Can also show off outside the system
Although public hospitals are overcrowded, many doctors still lack the opportunity to go out for outpatient clinics and perform surgery themselves. There is a lot of free time. Even for key doctors, legal income is low
Since the establishment of the Hartrim Doctors Group, Liu Xingpeng, the chief physician of the Department of Cardiology of Beijing Chaoyang Hospital, feels that his awareness of serving patients has increased, and technology has become more useful.
“Before, I was very busy in a big hospital. Many patients came to see the hospital’s reputation. I was busy with the tide-like patients every day. In fact, most of the cases did not require a specialist like me to handle it. This is also the original intention of the country to promote graded diagnosis and treatment. After the founding of the doctors' group, I realized that the doctor's brand is very important. I must focus on medical services and improve my skills. Everything from the patient's point of view, while building my own brand, can improve efficiency and spend time on specialists who need me. On the case," said Liu Xingpeng.
The 10 core experts of the Donglei Brain Doctor Group are full-time and do not retain the identity within the system. Dong Fanning, the co-founder of the group, said that public hospitals are like a thermal insulation bucket. When they first came out, in the face of market competition, doctors did have a sense of discomfort. However, it will be slowly discovered that after the time comes out, the choice becomes larger, and the professional development enters a benign track, which is more enjoyable and happy. “You don’t have to rely on publishing international core journal papers to prove yourself. The market can evaluate your professional ability. The relationship between doctors and patients has also changed. Patients have become food and clothing parents. Only by providing better services can they have a foothold in the market. place."
Recently, a doctor group research report released by the National Health and Health Research Center of the National Health and Family Planning Committee believes that the doctors group provides a breakthrough for medical reform, practicing more doctors, sinking high-quality medical resources, achieving graded diagnosis and treatment, and alleviating contradictions between doctors and patients. It is a useful exploration to reform the medical staff's salary system, build a diversified medical service supply system, and improve the patient's medical experience.
Researcher Miao Yanqing of the center found that in public hospitals, most key doctors generally have more demand for practice. "Although public hospitals are overcrowded, many doctors still lack the opportunity to go out for outpatient surgery and personally perform surgery. Less. Even the backbone doctors, the legal income is low. Many doctors are eager to obtain dignified sunshine income through their own technology.†Some primary medical institutions or private medical institutions need doctors capable of invigorating large hospitals to invigorate them, especially Patients such as cardiovascular and brain sciences have proliferated and there is an urgent need to improve their service capabilities.
“The Doctor Group will bring together doctors with more practical needs, establish an information exchange platform, help doctors choose to sign hospitals, concentrate on negotiations, and respond to risks, providing a more convenient platform for doctors to practice more, and improve the efficiency and promotion of health services. The rational distribution of medical resources is a useful exploration. Allowing doctors to obtain dignified income, enhance the professional value of doctors, and stimulate the internal motivation of doctors to serve patients is one of the important goals of promoting healthy China construction and deepening medical reform. Appeared, providing new ideas and new ways to solve this problem." Miao Yanqing said.
Doctor group identityå°´å°¬
Since the doctors' group is not a medical institution, the doctors within the group cannot legally practise as a group, but must register the practice location with the cooperative medical institution.
Is the doctor group a medical institution or a general business organization? So far, its identity is still a controversial topic.
In March 2016, Shenzhen issued the first “Doctor Group†business license in the country. Subsequently, Guangdong, Fujian, Shaanxi, Guizhou, Anhui, Yunnan, Hunan and Xinjiang also approved the industrial and commercial registration of the “Doctor Groupâ€, but so far no one has obtained the medical industry 's qualifications. Most doctors' groups are engaged in medical investment, management investment, technical consultation, etc. Only some areas such as Shenzhen and Hunan have joined the “providing medical and human resources management services within the business scope of some doctors' groups; organizing medical personnel in legal medical care. The organization conducts medical services and other related content.
When most doctor groups and medical institutions cooperate, they sign technical consultations and cooperation agreements. Most doctor groups are just "doctor's brokerage platforms", and some Internet-based doctor groups only use Internet technology to build a doctoral consultation platform, and some so-called doctor groups belong to the "yellow cattle" nature.
The complex service content is not conducive to the healthy development of the doctor's group's main business. The research report of the Health Development Research Center of the National Health and Family Planning Committee proposes that the scope of the medical business of non-medical services should be studied as soon as possible, and the nursing, care, lifestyle management, psychological counseling, and weight management should be actively explored and studied. The content of the service is included in the scope of the doctor's group.
Since the doctors' group is not a medical institution, the doctors in the group cannot legally practise as a group, but must register the practice location with the cooperative medical institution. The doctors also need to cooperate with the medical institution to purchase the medical insurance.
