Doctors more practice "not hit" gave money

imparting knowledge "is still popular.

People's Daily

Cure of as a feature of the pilot work practice, doctors more has been developing for two years. Recently, the health ministry has issued relevant regulations, encourage again doctors more practice, hope more doctors to join them. However, this be regarded as can effectively relieve difficulties in getting policy, but facing many difficulties. What is the status of practicing doctors more? Reform way out? From today on, this version will launch reported, attention please.

The doctor lower participation rate--

Doctors more practice "not hit" gave. Whether bid for more practice? Many doctors, watching the hospital "expression"

In April, 2009, the central committee of the communist party of the state council on deepening the reform of medical care system opinion "put forward" the research exploration registered doctors more practice ". In September, the health ministry issued the relevant problems about doctors more practice, notice of relevant standards and make. Then, guangdong, hainan and yunnan, sichuan, Beijing, jiangsu, pilot expansion.

After two years of trial run, in July 2011, the ministry of health issued a circular, decided to pilot areas to expand the national all provinces, at the same time, reduce the threshold, apply for the qualification of physicians by more than four came for intermediate above.

However, in the face of the state encourages doctors to practice more, the doctor did not seem to give policy positive response, doctors more practice "not hit" gave.

This year on March 1, "Beijing doctors more practice management measures (trial implementation)". As of June 30, only 166 physicians for registration.

The first trial of guangdong province, the provincial pilot doctors more practice more than a year, more than 100 doctors only apply for registration, and all for the same system internal more practice.

A series of pilot projects in kunming for 2 years so far this year, May 17, 1223 doctors more practice, signed the registered accounts for only 5.32% of the number of doctors.

Such a small "action", and to promote the high quality hard far medical resources to grassroots, private medical institutions of flow purpose. Obviously, more practice are not the doctor's favor.

"Now, I haven't applied for more practice and see how it goes." The Beijing some 3 armour hospital a senior dentist, and in recent years time by day, to a private clinic regularly joint venture do teeth preferences. "In the medical practice does not involve personnel system, not like the current regulations so a concern. He said.

According to information, to ensure that the doctor in its first registered place medical effects, the Beijing municipal provisions apply for more doctors to practice before, to get the consent of the current post hospital, and a written agreement in the hospital, the doctor of the clear responsibilities. Whether bid for more practice? Many doctors, watching the hospital "expression".

"Big hospital human resource nervous, most doctors working time is saturated state, go out much time practicing medicine. To practice more, will definitely affect this unit work." Beijing military area commands general hospital uropoiesis surgical department, deputy director of ZhangGuoHui said.

"The reason I didn't put forward an application, because the benefits of institutions. Crush" A Beijing hospital doctors say, "my wife" means have the patient of resources, scientific research conditions and other benefits, public hospital can provide more professional achievement, so most doctors still don't want to do freelancers.

"Money imparting knowledge" is still popular--

The doctor status is "unit person", not "society", this is the biggest obstacle to the free flow of

Although more practice had a chill welcome, but the doctor "money imparting knowledge" currents still raging. All the famous doctors, especially large hospital doctor, good operation in the unit, had long been a practicing outside an open secret.

Six months ago, hebei hengshui city middle school teachers' little bud of a father suffered from stomach cancer. After her request, the city from the provincial hospital a hospital for surgery. The big, please Total expenses of operation of 36000 yuan, the old man recovered well.

"If I and love to go to Beijing to see the doctor, with father 3 individual sit back and forth the train travel about 500 yuan and 200 yuan hotel every day, when can hang ZhuanGuHao live even senate? Just wait, wait for means money." Small rapunzel, let people think at home can look experts, is a "three win" good: for doctors bring more reward; As for patients, get experts, save medical expense and diagnosis; Both for medical institutions, keep the patients, learned the technology, it also increases the income.

It is reported that in 2005 the health ministry issued the doctor out consultation provisional regulations of the administration, many experts on approved by the hospital where, in order to "go out" style and consultation on the practical significance of the more practice, is just a random, not fixed. And more "weekend outpatient service", "flight" surgical "underground" phenomenon, has become a money imparting knowledge industry unspoken rules. The municipal bureau of health medical administration of place, according to the survey, a dozen private hospitals in Beijing, 174 from Beijing each hospital doctor.

