結果：研究結果發現醫院市場導向對醫病關係、病人知覺市場導向會產生正向影響。高階管理者市場導向會對第一線服務人員市場導向產生正向影響，高階管理者可藉由內部行銷來強化第一線服務人員的市場導向，而第一線服務人員知覺內部行銷對醫病關係的正向影響。結論：高階管理者與第一線服務人員確實存在市場導向缺口，而此缺口會對病人知覺市場導向程度產生負向影響，此外，第一線服務人員知覺市場導向對病人知覺市場導向以及醫病關係有正向影響。第一線服務人員與病人間確實存在市場導向缺口，此缺口會負向影響醫病關係。 Purposes: The purpose of this study was to examine the impact that market orientation within a hospital has on the physician-patient relationship, to explore perceptual market orientation gaps between first line employees and patients as well as between hospital management and first line employees, and their impact on the physician-patient relationship, and to verify the critical role of internal marketing on developing market orientation. Methods: We built our research propositions by in-depth interviews and a review of the literature. We adopted a theory-driven sampling method to select four top hospital managers, two first- line physicians, and two first- line nurses for interviews at a medical center in mid-Taiwan. Afterward, content analysis was used to analyze the text data. Results: Market orientation within the hospital had a positive impact on patients’ perception of market orientation. Market orientation from top managers affected first line employees’ perception of market orientation and top mangers employed internal marketing to improve first line employees’ perception of market orientation. First line employees’ internal marketing had a positive impact on the physician-patient relationship. There was a perception of market orientation gap between hospital management and first line employees and it had a negative impact on patient perception of market orientation. In addition, first line employees’ perception of market orientation had a positive impact on patient perception of market orientation and the physician-patient relationship. Conclusions: There was a perception of market orientation gap between first line employees and patients and it had a negative impact on the physician-patient relationship.
