Medical Marketization ≠ Commercialization of Medical Practice: Clarifying Misconceptions in Healthcare Reform

Medical Interpretation

Topic: Common Misconceptions About Healthcare Marketization

Location: Dayi Cloud Valley

Contributor: Liang LiangliangGong Nan

Whether it is telemedicine or physician groups, the fundamental issues that ultimately need to be addressed are the location of medical practice and regulatory oversight. In terms of regulation, the role of physician industry associations should be strengthened. On one hand, these associations should protect physicians’ legitimate rights to practice; on the other hand, they should impose industry sanctions on physicians who commit serious violations or demonstrate gross negligence. This approach is quite similar to the current model of bar associations. Bar associations are responsible not only for training within the legal profession but also for its management. Complaints from clients are reviewed by a dedicated disciplinary committee, and those found to have genuine misconduct are penalized in accordance with the bar association’s professional standards.

Furthermore, regarding medical services, I have always believed that most people conflate clinical diagnosis and treatment services with customer service management. Customer service management is implemented as a support system to facilitate the delivery of clinical care, encompassing tasks such as appointment scheduling, medication procurement, and payment processing. Consequently, many internet companies have historically provided services falling strictly within the realm of customer service, without penetrating the core domain of clinical diagnosis and treatment. The essence of clinical care lies in the direct interaction between physicians and patients, which should remain anchored within medical institutions.

Under market economy conditions, the healthcare industry is indeed intertwined with money; however, its fundamental premise for millennia has always been to save lives and heal the wounded. In this world, human life and dignity represent the highest universal values. When the power of money corrodes these universal values, it becomes the basic responsibility of all medical professionals to rise up and defend them.

"Marketization" by no means implies the marketization of medical practices themselves; rather, it refers to leveraging market-oriented management and services to enable healthcare providers to deliver medical care to patients more effectively.

Marketization in healthcare has its own space for survival and even development; for instance, private for-profit hospitals fall within this scope, as does the market-oriented operation of non-profit hospitals. Unfortunately, everyone has rushed headlong into the so-called “black hole” of marketization and become trapped.

For instance, health economics and medical economics were not developed to generate profit from healthcare and medical services, but rather to enhance operational efficiency, conserve energy, and reduce consumption. However, many individuals invoking the banner of economics have been advocating for the marketization of healthcare, gaining considerable endorsement from medical professionals. This trend not only misleads students and practitioners but also poses long-term detrimental consequences.

Medical Jokes

Topic: Physician Groups Earnestly Summarize Lessons Learned, Continuously Enhance Professional Competence (Entertainment Joke)

Location: Doctor Group Chat

Participation: (Repost)

China's Healthcare Reform: The Physician Group Edition:

Public Hospitals Say, “Listen to Me: Give us headcount quotas, beds, and supportive policies so we can generate more revenue. Only then can we use salaries to incentivize doctors and nurses, and only by increasing earnings can we deliver better services to the public…”

Pharmaceutical manufacturers and drug distributors, listen to me: Our medicines are for treating diseases. Do not create obstacles; we must encourage the public to take more medication—indeed, to take it in greater quantities.

"The patient said, 'Listen to me: It's difficult and expensive to see a doctor. Although medical insurance covers some costs, the price of medications has increased several-fold...'"

The government said, “I have no money. Whose advice should I follow?” After much deliberation, and then some more, it cautiously suggested, “How about we try the Sanming model?”

Pharmaceutical distributors issue a warning to the government: “If you dare implement the Sanming Model, we will collapse immediately, leading to nationwide drug shortages… Under the Sanming Model, employees will surely walk away…”

The government stated, “Stability is paramount… We will continue to deliberate…”

Foreign pharmaceutical companies say: “There are so many idiots with so much money—come on, drug them……”

The market says: We will use "Internet Plus" to disrupt healthcare, fundamentally transforming the difficulties and high costs associated with accessing medical care...

Hospital administrators say: “Heh, do you think we’re in the taxi industry, ready to be disrupted at will? If you’re so capable, why don’t you come and do it? Until policies are issued, we won’t take the initiative to change. Are you going to make the changes?”

The government stated: "Marketization... we must pursue marketization..."

Experts Ask: In Areas Prone to Market Failure, Would Anyone Dare to Implement Full-Scale Marketization in Zhenjiang Again?