November 15, 2010, "the queen the facial plastic surgery to death" events once again exposed the this outside the hospital "the live" hidden trouble. On the basis of the surgeon, WangBei WangLiangMing registered in guangzhou qualifications, but in wuhan medical practice more than a year.

The medical work is organized, continuity of behavior, consultation of the way the organized and continuity interrupted, often is the doctor finish see disease, finish operation goes, the treatment of patients with observation late hard to get the security.

Experts point out that, our country doctor status is "unit person", not "society", this is the biggest obstacle to the free flow of. Only let the doctor by "units" gradually transition to "social", to make more practice policy into effect.

"The doctors more practice is consistent with the international prevailing rules of approach." Beijing mainly introduces, person in charge of the dental HeZhou in some developed countries, doctors are self-employed, get qualifications and through an application, can be in many hospitals flow practice. Doctors and hospitals are not employment relationship, but collaboration.

"In addition to the sudden illness need to go to a hospital emergency outside, the American doctor generally, looking for his own family doctor." HeZhou for example, the patient abdominal pain, the family doctor after open primary diagnosis, the patient to the hospital to check list. According to the test results, the family doctor if think is stomach trouble and will recommend stomach trouble specialized subject doctor. If you need surgery, this specialized subject doctor in the hospital will give patients do. Cooperation This system arrangement, and to release the productivity of the doctor, good directly the doctor and the patient doesn't need to focus on ran to the big hospital.

The Massachusetts health welfare department, central, a senior fellow at business school and Shanghai filthy part-time professor CAI jiangnan think, experts in different level if can flow between medical institutions, to a certain extent, can dissolve the medical resources uneven distribution of the difficult question of doctor brought.

The Beijing health bureau, said the deputy director of DengXiaoHong will conduct special inspection, urged outside the hospital doctors bid for more part-time as soon as possible to practice as a certified, otherwise will according to punish illegal medical practice.

Policy remains to be perfect--

The hospital has been put doctors as their assets. Doctors more practice if comprehensively launches, the hospital will face the core competitiveness of the shunt risk

A aimed at relieving the difficulties in getting good policy, why push up problematic?

"To implement the doctor more practice to civilian battalion hospital, it is a good thing, but at present the relevant provisions of the scruples and let doctors." A private dental clinics chief says to the reporter, "and to the YiWuChu our approval, but also to health bureau, who also went to bid for the record? I here part-time doctors are famous Beijing hospital subject experts, they go out are not willing to let the medical unit know."

The reporter interviews found that for doctors more practice topic, Beijing hospitals most take evasive attitude. "Hospitals will not support from your heart doctors more practice." A private in the outside the hospital part-time doctor says to the reporter, the current system arrangement, will doctors and hospitals are bound together.

According to introducing, at present, China's medical talents rely mainly on the employing units of investment, the government's investment is for the implementation of the basic unit, teaching, scientific research resources mainly concentrated in the large public hospital. The doctor in the academic circle of the position and the hospital where the influence closely related.

The doctor's growth cannot leave the hospital platform, the core competitiveness of the hospital from the high quality human resources. Therefore, DuoNian to hospital has been put doctors as their assets. Doctors more practice if comprehensively launches, the hospital will face the core competitiveness of the shunt risk.

"In addition to unit pressure, medical liability risk is is not open around the difficulty." ZhangGuoHui pointed out that in developed countries, a specialist after surgery, and other links have person for them. But in China the to the surgeon from beginning to end is responsible for a hospital patients, among which link problems, want to assume responsibility.

According to understand, because financial investment, less public hospital now mostly didn't give doctors buy medical liability insurance. Happen when compensation, most medical hospital adopt hospitals and department of department cost share, most physicians by liability bill. In this case, many doctors to practice more medical risk be concerns.

"Right now, the civilian battalion hospital and foreign experts discuss part-time, often avoid liability problem." Introduce according to the personage inside course, some civilian battalion hospital from part-time experts will pay 5% as risk, extraction of dental benefits. A year come down, if not happened, the responsibility for dental benefits will be refunded.

"The medical quality how to ensure medical liability? Who will bear? These are the key issues of the practice more, the government should make clear rules." CAI jiangnan said. (reporter LiXiaoHong)