On the afternoon of September 24, 2021, Medical Strategic Marketing Zhong Chonghai was invited by the Medical Association Cloud Platform of the China Association of Non-Public Medical Institutions to give a legal lecture on the theme of "Enhance industry self-discipline and higher requirements for physicians". This article is a relevant summary and extension of the lecture. Among them, the Physician Law is the abbreviation of the Physician Law of the People's Republic of China and is hereby marked.
Current status and reasons for the doctor's practice environment
Medical strategy team, from the perspective of litigation cases, searched the relevant keywords on the China Judgment Documents Network (https://wenshu.court.gov.cn) to obtain the practice environment of doctors through relevant keywords. The following data is collected:
From the above figure, it can be seen that since 2014, the number of litigation cases related to "medical disputes" and "medical accidents" has increased sharply, and continues to rise . Although there is a slight decline in 2020, the relevant impact of the epidemic must be considered.
The above figure is from the "Statistical Bulletin of the Development of my country's Health and Health Care Industry in 2020". It can be seen that under normal circumstances, the number of outpatient clinics has increased to a certain extent every year. For example, in 2016, it increased by 3.1% year-on-year, and in 2019, it increased by 4.9%, but in 2020, it decreased by 11.2% year-on-year.
And there is another special situation in 2020: Tens of thousands of medical staff across the country rushed to Wuhan for the epidemic, regardless of their personal safety, and millions of medical staff from public and private hospitals across the country are fighting on the front line of the local epidemic war! At that time, the feats of the white-clothed warriors moved the whole of China and the whole world.
If the factors that affect the decline in outpatient volume and the feeling of touching medical care are removed, it is not difficult to speculate that there will be more medical litigation cases in 2020 than in 2019. In other words, since the sharp increase in 2014, medical litigation cases have continued to rise!
Doctors and patients should be dependent on each other , but according to a survey by "Phoenix.com ", 71.09% of the participants chose to support "security check first, then medical treatment"!
In general, the current practice environment of doctors has changed, and doctors have become a high-risk profession. There are even semi-joking and helpless statements in the industry, "Persuad people to study medicine, and the sky will hit lightning" .
The deterioration of the doctor's practice environment is essentially a manifestation of the deterioration of the doctor-patient relationship. So, what causes the doctor-patient relationship to be so distorted? Teacher Zhong Chonghai was reprinted by many media in 2019. "There have been these six reasons for the past 18 years, but nearly 50 medical staff died! 》 In this article, the reasons for the deterioration of the doctor-patient relationship are summarized into the following 6 aspects:
, tiered diagnosis and treatment unscientific
, unreasonable medical salary
, circulation links are not clean
, a few hospitals are not standardized
5, some media are unfair
6, value concepts are unhealthy
in "enhance industry self-discipline After the legal publicity lecture, we also received supplements from many industry colleagues on the high medical disputes and the deterioration of the relationship between doctors and patients: a small number of greedy lawyers took the initiative to instigate the patient's lawsuit or cause trouble for the hospital, and also received a screenshot:
Among the six major reasons, a few hospitals are not standardized, which can be said to be well known inside and outside the industry, and many places have been banned and relevant personnel have been criminally punished.It can be said that the irregularities of these few medical institutions not only seriously infringe on the rights and interests of patients, but also make the entire medical industry widely smear, thus continuing to widen the cracks in the doctor-patient relationship!
Top changes and three highlights of the new "Doctor's Law"
Let's first review the key process of the Doctor's Law:
June 26, 1998, " Practical Doctor's Law " was revised and translated into It has been implemented until now;
In January 2021, the first draft of the new "Doctor Law" was submitted for review;
In June 2021, the second draft of the new "Doctor Law" was submitted for review;
On August 20, 2021, the "Doctor Law" was officially passed and officially implemented on March 1, 2022.
