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A lot of doctors lose: Eight adults want to change jobs
On March 25th, the China Hospital Association released the Investigation Report on the Loss of Talents (Flows) in County Hospitals (hereinafter abbreviated as “Reportâ€). It was clearly pointed out that there was a clear trend of the loss of staff in county-level hospitals, which exceeded the expertise of public hospitals at county level. The number of talents is difficult to meet the demand for medical services. In fact, in the current contradictions between doctors and patients, and the frequent occurrence of malignant medical incidents, all levels of hospitals in the country are facing the dilemma of doctors changing jobs or changing jobs.
Bacheng doctor wanted to change career
The "Report" pointed out that from 2008 to 2012, the average number of emergency personnel at county level public hospitals rose from 201,000 to 318,000, and the average number of people hospitalized increased from 16,000 to 26,000. In contrast, the number of doctors is rapidly decreasing. The growing "used people shortage" has added to the shortage of talented county-level hospitals.
After investigating on-site investigations in Jiangxi, Guizhou, and Shaanxi, researchers found that out of the 86 county-level public hospitals, a total of 9,392 medical personnel flowed out in four years, and an average of 20 to 30 people flowed out of each county hospital each year. Outpatients were mainly clinicians, of whom more than 70% went to higher-level hospitals or economically developed areas; youth, intermediate professional titles accounted for 76.6%, and associate senior professional titles accounted for 36.4%.
In other hospitals, the phenomenon of doctors changing is also more common. In 2013, a survey conducted by the Lilac Park website showed that among the 11,910 first-line clinicians, 81.9% said that they had changed their minds. In January of this year, the investigation report issued by the Liaoning Provincial Physicians Association also pointed out that more than half of doctors lacked sense of accomplishment and 41.4% of doctors had a tendency to leave.
The reason is that the survey of the Clove Garden shows that about 64.3% of people believe that "the workload is too heavy, lack of rest time"; about 57.4% of people are "not satisfied with the income situation"; about 51.5% of people think that "work pressure is high" . "Social bias, media distortions" also made nearly half of the doctors unbearable.
In recent years, frequent malignant medical incidents have also affected the enthusiasm of doctors. After the 2012 medical doctor's killing of the medical incident, Zhang Qiang, then director of the Department of Vascular Surgery at Dongfang Hospital, Tongji University, found that the loss of young doctors in the hospital was very serious and many doctors went to become medical representatives. Yang Dongping, director of the Party Committee Office of Peking University Third Hospital, told the "Life Times" reporter that the injuries caused by doctors and doctors killed doctors and their families.
Three types of doctors flow
For the “hospital employment shortage,†Liao Xinbo, deputy director of the Guangdong Provincial Health and Development Commission, said that at this stage, the flow of doctors in China can be divided into three types:
Grass-roots hospitals flow to higher-level hospitals. This is mainly due to problems in the salary and training of grassroots medical personnel. For example, in London, the income of doctors in major hospitals and grass-roots hospitals is almost the same; but in our country, the latter may be less than half of the former. The upward flow of grass-roots doctors is also human. However, letting this happen will lead to an indefinite expansion of large public hospitals, grass-roots hospitals will become increasingly weak, and grading medical care will not be realized. The problem of medical care will not be solved. Liao Xinbo believes that at this stage, it is necessary to promote more practices and achieve the flow of talents from higher level hospitals to basic level hospitals.
Public hospitals flow to private hospitals. This kind of flow is worth advocating because the doctors always visit the people where they are, but the patients and the pay are not the same.
Medical posts flow to other professions. The turnover of doctors is a brain drain and a great waste of talent. The Clove Park survey found that 37% of people will choose non-pharmaceutical industries after they change jobs, and 27% will turn to representatives of pharmaceutical companies. Kiris Lee, general manager of Bayer HealthCare China, said that in most countries, it is extremely rare for doctors to switch to medical representatives. In the view of some Chinese doctors, going to foreign companies to do medical representation is a good way out, because doctors' training costs continue to climb and post-worker pay is generally low.
Combine "keeping up" and keep doctors
The loss of hospital personnel will eventually lead to the lagging development of the country’s medical care, and the health of the people will be difficult to guarantee. Liao Xinbo believes that the retention of doctors should start with two approaches: First, "cultivation" of doctors, to provide doctors with appropriate treatment and work environment; second is to "discharge" doctors to provide free flow of space for doctors.
First, strengthen the construction of basic hospitals. With the expansion of large public hospitals, tens of thousands of beds of hospitals have emerged one after another. In contrast, the development of primary hospitals has obviously fallen behind, and some even the most basic equipment and technologies have not been popularized. It is difficult for such hospitals to retain doctors.
Second, improve the treatment of doctors at the basic level. The philosophy of training general practitioners is good. The government has repeatedly encouraged medical personnel to go to the grassroots. However, in fact, "encouraging" is not as "attracting". It should be based on market rules to increase attractiveness in terms of treatment. For example, the Heyuan government in Guangdong is implementing monthly subsidies for doctors at primary hospitals to retain talent.
Third, publicity leads the people to change their minds. The key to the development of grass-roots hospitals is talent and technology, but it is not enough to do just that. What is more important is that ordinary people change their minds and realize that primary hospitals can solve most of the diseases. At the same time, outpatient clinics of large hospitals should be restricted. For example, they can only solve incurable diseases, minor diseases such as colds can not be reimbursed, and so on, in order to urge everyone to go to primary hospitals to see minor illnesses.
Fourth, correct hospital revenue-generating behavior. Hospitals aiming at income generation will inevitably bring about excessive medical treatment, and doctors' values ​​cannot be truly reflected. It is suggested that the hospital charges be divided into two parts. Doctors' medical treatment fees should be divided into five grades and one grade. Hospital charges should be divided according to different levels. The higher the seniority, the higher the fee; the higher the hospital level, the higher the charge.
Finally, break the doctor's system concept. At present, one of the major obstacles to the healthy flow of doctors is the system. Many public hospital doctors think that the work in the system is an iron rice bowl. After worrying about leaving the system, it is very difficult to re-enter, and applications for professional titles and scientific research projects will also be affected. This situation is in urgent need of change.