Hospital Leaders and Internet Healthcare Executives Discuss Industry Challenges and Opportunities Amid Beijing's 'No Extra Appointments' Policy

Correct Interpretation of Beijing’s “Prohibition on Doctors Adding Extra Appointments” Policy: It Is Permissible for Doctors to Provide Services Outside Their Eight-Hour Workday

President Liu Yucun of Peking University First Hospital:The Beijing Health Bureau must have had its reasons for introducing this policy. However, in the Internet era, I believe it is no longer feasible to restrict everyone’s behavior through a mere administrative order. We must adopt an open mindset to embrace the future created by the Internet.

As for the chain reaction triggered by the scalper incident, I believe these are all emergency measures that are understandable and justifiable. If a doctor adds appointment slots through such means, from both my personal perspective and that of a hospital president, I consider it a positive development. If the internet can solve problems for patients, build a bridge for doctors, and establish connections with patients, this is inherently not a bad thing.

However, there is one point: if any physician seeks to generate personal financial gain through such means, this method of wealth extraction is problematic. Conversely, if the approach is adopted from the patient’s perspective, with the primary intent of providing better medical care, I can personally understand and accept minor procedural flaws.

Wang Hang, Founder and CEO of Haodf:This policy has a relatively significant impact on Haodafu.

However, the National Health and Family Planning Commission’s stance is to clearly distinguish between basic services and commercial services. I do not object to physicians engaging in commercial activities outside their eight-hour workday; however, they should not entertain commercial motives within outpatient consultation units in hospitals, as these belong to society and constitute physicians’ basic service responsibilities. This reflects the original intent of the National Health and Family Planning Commission, which I believe is highly accurate.

The level of implementation varies significantly across hospitals. Some hospitals are quite progressive, recognizing that the internet can deliver value to both institutions and individuals. Others, however, take a different view; they remain uncertain about the role of the internet and often question why their physicians are working on external platforms. They feel unable to mobilize these doctors internally, yet wonder why they should freely answer patient queries on platforms such as Haodf.com.

Within the eight-hour workday, hospital administrators certainly have the methods and influence to mobilize physicians to deliver care. Outside of these hours, internet platforms effectively balance personal branding with institutional branding, enabling doctors to build their own professional reputations while simultaneously enhancing the hospital’s brand equity. This is because every physician is akin to a vibrant leaf or fruit on the mighty tree of a public hospital.

Regarding this policy, what strikes me most is that in a booming industry, if the leaders fail to rally everyone to establish self-regulation against non-compliant practices, then by the time the government steps in to regulate the sector, it is often not the non-compliant companies that suffer the most, but rather us who incur greater losses.

Pan Zhongying, President of United Family Hospital:"In the Internet era, we see it as an opportunity. Hospital doctors and experts can use their own time and professional knowledge to serve patients. However, while it is natural to seek financial gain, it must be done through proper channels—meaning in a reasonable, sensible, lawful, and appropriate manner. With the vast amount of online traffic and diverse patient needs, combined with service platforms like United Family Healthcare and the proper approvals from the National Health and Family Planning Commission, I believe this presents a significant opportunity for our development."

Liao Jieyuan, Chairman and CEO of WeDoctor Group

Host Liu Qian:Micro Medical Group operates an internet hospital, which I understand to be a new form of healthcare delivery for the future. What is its relationship with existing hospitals?

WeDoctor CEO Liao Jieyuan:First, we must distinguish between public services provided during working hours and autonomous services offered during personal time; these are two entirely different concepts. However, I have observed that many media outlets currently conflate them. As a physician in a public hospital, I provide public services during working hours because our hospital is a public service institution. Undoubtedly, all income generated from this work belongs to the hospital. I then receive corresponding compensation from the hospital’s accounts in accordance with its salary and incentive policies. It is inappropriate to leverage resources allocated for public services during working hours to generate additional income. Policies explicitly and strictly prohibit such practices. However, all policy interpretations clearly state that physicians may utilize their personal time to provide additional services to patients, whether through consultations, follow-ups, continued care, or even multi-site practice. A core direction of our healthcare reform guidance is to promote multi-site practice and independent practice among physicians.

