First doctor group license built in Shenzhen | | more practice _ health reform news
Doctors practising will usher in the spring?

"Congratulations! Doctors group ahead every step of the way, we leave our history ink. In 2016, doctors groups have sprung up. "On March 16, Zhang Qiang, Twitter released this statement, he is the founder of China's first specialist group, one of China's most well-known doctor minimally invasive surgery for varicose veins, this post is in honor of the first doctor's group license built in Shenzhen.

Getting this license is "German medical doctors group limited Shenzhen" (hereinafter referred to as the Baird), its "predecessor" is China's first "private doctors". On March 15, the corporate representative of Taiwan at Lo Wu control point in Shenzhen People's Hospital, held a press conference to announce it.

According to reports, Baird jialian patterns are medical practitioners and hospital signed a group of doctors and hospitals to sign service contracts, provide a valuable service, breaking the previous scope of practice restrictions, as long as the physician Group's medical register, you can practise in all medical institutions in Shenzhen.

　　First recognized by the business

Birth of the first doctor group in Shenzhen business license news, quickly drew the concern of the community, the doctors Group's future has become the focus of public discussion.

Interface journalists access to national industrial and commercial registration information found Baird's business scope includes medical management, medical research, three large domestic trade in goods. According to the record, on March 11, the company's name from "medical management dejia limited Shenzhen" is changed to "Shenzhen dejia physician group medical co., Ltd."

However, can register names with "doctor group" four words when you spent a lot of time. Baird CEO Xie Rushi said previously on business terms could not be registered "doctor group" Word, because of the "group" Word, the business sector will be asked to follow the group to declare, and later by the Shenzhen Municipal Health Planning Commission communication with market Administration Office.

In this regard, Zhang Qiang, founder of China's first specialist group has deep experience. He told interface journalists, their doctor Zhang Qiang group was established in July 2014, because at that time "the doctor group" is a new thing in China, industrial and commercial sectors could not be recognized, the words to appear on the registered name almost impossible, we can only use "medical technology", or "medical technology company limited" and other names instead.

Industry, Shenzhen issued China's first doctor's group license is of special significance. "This reflects ' a group ' has been recognized by the society, business license in the name of ' health care ' two words, having run the preconditions of medical institutions, it's a very big breakthrough. "Zhang Qiang said, established prior to doctor groups can only invest in medical institutions, to ban medical institutions also need another registered medical company.

At present, most doctors group using PHP (doctors-hospitals-partner) model cooperation with hospitals, in this mode, the doctors group does not belong to any hospital, sign it as a separate platform with a number of hospitals, and has its own customer service and return to the team.

Some doctors groups, within the doctor has not completely left the hospital, used the spare time to participate in the "doctor" group practice, such as Beijing's "people"; all others left the system, relying on their ability to obtain revenues, Zhang Qiang doctors group is one of the establishment.

2015, the doctors group in the domestic games. According to incomplete statistics, more than last year, there were more than 20 "doctor group" set up, "the doctor group" this concept has attracted more and more attention. Insiders pointed out that, as the Shenzhen made the first doctor group license, or doctor groups have sprung up growth in the future.

　　Doctors practising is expected to usher in spring

Doctor groups are recognized by society, to register more practising physician and freedom of choice of medical practitioners, it is undoubtedly good news. After obtaining the business license of the doctor group, they can justifiably carry out practice, development charges, there will be cooperation with more hospitals will push doctors to practise.

From 2009 "more practice" since the start of the pilot, the State has been promoting the policy, but the implementation is not satisfactory. In 2009, the Ministry of Health issued a notice on relevant issues in physician practice, raised a number of hospitals have signed an agreement through forms, horizontal or vertical cooperation, physicians to practise in other hospital medical cooperation.

In 2011, the former Ministry of health promulgated on broadening the range of physician practice pilot notification, asking state hospital reform pilot city, contact the provincial public hospital reform pilot areas, as well as two prefecture-level cities in every province except above cities, expanded for physicians practicing in pilot regions.

In 2014, the State Health Planning Commission, national development and Reform Commission, people and Social Affairs, the administration of traditional Chinese medicine, the China insurance regulatory Commission five ministries jointly issued a circular on promoting and standardizing the number of practising physicians more opinion to demand the cancellation of practice is limited by the number.