1 Compared with the old "Practical Physician Law", there are the following 0 major changes :
, cancel the qualification for medical practitioners for secondary school education
, for many Click on practice to open the door to convenience
, life-long ban industry has been written into the law for the first time
, and more emphasis is placed on protecting the legal rights and interests of doctors
5, giving doctors more autonomy in diagnosis and treatment
6. More fully authorized physicians’ emergency assistance behavior and responsibility exemption principles
7, resident physician standard training and specialist training method
8, Chinese medicine use Western medicine technology and Western medicine use traditional Chinese medicine can be used according to
9. In order to ensure the safety of physician practice, it is necessary to increase efforts to
0, establish a risk sharing mechanism
Overall, the new version of the physician method has three highlights: :
• Improve the protection of physician rights and interests, establish and improve the salary and professional title reward system;
• Strengthen the professional standards of doctors, and doctors with secondary technical education become history;
• Promote development in multiple dimensions, focusing on grassroots, traditional Chinese and Western medicine, and public health fields.
The full text of the previous "Practicing Physician Law" has a total of 5051 words, while the full text of the new version of "Practicing Physician Law" has a total of 9273 words. Not only is the expression more detailed, but the relevant terms are more reasonable and scientific.
For example, if a traditional Chinese medicine practitioner with a low level of education but masters the diagnosis and treatment skills and does have expertise in the form of a teacher, if you want to obtain the practicing physician certificate according to the "Practicing Physician Law", you must take the exam. However, Article 11 of the new version of the "Practicing Physician Law" stipulates that if you learn Chinese medicine through the form of teacher or have many years of practice and have expertise in medical skills, you will be recommended by at least two traditional Chinese medicine physicians . After the traditional Chinese medicine department of the provincial people's government organizes the practical skills and effect assessment and pass, you can obtain the qualification of a traditional Chinese medicine physician and the corresponding qualification certificate.
Therefore, the hospital management and legal circles generally believe that the introduction of the new physician law is very beneficial to the development of the medical industry and the protection of doctors' rights and interests.
The legal risks faced by doctors are higher
Only from the high medical litigation cases and the "business" of some lawyers has actively penetrated into patients who have just been hospitalized, it can be seen that doctors are facing many legal risks in their practice. While the new "Doctors Law" specifically adds Chapter 5 "safeguard measures" to maintain the safety of physicians' practice, the requirements for physicians' practice are also higher. After all, rights and obligations have always been equal.
Overall, compared with the new "Doctor Law" and the "Practicing Physician Law", the following six aspects are more severe in punishment:
, Renting and lending of practice certificates
, not according to the category range of registered location
, Five illegal acts may be "received"
, Six acts will be suspended from practicing or receiving html l2
5. Increase the penalties for non-medical practitioners
6. Doctors violate regulations and may prohibit practice medicine for life
For example, for illegal practice of medicine, the fine of the "Practicing Physicians Law" is less than 100,000 yuan, while Article 59 of the new version of the "Practicing Physicians Law" is changed to "Immunity of fines of less than twice but less than ten times of the illegal income" . With such strength, illegal practice of medicine may be fined hundreds of thousands, millions or even more!
The most severe measure to punish the new version of the "Doctor Law" is Article 58. This article stipulates that if a serious violation of the professional ethics of physicians and causes bad social impact, the health and health department of the people's government at or above the provincial level shall revoke the physician's practice certificate or order it to stop illegal practice activities. It will be prohibited from engaging in medical and health services or medical clinical research for five years until for life.
Mr. Zhong Chonghai proposed in the lecture: In the short term, these severe punishment regulations will make doctors more legal risks and psychological pressure higher, but in the long term, as long as the new version of the "Doctor Law" is implemented in place, the entire medical industry will surely be more purified. Therefore, the doctor-patient relationship is expected to return to harmony and the doctor's practice environment will be safer. Therefore, short-term severe punishment is actually a long-term benefit.