According to international experience, the doctors' group is an entity consisting of more than two doctors, with doctors as the main body, and the main income is the income from medical services. In China's "Administrative Rules for Medical Institutions", the category of medical institutions does not include the "doctor group." If you register as a medical institution, you will need to use rooms, equipment, etc. "The biggest advantage of the doctors' group should be light asset management. China can position the doctors group as a 'corporate group' or 'entity institution' that mainly provides medical services." Miao Yanqing said.
Deng Yong, an associate professor of medical and health law at Beijing University of Chinese Medicine, believes that the doctor group itself is a model for doctors to practice. The form of the group company does not affect the practice of doctors, but it can make doctors more flexible in providing medical services. It is recommended that the nature of the doctor's group be defined as a non-medical institution, adopting general industrial and commercial registration, and conducting supervision and tax collection and management in accordance with general enterprises.
Dong Fading suggested that for the current doctor group companies, the management qualifications such as doctors' practice registration and job title promotion can be granted by law, similar to the form of law firms, in order to better regulate the practice of doctors.
Unlike foreign countries, there is no special “doctor service fee†in China. Due to fee-based items and price restrictions, most doctor groups have more cooperation with private hospitals and less cooperation with public hospitals. Some doctors' groups are working on the development of the corresponding clinical path and cost accounting system to determine the cost of medical personnel's technology and services. To this end, the National Health and Medical Research Center of the National Health and Family Planning Committee recommended that the "medical insurance designated doctors" and "medical insurance designated doctors group" should be added, and the "physician service fee" should be piloted as a expenditure item for medical institutions.
Deng Yong believes that because the doctors group has changed the charging mode of traditional medical institutions, the cost of medical treatment is determined by the market supply and demand, which further highlights the independent pricing of doctors, and generally charges higher than public hospitals. This income gap may lead doctors to transfer patients from public hospitals to contracted private institutions to increase their labor income and so on, causing losses to public hospitals. Therefore, it is necessary to properly regulate the development of doctors' groups to prevent doctors from maliciously diverting patients to the original medical institutions. "It is advisable to use non-prohibited norms to encourage innovation and create a relaxed legal environment for the development of doctors' groups."
"Shared hospital" is worth learning
The doctor group and the medical institution can only accept the consulting fee, which does not reflect the doctor's labor technology value; the public medical institution and the doctor group have concerns when they cooperate, fearing the loss of state-owned assets.
"The future doctors' group can be a partnership of light assets or a medical group with heavy assets." Dong Fating believes that doctor groups are generally dominated by loose alliances and part-time jobs. The 2.0 version of the joint development will be based on full-time, the company has unified values, reasonable organizational structure, and a preliminary profit model. The stable and expandable version 3.0 has a reasonable shareholding structure design, has clear talent training ideas, is supported by reasonable charging standards, and has a medical entity as the foundation.
"Capital can enter, but it must be a doctor-led entity medical institution." Dong Fanting said. He explained that the original patient was looking for a hospital, and the doctor was an accessory to the hospital. After the emergence of the doctor group, the patient is the customer, the hospital becomes a platform, and the doctor does not need to be bound in the hospital. However, the doctors' group should be the main body of responsibility in order to enable doctors to better practice, to provide patients with quality medical services, and to cultivate their own academic teams and systems. "Now the medical group does not have its own physical medical institution and cannot be the subject of responsibility. It cooperates with medical institutions, safeguards the rights and interests of doctors, and charges are restricted." Dong Fanting said.
According to Miao Yanqing, doctors' groups and medical institutions can only accept consulting fees, which cannot reflect the value of doctors' labor technology. Public medical institutions and doctors' groups have concerns when they cooperate, fearing the loss of state-owned assets. Therefore, the medical team is trying to find a way to build their own medical institutions.
Fan Rui, chief operating officer of the Hartrim Doctor Group, is also preparing to build the group's medical institutions. “We have a mature professional team, experts are responsible for treating patients, and the operation team has 20 or 30 people, including brand building, market development, nurse team building, etc. Doctors concentrate on developing academics, and others can be handed over to the company for operation. If you have your own medical institution, the Group can better carry out medical service process innovation and discipline talent training, and provide higher standards of medical services and talent reserves for partner institutions to better achieve the Group's goals."
Miao Yanqing believes that in many developed countries, medical insurance dominates the practice of doctors. After most specialists are included in the insurance list, they can rent a “shared hospital†office and use the shared hospital equipment and pathology center. Practiced. If there is a similar “shared hospital†in China, the doctors group does not need to create a huge medical institution. Once you become a medical institution, you lose the advantage of its light assets. The medical group only needs to be an entity that can provide medical services, and the management department gives permission to practice and establish specifications. (People's Daily)
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