The Guangdong Provincial Medical Reform Office is formulating a number of “Policy Measures for Accelerating the Development of Social Medicines†(hereinafter referred to as “Measuresâ€), which will support and encourage private medical institutions by simplifying examination and approval procedures, exploring public-private partnerships, and promoting multi-point practice. development of. The "Measures" allow eligible pharmacies to be approved by the government for approval. Liberation of doctors, nurses and pharmacies, allowing public hospital doctors, nurses and hospitals to sign flexible employment contracts, to go to the social medical institutions to practice more.
At present, the reality of China is still in the state of doctors practicing at a fixed point. Medical resources are highly concentrated in public hospitals, and the medical levels of hospitals at all levels and at all levels are extremely different and unevenly distributed. In the medical reform, the decision-making level has been striving to implement multi-point practice and encourage the development of private medical institutions. Many policy measures have also been introduced, but there has not been any breakthrough.
Since the original Ministry of Health first proposed in 2009 to “explore the practice of registered physiciansâ€, it has been six years, and the latest policy introduced in January this year has removed the regulations for doctors to apply for medical institutions. Reporting. However, the practice of multi-point practice is still very embarrassing. Young doctors are afraid to apply for fear of affecting promotion. The chief physician has been working full-time and full-time. At the end of the day, the application for more practice has become synonymous with courage, far from being normalized. . In fact, China's medical resources and medical evaluation system are concentrated in public hospitals rather than doctors. Under the relationship between employers and employees, for the sake of their own interests, more practice can not bring benefits to both parties. Public hospitals It is impossible for doctors and doctors to treat multiple practice as an occupational norm. The development of private medical institutions such as community hospitals and clinics is even more difficult to develop in the absence of doctor resources.
Due to the concentration of medical resources, doctors' dependence on public hospitals is very serious, and it is difficult to have practical results in many practice. To achieve multi-point practice and promote the development of private medical institutions, it is first necessary for doctors with licensed doctors to choose a practice mode and a fully competitive environment so that doctors not only rely on hospitals. This environment requires not only the separation of a hospital management office, but also the establishment of a doctoral evaluation system and self-discipline regulation that is independent of the hospital, that is, establishing a diversified medical system on the basis of ensuring the free flow of doctors.
In the "Measures" proposed, "signing a flexible employment contract", the form is limited to the doctors loosened, laying the procedural foundation for the realization of multi-point practice normalization. However, in order to ensure the effective implementation of multi-point practice, the problems that need to be solved are very realistic. For example, doctors have their own patients who can use hospital beds, equipment and nurses, that is, doctors who sign flexible employment contracts will get the corresponding resources. And after they sign a flexible employment contract, whether there are channels in the market that allow them to reach patients and achieve the same or even more value as a full-time practice in a public hospital. If the answer is no, this breakthrough new rule may become a dead letter.
To realize the practice of doctors and promote the development of private medical institutions, in fact, it is possible to leverage Internet medical care. Internet medical care has always been favored by all walks of life, but the focus is mostly on online medical treatment. Due to safety and regulatory difficulties, online medical treatment has been stopped. But in fact, Internet medical care for the current China, the greater possibility and development space may be to break the original medical system resources and liberate doctors from the dependence on the hospital. The nature of Internet medical care itself is to provide a channel outside the hospital for doctors' personal contact with patients, and this channel itself helps to form an evaluation system. In foreign countries, there have been very successful cases. ZocDoc was founded in 2007 to recommend doctors according to the geographical location, insurance status and doctor's professional factors, and can complete the appointment directly on the platform. The charging mode is to charge individual doctors. The patient is free. Of course, Uber in the medical field needs the cooperation of the medical insurance system and the environment in which doctors practice freely, but in turn, Uber, who borrows the medical profession, can also force the adjustment of medical reform and medical insurance system.
The flexible employment contract is a breakthrough in the medical reform process. However, in order to resolve the reality of multi-point practice, it is still necessary to take advantage of the power of Internet medical care to activate individual doctors, ease the uneven distribution of medical resources, and reduce the cost of medical treatment.
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