How doctors avoid legal risks
New version of the "Doctor Law" Article 2 stipulates: The doctor referred to in this law refers to professional medical personnel who have obtained the qualification of a doctor in accordance with the law and have been registered to practice in medical and health institutions, including practicing physicians and practicing assistant physicians . In other words, the application target is the majority of doctors who practice legally. To avoid legal risks, the majority of doctors should start with themselves. Teacher Zhong Chonghai suggested that doctors should do four things:
Strengthening method: , especially the relevant regulations on severe punishment of 6 categories, should be thoroughly understood and not violated.
Don’t forget the original intention: Understanding, tolerance, and trust are mutual. Only by not forgetting the original intention can you achieve the end.
Respect the three rights: Patients’ right to know, right to choose, and right to privacy must be fully respected.
Pay attention to evidence: For the patient's doubts but thinks it is correct, the evidence should be retained.
Hippocratic oath English version Medical student oath English version
Doctors are also mortals, and people are the sum of all social relations. Therefore, how to avoid legal risks for doctors should not be a unilateral task for doctors, and medical parties should do something.
First of all, although the new version of the "Doctor Law" has made many significant improvements, there is still an operational discussion on how to implement it, especially the provisions in Article 31 that " shall not perform unnecessary examinations and treatments on patients" , and it is difficult to issue relevant standards without it. Because the disease is misdiagnosed and misdiagnosed, the doctor faces legal risks; if a certain disease is suspected to be tested, it is normal, but the doctor faces the question of overexamination and may even be used as evidence of litigation. It is impossible for a doctor to have the magical skills of a ignorant eye. So, when facing uncertain diseases, do relevant examinations, or do not? Therefore, standards or implementation details in this regard need to be issued as soon as possible.
Secondly, the hospital (here refers to all medical institutions) is not only a platform for doctors to practice, but also a home for doctors.Therefore, hospital managers should strengthen the construction of hospital culture with connotation and more practicality, so that doctors can have a strong sense of belonging, security, honor, and mission. After , doctors will be more self-disciplined and will naturally have fewer behaviors that violate the provisions of the "Doctors Law". At the same time, hospitals should follow the relevant requirements in the "Opinions of the General Office of the State Council on Promoting the High-Quality Development of Public Hospitals" and strengthen and correctly publicize, such as: digging and organizing the history, cultural characteristics of the hospital, academic thoughts and noble medical ethics of famous doctors; refining the hospital's motto, vision, and mission, and gathering the spiritual strength to support the high-quality development of the hospital. Through publicity, sing the main theme of sincerity of great doctors and kindness of doctors, the public opinion orientation of the entire society will be more conducive to the construction of harmonious doctor-patient relationships.
Again, as the other party in the doctor-patient relationship, the majority of patients must improve their health literacy, especially to do 3 points:
) We must realize that medicine is not perfect, and many diseases cannot yet clarify the cause and the treatment effect;
) We must agree that doctors are not gods, but people have the possibility of errors, and we cannot give them as long as an unexpected situation occurs. Doctors are labeled;
) Even if medical accidents are really the responsibility of hospitals and doctors, they should abide by the law and protect their rights legally, and should not take excessive behaviors, because the "Doctors Law" has clearly stipulated that "any organization or individual is prohibited from obstructing doctors' practice in accordance with the law and interfering with doctors' normal work and life; it is prohibited to infringe on the personal dignity and personal safety of doctors through insults, slander, threats, and beatings." "If a violation of the provisions of this Law and constitutes a crime, criminal responsibility shall be pursued in accordance with the law; if personal or property damage is caused, civil liability shall be borne in accordance with the law."
Finally, let’s call for it. All sectors of society must know: There is no beneficiary for the deterioration of the doctor-patient relationship . The harmony of the doctor-patient relationship requires the joint efforts of the whole society!
Author of this article | Zhong Chonghai Founder of medical and strategic marketing CEO, medical industry researcher , hospital brand management practical expert, hospital brand senior consultant, hospital marketing promotion trainer, hospital think tank brand research institute, director of the three "medical" think tank brand research institute, medical media columnist such as " Health ", "Yio Big Health", and "Huaxia Medical Circle Network", and the initiator of Xiaojudeng blind medical assistance.
