Under the rapid evolution of the domestic medical environment, reform of healthcare policies, lift of limitations of medical laws, implementation of national health insurance, and the change of payment systems, domestic medical institutes all perceived the importance of management. For effective management and continuous growth of hospitals, the demand for professionally trained Diplomate of Taiwan College of Healthcare Executives significantly increased and many medical affair management professionals had been cultivated in schools. A licensing system was set up in such background. Having been implemented for several years, this licensing system has shown limited effects. To understand the opinions of medical institutes and governmental departments on the implementation of this system, in-depth interviews were performed on license holders, service receivers, and high-ranking executives in the government to collect opinions from various perspectives and analyze the problems. The research findings showed: 1. Diplomate of Taiwan College of Healthcare Executives are equipped with basic knowledge about medical affair management and hold a positive attitude toward further training, but they still lack practical experience and professional capabilities. Therefore, their contribution to hospital management is limited, and it is urgent to improve the professional capabilities of Diplomate of Taiwan College of Healthcare Executives. 2. Due to the difference between Diplomate of Taiwan College of Healthcare Executives and medical personnel in their work properties and influence on patient¡¦s life, a more conservative view was considered during the enactment of the certification system. 3. As to the position and acquisition of a Diplomate of Taiwan College of Healthcare Executives license, it was suggested that medical affair management be developed into a subspecialty and graded, and test subjects and training courses be planned for each subspecialty and grade.

The primary purpose of this research was to review the relationship between moral cognizance, as defined by the Defining Issues Test, and the compensation plan of a healthcare executive when factors such as licensure, career stage, gender, age, and ethics training were present. The study was conducted on 142 healthcare executives from both a publically traded for-profit hospital corporation and a multi-physician private practice. Analysis of Variance (ANOVA) tests were utilized to test the hypotheses of these moderating variables. The outcome of this study indicates that there is no difference in the relationship of moral cognizance and compensation plan of a healthcare executive when the factors of license, career stage, gender, age, or ethics training are involved. However, the analyses did find some interesting interactions of statistical significance between moral cognizance, as determined by P-score, and the individual factors of license and gender when compensation was not included. While the results of the study were inconclusive, the study extends Kohlberg's research on cognitive moral development using Rest's Defining Issues Test to healthcare executives. It also contributes to the existing body of literature by introducing the variable of compensation plan to the moral cognizance equation. Future research in the healthcare field in relation to moral cognizance and financial performance will become a necessity as the focus on healthcare as a business continues to grow and society insists the highest values from its providers.