[CCTV Review] Refuse to prescribe medicine without examination？ Why did the hospital make this decision？

The hospital stipulates that the examination fee and medicine fee prescribed by doctors for patients should reach 1:1, and bonuses will be deducted if they fail to meet the standards; Therefore, doctors can only "implore" patients not to prescribe drugs without examination.

In recent days, a piece of "An Min Notice" on the desktop of the oncology specialist clinic of Guangzhou Hospital of Traditional Chinese Medicine has attracted attention. Some doctors revealed that because income is linked to "billing", doctors, nurses and even department directors have resigned. (April 10, Yangcheng Evening News)

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What is the reason why Guangzhou Hospital of Traditional Chinese Medicine did this?

The income of doctors is directly linked to the income of departments.

The income of the hospital is mainly composed of drug income, examination income, medical income and other income.Especially in some traditional Chinese medicine hospitals, their turnover of examination, operation and prescription is generally far behind that of general hospitals. In order to support doctors and nurses, hospitals must try their best to encourage doctors to pay more examination fees with lower cost, and also combine examination fees with performance distribution.

Reducing "Drug Proportion" to Meet Higher Inspection

There is a very important index — — Proportion of medical expenses.According to the current requirements, the drug fee income of tertiary hospitals generally does not exceed 50% of the total hospital income.In this reality, some hospitals require to ensure that the ratio of drug fees to inspection fees is always 1: 1.

The purpose of controlling the "proportion of drugs" at the national level is to control the drug income of hospitals, so as to effectively solve the problem of supporting doctors with drugs, but why did it change its taste when it came to Guangzhou Traditional Chinese Medicine Hospital? What happened when I left?

【Cctv review] get rid of taking medicine to support medicine, and don’t let the crooked monk bend the scriptures.

It is the highlight of promoting the reform of the medical system to get rid of using medicine to support doctors.In recent years, there have been many water tests all over the country, and many places have also summed up good experiences. However, this time, the situation in Guangzhou Chinese Medicine Hospital has greatly reduced people’s confidence.Will "medical care with medicine" be replaced by "medical care with examination"?

"It is difficult and expensive to see a doctor" has been criticized, and "separation of medicine" has always been considered as a magic weapon to alleviate "expensive medical treatment".When the income of doctors and hospitals is no longer linked to drugs, the impulse of doctors to promote drugs will naturally fade, which will eventually benefit patients.For example, Beijing Chaoyang Hospital introduced medical service fees in 2012, and at the same time cancelled drug addition. 1148 kinds of drugs sold in hospitals are all sold at the purchase price. The reform has made many people see the hope of "separation of medicine".

However, this time, the regulations of Guangzhou Chinese Medicine Hospital are like taking a pot of cold water. In the process of "separation of medicine and medicine", the cost of medicine may have dropped, and the cost of examination has gone up, and the patient has not benefited. Why is this happening?As we all know, the diagnosis and treatment systems of traditional Chinese medicine and western medicine are completely different.Western medicine relies more on technical equipment for diagnosis and treatment, and obtains the basic data of the disease through CT, chest X-ray, electrocardiogram and other inspection items. Traditional Chinese medicine relies more on experience to feel the patient’s condition and prescribe the right medicine. Therefore, in the income composition, Chinese medicine relies more on Chinese medicine, while western medicine accounts for part of the inspection fee and medicine fee. As you can imagine,When the hospital is asked to reduce the drug fee, in order to increase the income, it must raise the inspection fee like a seesaw, and the wonderful regulations come from this.

Necessary examination subjects are indispensable, but unnecessary examination subjects will increase the burden on patients.As you can imagine, when you have to do ECG and X-ray for minor illnesses such as catching a cold, "reducing the burden on patients" becomes an empty talk.

At the national level, the top-level regulation of "drug proportion" is made to control the drug income of hospitals, thus effectively breaking the practice of supporting doctors with drugs. However, at the implementation level, it has become a "medical examination", which shows that "separation of medicine" can not be achieved in one battle. In the process of promoting reform, medical institutions should also take the initiative to enhance the underlying design. Otherwise, the original intention of good reform will inevitably change at the grassroots level, and "expensive medical treatment" will become "more expensive medical treatment".

Reducing the proportion of drugs is to reduce the burden on patients.On the one hand, efforts should be made to reduce the impulse of doctors to sell drugs through changes in institutional mechanisms.Of course, this does not depend on promoting the impulse of doctors to sell "examination subjects", nor can we expect doctors to lose their income.Therefore, we should do everything possible to mobilize the enthusiasm of doctors to provide better medical services for patients.The medical service fee for testing water in Chaoyang Hospital emphasizes the value of doctors’ professional services, which can be used for reference.On the other hand, the reform of "taking medicine to support doctors" should also appropriately increase investment in hospitals.Otherwise, blindly emphasizing self-revolution and letting doctors reduce their income will lead to an embarrassing scene in Guangzhou Traditional Chinese Medicine Hospital: doctors work hard to see a doctor with their conscience and earn 18 yuan wages in one month; Or don’t prescribe drugs to patients unless they undergo a series of unnecessary medical examinations.

Get rid of medicine to support doctors, yes! Reducing the cost of medicine is also true!The mistake of Guangzhou Hospital of Traditional Chinese Medicine lies in the fixed thinking: the loss inside the embankment must be compensated outside the embankment.This also tells us that it will not be smooth sailing to break the road of supporting doctors with medicine.In order to make the medical system reform finally succeed, "patients’ interests" and "doctors’ enthusiasm" must achieve a win-win situation, and neither can be less!