Beijing Clarifies Policy on Commercial Platforms for Doctor Appointment Add-ons: Not a Complete Ban, but Strict Regulation
Mar 08, 2016 12:08
CST Updated
12:08
Mao Yu, Deputy Director of the Beijing Municipal Health and Family Planning Commission: Paid collaborations with commercial companies during working hours are prohibited
“It is impermissible for physicians to leverage public authority, utilize existing facilities and equipment, and engage in paid, high-priced collaborations with commercial companies during working hours. Patients are not only burdened with additional registration fees but also required to pay substantial operational costs to the appointment-booking platform for each added slot. This practice is firmly opposed by Beijing.”Mao Yu, Deputy Director of the Beijing Municipal Health and Family Planning CommissionProvide a detailed explanation of the document. Mao Yu stated candidly that utilizing other forms of multi-site practice, leveraging one’s own time, and clearly listing prices are not the same as the practices we aim to curb. “What we seek to prevent is improper conduct that damages reputation; this does not imply that the approach itself is inherently flawed.”
“Beijing Municipality does not oppose commercial companies leveraging information technology to advance healthcare services and participate in healthcare reform. Nor does it object to medical professionals engaging in collaborations with commercial websites through the formal channel of multi-site practice after working hours.”FeathersIntroduction: Beijing is currently aiming to eradicate the practice, prevalent in public hospitals, whereby medical staff privately arrange appointments or add-on registrations through commercial websites while completing or reducing their outpatient workload at public hospitals.
InMao YuIt appears that eliminating activities in which physicians and commercial companies engage for profit is also a necessary condition for hospitals to strengthen internal management and promote appointment-based registration. It is permissible for commercial companies to enter the healthcare industry through legitimate channels, ensuring that patients’ rights are protected with their informed consent, that revenue is disclosed transparently, and that taxes are paid accordingly. This approach is entirely distinct from boycotting internet companies.
Fang Laiying, Director of the Beijing Municipal Health and Family Planning CommissionIt was proposed that Beijing has never prohibited doctors from adding extra appointments; it has only eliminated paper-based add-on registrations. This approach offers three benefits: first, it shields doctors from harassment by ticket scalpers; second, it controls outpatient volume to ensure the quality of care; and third, it safeguards doctors’ right to rest.
In this regard,Dr. Gong XiaomingIt is also proposed that since the low registration fees at public hospitals serve a public welfare purpose, commercial companies should not be allowed to participate for profit. Experts in public hospitals should focus on fulfilling their responsibilities in teaching clinics, rather than personally attending to every detail of each patient’s care.
Cao Jian, Expert at the Medical Management Research Center of Tsinghua UniversityIt is proposed that commercial practices of adding extra appointment slots should be comprehensively banned. Eliminating such added slots does not equate to a reduction in the supply of specialist resources; rather, it is essential to ensure that the existing number of specialist appointments provided by hospitals—including all types of added slots—does not decrease. The so-called "difficulty in accessing medical care" is largely attributable to patients who do not truly require specialist attention seeking care at higher-level facilities, thereby wasting and occupying opportunities for those who genuinely need specialist diagnosis and treatment.
InProfessor Chen Biao, Xuanwu Hospital of Capital Medical UniversityIt appears that the measures currently being promoted in Beijing will inevitably dampen the enthusiasm of physicians who are actively engaged in online mobile healthcare services, and are highly likely to exacerbate the difficulty of accessing medical care in the short term. In light of this, the government should accelerate the formulation and clarification of specific policies for physicians’ multi-site practice, specifying the conditions under which doctors may provide services outside their primary institutions and receive reasonable compensation. This approach would encourage more physicians to leverage their fragmented time to serve patients, thereby helping to alleviate the challenge of difficult access to medical care.
Mao YuIt was stated that the key priority of the Beijing Municipal Health and Family Planning Commission thereafter would be to implement the aforementioned initiatives. This includes requiring medical institutions to proactively consider and refine operational details during implementation, ensuring that beneficial measures for the public are effectively carried out, rather than being mechanically copied without refined management. To this end, the Beijing Municipal Health and Family Planning Commission will further strengthen supervision and inspection.
How to Allocate Scarce Resources Sparks Debate
For the general public, securing an appointment with a specialist is notoriously difficult. As the pinnacle of medical resources, specialist expertise is extremely scarce. Some argue that such scarce medical resources should be treated as public goods. Others contend that while basic healthcare is a public good, high-quality, scarce medical resources cannot be made universally accessible and available to all as a public good.Liao Xinbo, Inspector of the Guangdong Provincial Health and Family Planning CommissionIt was pointed out that in the past, “scarce resources” were primarily used to address complex and difficult cases, but now they have become more akin to “exclusive offerings,” having deteriorated into something more bureaucratic and market-driven.
How Should Scarce Medical Resources Be Allocated?Zhou Bing, Editor-in-Chief of Health NewsIt has been proposed that whether addressing the issue of paid registration and additional appointment slots on commercial websites, or promoting comprehensive appointment-based registration for non-emergency cases, the core pain point of healthcare reform always centers on the allocation of high-quality yet scarce medical resources. Even prominent physicians, who themselves represent a scarce resource, feel helpless and powerless in the face of this allocation challenge. In fact, current policy initiatives—including reforms in medical service pricing and compensation systems, as well as the promotion of tiered diagnosis and treatment—are all aimed at addressing this very issue. Therefore, while it is undoubtedly necessary for the government to clarify and resolve these problems through administrative measures, market-oriented approaches should also be incorporated into governmental services during this process.
Professor Chen Biao, Xuanwu Hospital of Capital Medical UniversityIt is argued that the common practice abroad is for physicians to provide services at public hospitals during working hours and to see patients at clinics outside the hospital after hours or with hospital approval. This approach ensures that medical experts truly serve as a public resource. The primary issue should be the public ownership of “scarce resources,” while the key lies in how to reasonably open up these scarce resources to the market. Scarce resources should not be simply segmented, thereby rendering them an impractical ideal.
Wang Hang, Founder of Haodf.comIt is believed that the limited expert resources in public hospitals can only be allocated based on demand. The current priority mechanism for appointment registration and queuing may lead to patients with minor illnesses consulting specialists, thereby wasting expert resources.Xu Chunhua, Vice President of Winning HealthIt is certainly wrong to treat appointment slots in public hospitals as a commercial resource. However, market forces should be leveraged to maximize the public benefit of this resource.Medical Consultation160Founder: Luo NingzhengIt is beneficial to standardize the order of appointment registration and additional slot allocation. Mobile healthcare companies must attract or cultivate users by providing high-quality services; any involvement in the resale of medical resources is unsustainable and poses significant risks.
Zhou BingIt is argued that appointment slots offered by physicians at public hospitals during their official working hours should be considered public goods, with the core challenge lying in the equitable allocation of these scarce resources. Medical services provided by physicians during their private time outside public hospitals do not fall within the scope of public goods. Indeed, the goal of healthcare reform is to ensure that the allocation and access to such “scarce resources” align across three dimensions: reasonableness, rationality, and legality.
(By Yan Yan, Wang Dan, Zhang Hao; Source: Health News)