In recent years, Guangdong, Beijing, Hunan and other provinces and cities have introduced a policy of more practice, but the result was unsatisfactory. According to the economic daily news reported, 2009 16 hospitals in Guangdong province became the pilot units, as of 2014 data show that Guangdong doctor 217,000 people, handle more registered medical practitioners is only more than more than 4,000.

Doctors practising policies of cold case, and resistance from public hospitals and the regulatory system has a relationship. Shanyang County, Shaanxi Province, well-known columnist Xu Yucai, Deputy Director of health, the industry believes that more practice the procedures complicated, hidden in public hospitals and welfare higher and doctors work, why are difficult to implement.

In addition, the policy does not limit the practising conditions, he told reporters on the interface: "in a traditional medical system, doctors are people, not social beings, including personnel system, grade promotion and pension were all from the health sector, is not conducive to doctors from the unit into the social person. ”

However, Xu Yucai, now national policy reforms conducive to a doctor to practise free direction, physician practice is expected to loose more and more. He said enterprises have broken pension two-track system, which helps alleviate their psychological burden to protect doctors walked out of the hospital, achieving more practising.

With the deepening of reform in the past by the Ministry of health, human and social sectors to doctor title and promotion mechanisms for evaluation will be gradually transformed into by a third party agency, it also helps doctors transition from people as social beings, reduce doctors ' worries doctors more practice and free practice has a role in promoting.

　　Doctor groups can move health care dilemma?

All along, the doctor is difficult and expensive, and the doctor-patient relationship, and inefficient allocation of health human resource issues plaguing the country's health care system.

From July 1, 2014, Zhang Qiang was established after the first group of doctors, doctors group were many health-care experts think the trend is health care reform, is expected to move health care reform difficult even hope, doctors group really have so much energy?

In our public hospitals, doctors and hospitals often "tied together". Also in the law on medical practitioners, medical practitioners "to practise, a registration". Therefore, registered by doctors for doctors in public hospitals have great control, also became a resistance of health care reform.

Xu Yucai believes that current health reform's biggest difficulty is how doctors become social beings, now doctors belong to units within the system, this resulted in doctors do not need personal brand, is to visit a doctor at the Hospital of the people rather than a doctor, so hard to create a better quality of medical service.

"If doctors leave public hospitals, doctors must create their own brands. Have their own brands, have their own patient populations, physician development space is even bigger. "Xu Yucai said doctors each doctor is a separate entity in the group, is a member of the group, as well as more personal value.

Unreasonable remuneration of medical personnel system in China also has been criticized in public hospitals, doctors ' salaries are very low, based on the gross business income to determine the distribution, this method of remuneration is in fact encourage medical personnel to carry out income-generating, opening big prescription, to close red envelope phenomena such as trigger and continuing deterioration in the relationship between doctor and patient.

In recent years, many provinces are also studying a more reasonable system for medical staff, such as recently introduced healthcare reform in Beijing, one target "incentive mechanism of income distribution is more active and effective. Reasonably reflected labor value of medical technology. "However, the industry believes, medical service price adjustment has little space in public hospitals.

Zhang expressed, the health care system needs to release the doctor's labor, make rational allocation of human resources. Doctors in public hospitals do a good income is about the same, doctor's medical service prices and to increase income tied up the quality of care and the doctor group, good doctors ' income increased, doctors with poor earnings decline, which is more reasonable.

"Once you have left the institutional constraints, take part in market competition, we must rely on technology and service quality reputation, so doctors will attach greater importance to the patient experience. Will pay more attention to the brand. "Zhang Qiang said, doctors and hospitals is an equal partnership, but is now the hospital controls the doctor, and the doctor is able to change the business model of the group, the hospital physician services must be good to get more good resources.

Outlook for the development of domestic doctor groups, widely optimistic, but others believe that resistance in the process of development is not small. Xu Yucai, said doctor group's "road" is still very long, in order to get a better development, and health management laws and regulations must be amended, such as easing restrictions on practitioners of the law and to relax restrictions on physicians group hospital.

