THE PROCESSES OF BEING EMPLOYED AS FOREIGN HOSPITAL EMPLOYEES IN THAILAND: A MIXED METHODS STUDY

Abstract

Background: Currently, labor mobility has been an issue of interest among ASEAN countries with the establishment of the ASEAN Economic Community (AEC) at the end of 2015, which allows the free movement of healthcare providers within the countries. The aims of a study were to explore the characteristics of foreign hospital employees, factors influencing decision making of the foreigners, the process of being employed as foreign hospital employees, and problems or obstacles encountered while working in Thailand.

Methods: One hundred foreign hospital employees in both government and private hospitals in Thailand were recruited using snowball sampling. This mixed-method study used a questionnaire and in-depth interviews for data collection. The quantitative data was analyzed using descriptive statistics, including frequency, percentage, mean, standard deviation, whereas the qualitative data was analyzed using the thematic analysis.

Results: The results revealed that most participants were females and 38% of foreign hospital employees were Philippine nationality. Most participants had moderate and high English language proficiencies, respectively. Supporting factors of the success in applying to work in Thailand included level of education, competencies/ special skills that are needed, and ability to communicate in Thai. Factors influencing decision making of the foreigners to Thailand seeking employment were both push factors, such as low wages, limited job availability, limited career progression, high living expenses, and pull factors, including gaining new experience, job opportunities, higher wages, better work benefits, low living expenses, opportunities to pursue higher education, being international health hub, safety of life and property, and educational collaboration. Furthermore, personal and family factors were indicated, such as ambition, exploring new experiences, and having family members living or working in Thailand. The processes of being employed as foreign healthcare providers included 1) preparing phase: language, working knowledge and employment laws, and health check-ups 2) applying phase: applying for a job by themselves after receiving information from the internet, friends, or relatives. A tourist visa was granted when initially arriving in Thailand and then changed to a non-immigrant visa “B”. The expenses involved in preparing for and coming to work included a VISA, passport, work permit, and travel. Most participants were working as medical service assistants, such as interpreters. Work permit renewal and adjusting to social and cultural differences were indicated as problems or obstacles encountered while working in Thailand.

Conclusions: The recommendations of the study were as follows: 1) the organization or employer should provide a basic training program in language and culture for foreign hospital employees, improve the regulations of VISA, MRA, professional licenses and 2) the organization or employer should improve workplace culture, such as being treated equally.