Host Liu Qian:Doctors are already overwhelmed with patient consultations and burdened by research responsibilities, among many other tasks. Why would they still have time outside their regular eight-hour workday to provide free services on your platform?

WeDoctor CEO Liao Jieyuan:Our strategic direction is for physicians to become independent practitioners. Therefore, how long they work at our hospital and how much free time they retain are decisions made by the physicians themselves in allocating their own schedules. Our policies will increasingly support such autonomous decision-making and allocation, although this transition will require time.

We must draw a clear distinction between public services provided during working hours and autonomous services offered during personal time. For autonomous services rendered in your free time, you may set prices according to market dynamics; however, these services are not covered by medical insurance. Patients may choose to pay at the physician’s discretionary rate out-of-pocket, but they will not be eligible for reimbursement. In contrast, public services delivered during official working hours must strictly adhere to hospital management regulations. All third-party service providers may only engage with medical institutions or government entities.

"Top-tier tertiary hospitals in China leverage our internet hospital platform to offer night and weekend clinics, enabling physicians to conduct follow-up visits and reconsultations during these hours and earn corresponding income and subsidies. With appropriate regulations in place, the system will naturally revert to a rational and sustainable state."

How Should Internet Healthcare Information Be Opened Up?

Host Liu Qian:How to Resolve the Issue of Hospital Information Silos?

President Liu Yucun:This involves protecting both hospital and patient privacy. I believe it is difficult for hospitals to specify the level of detail for the entire process. For instance, the medical record face sheet is currently filed with both the Beijing Municipal Health Bureau and the National Health and Family Planning Commission. This face sheet contains substantial information, which is used for various rankings, evaluations, and efficiency assessments. However, the substantive content within the medical records, such as test results, is actually accessible. Patients or their family members can obtain copies by presenting their ID cards. Nevertheless, there is no need to share subjective medical record entries online, such as daily physician notes, instructions, and discussion records. In the current era, I believe that combining the medical record face sheet with objective examination reports and results provides sufficient information for patients.

Host Liu Qian:The United States has aggressively promoted electronic health records (EHRs) and healthcare informatization. Have you made any unique attempts in this area?

President Pan Zhongying:We have fully implemented electronic medical records. In Beijing, in addition to our branch hospitals, we operate eight satellite clinics and the United Family Rehabilitation Hospital, enabling information sharing across all these institutions.

"In fact, I believe a critical point raised by Director Liu is that there is currently no standard for protecting patient privacy and facilitating third-party information exchange. The country lacks corresponding laws and regulations in this regard, and it is essential to clearly define the responsibilities of all parties involved in safeguarding such information."

I recall seeing a report this morning about a municipal Maternal and Child Health Hospital selling maternal patient information at prices ranging from 100 yuan to a maximum of 300 yuan per record. In reality, the security of such patient data is our greatest concern in daily hospital operations. Once this information falls into the hands of third parties, it completely escapes our control. It is not as some might imagine—a scenario where we are all thrilled by the advent of big data. If patient information is leaked, who will patients hold accountable? They will undoubtedly turn to the hospital. Therefore, as hospital administrators, we prefer to avoid unnecessary trouble and prioritize risk mitigation.

The second aspect is the national medical data platform. In essence, this should follow the principle of "leaders setting an example for subordinates to emulate," meaning that government agencies should publicly release shareable data. For instance, on the website of the U.S. Centers for Medicare & Medicaid Services (CMS), one can access data such as disease-specific payment ratios and employee counts for various hospitals. In contrast, China’s social security and medical insurance systems operate largely as a "black box," with external stakeholders lacking visibility into payment flows—including payments to individual hospitals—and the actual quality of care provided by these institutions. When collaborating with third parties, we typically must repeatedly engage legal departments to clarify how data exchanges will be conducted and how third-party information will be protected; however, such efforts are limited to case-by-case operations. Establishing a third-party protection agreement for medical information, similar to those in the United States, which clearly defines the liabilities borne by insurers and third-party entities, would, in my view, be more feasible.