Responsible editor: Wang Hao

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首张医生集团营业执照落户深圳|医改|多点执业_新闻资讯
医生多点执业将迎来春天？

　　“祝贺！医生集团往前每走一步，都会留下历史的墨迹。2016年，医生集团将如雨后春笋。”3月16日，张强在微博上发布了这段话，他是中国首家专科医生集团创始人，也是中国最知名的静脉曲张微创手术医生，此条微博正是为了祝贺国内首张医生集团营业执照落户深圳。

　　获得这张营业执照的是“深圳博德嘉联医生集团医疗有限公司”（以下简称博德嘉联），其“前身”是中国首家“私人医生工作室”。3月15日，该公司法人代表林锋在深圳罗湖人民医院举行新闻发布会宣布了此事。

　　据介绍，博德嘉联的执业模式是医生和医院签约，医生集团和医院签服务合同，提供有价值的服务，打破此前执业范围的限制，只要到医生集团下的医疗机构注册，就可以在深圳市所有医疗机构执业。

　　首次获工商认可

　　国内首张医生集团营业执照在深圳诞生的消息一经传出，迅速引来了社会各界的关注，医生集团的前景成为了民众讨论的焦点。

　　界面新闻记者查阅全国工商登记信息发现，博德嘉联的经营范围包括医疗管理、医疗技术研究、国内商品贸易三大块。据记载，3月11日，该公司名称由“深圳博德嘉联医疗管理有限公司”变更为“深圳博德嘉联医生集团医疗有限公司”。

　　然而，能在注册名称加上“医生集团”四个字当初也是费了一番功夫。据博德嘉联CEO谢汝石透露，此前在工商词条上不能注册“医生集团”等字眼，因为有“集团”二字，工商部门会要求按照集团公司来申报，后来经深圳市卫计委与市场监督管理局沟通协调才办下来。

　　对此，中国首家专科医生集团创始人张强也深有体会。他告诉界面新闻记者，他们在2014年7月成立了张强医生集团，由于当时“医生集团”在国内是一个新生事物，得不到工商部门认可，若要在注册名称上出现这几个字几乎不可能，只能以“医疗科技有限公司”或“医疗科技股份有限公司”等名称代替。

　　业内人士看来，深圳发放国内首张医生集团营业执照有着特殊的意义。“这反映出‘医生集团’已得到了社会的认可，营业执照的名称里有‘医疗’两个字，说明具有办医疗机构的前置条件，这是个非常大的突破。”张强说，之前成立的医生集团只能投资医疗机构，要办医疗机构还需要另外注册医疗公司。

　　目前，国内的医生集团大多采用PHP（医生—医院—合作伙伴）模式与医院开展合作，在这种模式下，医生集团不属于任何一家医院，它作为一个独立的平台与多家医院签约，并有自己的客服和回访团队。

　　有的医生集团，医生还未完全离开体制内医院，只是利用在原单位工作之余的时间，参加“医生集团”的执业，如北京的“大家医联”；有的则全部离开了体制，靠自己的能力获取收入，张强创立的医生集团便是其中之一。

　　2015年以来，医生集团在国内大放异彩。据不完全统计，去年国内便有20余家“医生集团”成立，“医生集团”这一概念也吸引了越来越多人的关注。有业内人士指出，随着深圳发放首张医生集团营业执照，今后医生集团或如雨后春笋般增长。

　　医生多点执业有望迎来春天

　　医生集团得到社会认可，对注册多点执业的医生和选择自由执业的医生来说，无疑是个好消息。医生集团取得营业执照后，便可以名正言顺开展执业，制定收费标准，过程中将会与更多的医院合作，将推动医生多点执业的开展。

　　从2009年“多点执业”开始试点以来，国家一直在推进该政策，但实施效果并不理想。2009年，原卫生部发布了《关于医师多点执业有关问题的通知》，提出多个医院可以通过签订协议等形式，开展横向或纵向医疗合作，医师可以在开展医疗合作的其他医院执业。

　　2011年，原卫生部又颁布关于扩大医师多点执业试点范围的通知，要求公立医院改革国家联系试点城市、公立医院改革省级联系试点地区，以及每个省除上述城市外的两个地级市，扩大为医师多点执业试点地区。

