National Health and Family Planning Commission Unveils Plan to Lift Salary Caps and Allow Medical Professionals to Earn Additional Income Through Part-Time Work
Recently, the National Health and Family Planning Commission formulated and issued the “13th Five-Year” National Plan for the Development of Health and Family Planning Human Resources (hereinafter referred to as the “Plan”). The Plan clearly states that, within the scope permitted by national laws, regulations, and policies, medical personnel may receive remuneration through part-time employment and dual compensation. It encourages and supports medical science and technology professionals in achieving career success through innovative practices, while enjoying corresponding social status and economic benefits.
At the end of 2016, CCTV suddenly exposed the “kickback scandal,” sending shockwaves through the medical community. Although various opinions have been expressed externally, there is a consensus that as long as medical service prices remain unreasonable, the problem of physician kickbacks cannot be fundamentally resolved. The “Plan” recently released by the National Health and Family Planning Commission provides clear direction for adjusting physicians’ income structures and enabling them to earn legitimate, transparent income.
How to Adjust Physicians’ Income Structure, Raise Medical Service Fees, and Increase Their Transparent Income? VCBeat Interviewed Healthcare Industry Practitioners to Seek Answers from Policy and Industry Perspectives.
In accordance with the overall deployment of the Healthy China Initiative, and adhering to the principles of meeting service demands, innovating mechanisms, optimizing structures, and improving quality, the 13th Five-Year Plan for Talent Development proposed five key indicators, seven major tasks, and institutional and mechanistic innovations in four areas.
Five Key Indicators: By 2020, the total number of health and family planning personnel nationwide shall reach 12.55 million, with more than 300,000 general practitioners; the number of licensed (assistant) physicians per 1,000 population shall exceed 2.50, registered nurses per 1,000 population shall exceed 3.14, and staff in specialized public health institutions per 1,000 population shall exceed 0.83.
Seven Key Tasks: First, address weaknesses by strengthening the workforce in grassroots health and family planning; second, adopt a demand-oriented approach to build teams of urgently needed and scarce specialized professionals; third, enhance professional competence by strengthening the team of health and family planning technical personnel; fourth, prioritize prevention by bolstering the public health workforce; fifth, drive innovation by developing high-level and managerial talent; sixth, serve society by strengthening the workforce in the health service industry; seventh, promote coordinated development by enhancing the workforce in family planning and traditional Chinese medicine.
Institutional and Mechanistic Innovations in Four Areas: First, implementing standardized physician training to innovate education and cultivation mechanisms; second, reforming industry compensation systems to innovate incentive and safeguard mechanisms; third, deepening the reform of professional title systems to innovate evaluation and utilization mechanisms; fourth, facilitating talent mobility channels to innovate mobility and allocation mechanisms.
“The Plan” points out that full consideration should be given to the long training cycle, high occupational risk, technical complexity, and heavy responsibility inherent in the medical industry. Efforts should be made to mobilize the enthusiasm, initiative, and creativity of healthcare professionals by improving their compensation, career development opportunities, practice environment, and social status. A compensation system for healthcare professionals that aligns with the characteristics of the industry should be established to reflect the value of their technical and labor contributions.
However, the adjustment of medical service prices is not a simple price increase; rather, it is a systematic project involving the coordinated reform of healthcare services, pharmaceuticals, and health insurance (“the three medical sectors”). It requires synergistic implementation to raise physicians’ income without significantly increasing the financial burden on patients.
At the end of 2016, the National Health and Family Planning Commission released two draft amendments for public comment: the Administrative Measures for Physician Practice Registration and the Detailed Rules for the Implementation of the Regulations on the Administration of Medical Institutions. The Administrative Measures liberalized the registration system to allow physicians to practice at multiple locations across different regions. The Detailed Rules removed the existing provision stating that “medical personnel who are currently employed by medical institutions, have retired due to illness, or are on unpaid leave shall not apply to establish medical institutions,” thereby permitting incumbent medical personnel to apply for the establishment of medical institutions.
The “13th Five-Year Plan” for Talent Development explicitly proposes to streamline talent mobility channels and innovate mechanisms for talent allocation. It aims to break down constraints imposed by household registration (hukou), geographic location, identity, educational background, and personnel affiliations, thereby promoting the rational flow of health and family planning professionals. The plan further improves the multi-site practice system for physicians, reforms the physician practice registration system, advances regional registration, and encourages physicians to engage in multi-site practice in grassroots, remote, and medically underserved areas. It seeks to facilitate talent mobility between urban and rural areas, across regions, and among healthcare institutions with different ownership structures, while actively exploring models such as independent physician practice, contractual service arrangements between individual physicians and medical institutions, and the formation of physician groups.
The policy window for physicians’ independent practice has arrived, and their transparent income is now foreseeable.
Wang Hang, CEO of Haodf Online Smart Internet Hospital, stated: “The primary concerns underlying the issue of kickbacks are the drug pricing system and the inadequately low level of physicians’ transparent income.”
Regarding the issue of how to increase physicians’ legitimate income, Wang Hang stated that substantially raising medical service prices in public hospitals is difficult to achieve in the short term, as it constitutes a systematic engineering project. Internet hospitals and multi-site practice can serve as beneficial supplements to boost physicians’ legitimate income. Generating revenue through medical services is a shared goal for both physicians and internet hospitals. The core of the business model for internet healthcare lies in charging for services; whether providing online consultations, remote consultations, expert surgeries, or disease management, these offerings leverage physicians’ professional expertise to deliver value to patients. Meanwhile, Haodaifu Online advocates for the marketization of medical service pricing, enabling physicians with higher clinical proficiency and better service quality to earn higher incomes. This model not only helps rationalize medical service pricing in the online sphere but also gradually cultivates patients’ willingness to pay, fostering broader societal recognition of the value of medical services and thereby supporting price system reforms in public hospitals.