"The government said: Let me think it over... How about we continue to strengthen the capacity of primary healthcare services?"

Primary care providers state: “There is a shortage of authorized personnel positions, with heavy workloads and understaffing; performance makes no difference to compensation; revenue and expenditure are managed under separate lines; staff retention is difficult; and primary care facilities are also required to deliver public health services and family planning services…”

Primary Healthcare Institutions in Mountainous Areas: Keep piling on the pressure. The era of "barefoot doctors" is nearly buried, and no one wants to work as a village doctor anymore. Making house calls across the mountains is exhausting. What can we do? We have no choice but to keep carrying our medical kits up the hills... When colleagues ask why we haven't transferred out yet, I think to myself, "I will leave sooner or later; I haven't been home for two weeks now..." I sincerely hope someone will take over our posts!

Upon further reflection, the government concluded that both sides were quite impressive. However, it decided to proceed with the Sanming Model, as it could at least alleviate the financial burden on the medical insurance fund...

Pharmaceutical distribution companies complain, “Isn’t this cutting off our livelihood?” They deploy online trolls to spread the message about how terrible and inefficient public hospitals are in foreign countries, arguing that privatization and marketization are indispensable... If public hospitals are not under government control, even reforms like those in Sanming or elsewhere would be futile. By the way, I also need to intimidate pharmaceutical manufacturers: “Listen up, folks! If the Sanming model takes hold, your drugs will immediately lose their market.”

 

Pharmaceutical manufacturers are suddenly acting all cute and fluffy, but when you crunch the numbers, the logistics costs for shipping out from those small drug factories built in various counties are damn high... Forget it, let’s just shut down.

An economics expert has spoken out loudly: “Look, who told you to promote the Sanming model in the first place? Now the real economy is suffering...”

Consequently, during the Two Sessions, the two factions exchanged proposals; however, given the formidable influence of vested interest groups, the Sanming Model persisted in various forms across different regions but ultimately existed in name only.

The patient said, “What’s all the racket? Is it really this hard to register? Is this Beijing? Is this the capital? …… You scalpers are utterly unscrupulous……”

Isn’t the Sanming Model supposed to provide annual salaries for doctors and hospital directors? Who is following suit? Same question…

Dr. Mou Feng and Dr. Mou Qiang waved their hands, saying, “We are tired of playing by the old rules; we’re forming our own group. Raise your hand if you’d like us to treat you.” Patients, apprehensive yet hopeful, sought consultations with these former experts from a top-tier (Grade 3A) hospital. To their surprise, they were moved by the entire experience. They felt conflicted about whether to offer red envelopes (cash gifts): giving one felt inappropriate, yet not doing so left them feeling indebted. Ultimately, a patient posted online praising the medical group for its exceptional clinical expertise and high ethical standards, sharing the experience with friends and family. Thus, the physician group was established.

Hold on, has a medical malpractice incident occurred? The insurance company says, “We apologize for the harm caused to you; we will take responsibility!”The physician group has diligently summarized its experiences and lessons, with clinical proficiency continuing to improve...

Doctors' Call

Topic: On Physician Voting.

Location: VCBeatDoctor Group

 Participants: Angela, White Planet

As a “Lei Feng” figure in the medical community, I feel compelled to share some thoughts on “doctor voting.” I manage physician groups and interact with doctors daily. They discuss medical issues, refer patients to one another, vent about healthcare reforms, and express their frustration with violence against medical staff—they are all admirable individuals. However, it saddens me when they start sending red packets to solicit votes, saying things like, “Please vote for Director XX. Scroll down to the second-to-last candidate and boost them to first place! Thanks! And please help forward this to other groups… It’s for scientific research! For winning awards!”Doctors are not politicians. Their competence should not be measured by fake votes cast by strangers, but rather by objective evaluations from colleagues—doctors, nurses, and allied health professionals—who have worked alongside them for years. Even if a doctor is widely renowned, the most trustworthy assessments and recommendations should still not come from unfamiliar physicians or patients. Therefore, I urge my entrepreneurial peers in the healthcare sector: even if “doctor voting” is an effective tactic for generating buzz and engagement, please refrain from using it. Such practices only undermine the dignity of both physicians and corporate brands.

 Want to join the WeChat Group Alliance for the Medical Community?

Want to continue discussing specific issues?

Want to subscribe to "MedCircle Weekly" for the long term?

Please add Zhan Shi on WeChat.