　　2014年，国家卫计委、发改委、人社部、中医药局、保监会五部委联合印发了《关于推进和规范医师多点执业的若干意见》，要求取消执业地点数量的限制。

　　近几年来，广东、北京、湖南等多省市先后推行了多点执业的政策，但实施的效果却不尽人意。据《每日经济新闻》报道，2009年广东16家医院成为了试点单位，截至2014年的数据显示，广东有医生21.7万人，办理多点执业注册的医师仅4000多名。

　　医生多点执业的政策遇冷，与公立医院的抵制和监管制度不完善有着关系。陕西省山阳县卫生局副局长、业内知名专栏作者徐毓才认为，多点执业申报的程序复杂，公立医院隐性福利高和医生工作任务重等都是实施难的原因。

　　此外，政策不配套也限制了多点执业的条件，他对界面新闻记者说：“在传统的医疗体系中，医生是单位人而不是社会人，包括人事制度、职称晋升还有养老保障等都脱离不了卫生部门，不利于医生从单位人变成社会人。”

　　不过，徐毓才称，现在国家的政策改革走向往有利于医生自由执业的方向发展，医师多点执业有望越来越宽松。他表示，企事业单位已破除养老金双轨制，这有利于减轻他们的心理包袱，保障医生从医院走出来，实现多点执业。

　　而随着医改的深入，过去由卫生部门、人社部门对医生职称、晋升进行评定的机制会将逐渐转变为由第三方机构评定，这也有利于让医生从单位人转型为社会人，减轻医生们的后顾之忧，对医生多点执业和自由执业都有推动作用。

　　医生集团能撬动医改难题？

　　一直以来，看病难、看病贵、医患关系恶化以及医疗人力资源配置效率低下等问题困扰着国内的医疗体系。

　　从2014年7月1日，张强成立国内第一家医生集团之后，医生集团模式便被不少医改专家认为是医改的大趋势，甚至被寄予撬动医改难点的希望，医生集团模式真的有如此大的能量吗？

　　在我国的公立医院中，医生和医院往往“捆绑在一起”。《医师法》中也规定，医生“一地一执业，一地一登记”。因此，医生所注册的公立医院对医生具有巨大的控制力，也成为了医疗改革的一个阻力。

　　徐毓才认为，目前医改最大的难点在于医生如何从单位人变为社会人，现在体制内的医生都属于单位的，这导致医生不需要个人品牌，老百姓去看病是冲着医院去而非医生，这样难以打造出好的医疗服务品质。

　　“若医生离开公立医院，医生必须打造自己的品牌。有了自己的品牌，有了自己的患者群，医生的发展空间便更大。”徐毓才说，医生集团中的每个医生就是独立的个体，既是集团的一份子，同时更重视个人的价值体现。

　　我国医务人员人事薪酬制度不合理的问题也一直被人们所诟病，在公立医院中，医生的工资被定得很低，再根据业务收入来确定可分配总额，这种薪酬方式实际上是在鼓励医护人员进行创收，开大处方、收红包等现象随之发生，医患关系持续恶化。

　　近年来，不少省市也在研究出台更合理的医务人员薪酬制度，如北京市近日出台的医改方案中，将其中一个目标定位“收入分配机制的激励作用更加积极有效。医务人员技术劳动价值得到合理体现。”不过，有业内人士认为，公立医院的医疗服务价格调整空间并不大。

　　张强对此表示，医疗体系需要释放医生的劳动力，实现医疗人力资源合理配置。在公立医院的医生做得好不好收入都差不多，医生的医疗服务价格难以提高，而医生集团把医疗质量和收入捆绑起来，好的医生收入增加，差的医生收入下降，这样更合理。

　　“一旦医生离开了体制的束缚，参与市场竞争，就必须靠技术和服务质量赢得口碑，因此医生会更重视病人的体验。会更注重服务品牌。”张强说，医生和医院本来是平等合作关系，但现在的情况是医院管制了医生，而医生集团则能改变医院的经营模式，医院必须把医生服务好才能获得更多优秀资源。

　　对于国内医生集团的发展前景，业内普遍表示看好，但也有人认为在发展过程中遇到的阻力并不小。徐毓才表示，医生集团要走的“路”还很长，要想得到更好的发展，必须修订医疗管理方面的法律、法规，如放宽《医师法》对医生执业的限制，以及放宽对医生集团创办医院的限制等。

责任编辑：王浩成

文章关键词：
医改 多点执业

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