YiQuan Weekly (WeChat Group) NO.3: Everyone 'Gets' Multi-Point Practice – Prospectus Summary

Location: Yishu |Duo Dian &Independent Practice

Contributor: Gong Nan

Topic: How to Safeguard Physicians’ Multi-Site Practice, and How to Integrate Internet Healthcare with Multi-Site Practice?

When disputes arise from physicians’ multi-site practice, a broker-like role is needed to help them address issues related to insurance, legal matters, and other areas. In daily operations, supporting nurses and physician assistants are also required. Their primary responsibilities include handling tasks beyond the physician’s direct diagnosis and treatment of patients, such as patient management, assistance during the diagnostic and therapeutic process, and providing routine professional guidance to patients. Physician assistants must possess a certain level of medical knowledge to identify abnormal patient conditions and promptly communicate them to the physician, who can then provide professional guidance or intervene accordingly.

To some extent, internet healthcare has been hyped to an excessive degree, with suspicions of being overstated. If we return to the essential nature of healthcare as a service to people and examine the internet from this perspective, we will find that the internet is merely a tool, and practitioners in internet healthcare often assume roles akin to informal physician assistants.

Therefore, internet-based healthcare services can position themselves as assistants to medical professionals, facilitating communication with and management of patients. The fundamental prerequisite is that physicians have had prior face-to-face consultations with patients, ensuring a clear understanding of their clinical conditions. Subsequently, daily monitoring and management—such as medication guidance and the integrated upload of physiological parameters—can be conducted via online platforms. By filtering and screening this data to extract actionable information for physicians, these services can enhance clinical efficiency. This enables physicians practicing at multiple sites to promptly access valid patient data and make accurate diagnoses and treatment decisions.

Location: Yi Shu |Multi-point &Independent Practice

Contributor: Gong Nan

Topic: Multi-site Practice, Easily Overlooked Conflicts.

Some platforms leverage personal relationships with certain experts to provide patients with appointment slots or other services, whether through registration platforms or so-called high-end diagnostic and treatment platforms. However, since these services are actually delivered at the doctor’s primary practice location (i.e., their affiliated hospital), a conflict of interest arises. Specifically, the physician utilizes their employing institution’s resources to fulfill work on internet-based platforms and thereby generates additional personal income. From a legal perspective, such conduct is impermissible.

If doctors provide services such as referrals or the currently popular lightweight consultations to patients during regular working hours and receive labor compensation for doing so, this actually constitutes a conflict of interest. Although no one is currently scrutinizing these practices, they are not permitted from a legal perspective.

Location: Dr. Zhang Qiang's Sharing Group

Contributor: Zhang Qiang

Topic: Multi-site Practice as a Prelude to Independent Practice: Where Do Physician Groups Within the Public Healthcare System Go from Here?

 The emergence of multi-site practice actually signifies the awakening of independent consciousness among Chinese physicians. From a positive perspective, it has galvanized doctors in China to take greater initiative in healthcare delivery and actively participate in healthcare reform. However, it faces a bottleneck: as long as the contractual relationship with their primary employing institution remains unchanged, any additional activities undertaken by physicians appear to operate in a legal gray area. From the standpoint of hospital directors, providing support for multi-site practice is considerably difficult without explicit administrative mandates.

Multi-site practice is not recommended for an extended period, as it becomes difficult to balance the interests of both the multi-site practice institutions and the original employer, and to allocate time effectively among family, the original employer, and the multi-site practice institutions. Therefore, physician groups within the public healthcare system face certain bottlenecks. If initial trials prove promising, physicians should transition to independent private practice as soon as possible.

Currently, physician groups operating within China’s public healthcare system are a product of the country’s unique domestic environment. In contrast, physician groups abroad are typically composed of freelance physicians. Many doctors in China currently lack either the capability or the courage to leave the public system. Given this immature landscape, however, physicians can use involvement in such within-system groups as a way to test the waters. For instance, some professors who are highly renowned within the public system and see an endless stream of patients may discover, upon leaving the system, that their personal brand is surprisingly weak. In other words, while within the public system, one’s reputation is largely conferred by the institution; once outside, one starts from scratch. This experience often leads to a profound reevaluation of oneself.

Therefore, I believe that the existence of physician groups within the public healthcare system represents a courageous first step. Subsequently, these groups will encounter bottlenecks and must strive to overcome them through various means. This may include some physicians leaving the public system entirely, severing all ties with their original institutions to pursue independent practice—scenarios that are highly likely to occur. If physician groups seek market recognition or substantial growth, they will likely need to completely detach from the public system and transition into fully freelance practitioners. Once this mechanism is established, a new contractual relationship between physician groups and their former institutions may emerge.

Location: Dr. Zhang Qiang's Sharing Group

Contributor: Zhang Qiang

Topic: In the Internet Era, "New Famous Doctors" Must Advance Both Online and Offline in Tandem.

In the Internet era, a new cohort of renowned physicians has indeed emerged, including myself, who have leveraged the power of the internet to some extent. However, it is important to note that for independent practitioner teams in this new era, clinical expertise remains their core competitiveness. Without a technological or professional advantage, relying solely on service quality or online dissemination will not sustain long-term success, nor can it indefinitely expand brand influence. In this regard, online and offline efforts should advance in tandem.

I have developed new perspectives on what constitutes a renowned physician. In the past, such physicians were often evaluated by their ability to perform “flying knife” procedures (traveling surgeries), which garnered them widespread popularity and esteem, as well as admiration from peers and students. This was the traditional archetype of a renowned physician.

However, I believe that future renowned physicians will be expected to meet several criteria: exceptional technical expertise, lawful income, dignified practice, tax compliance in accordance with the law, and active participation in charitable activities. These are, in my view, obligations that distinguished physicians should fulfill. Furthermore, I believe that renowned physicians should devote part of their efforts to healthcare reform, helping to inspire positive change. In summary, beyond possessing advanced medical skills, future renowned physicians should assume greater social responsibility.

Location: Dayi Cloud Valley

Participant: Liu Ye

Topic: The Past and Present of Physician Groups.

Why Have Physician Groups Emerged? For the Sake of Independent Practice. In short, independent practice means that physicians own their patient base, set their own prices, and bear their own risks. Opening a private clinic is the ideal form of independent practice; however, individuals often struggle to bear the pressures of establishment and medical liability. Therefore, several physicians may partner together to share costs, pool patient referrals, and jointly assume risks. As the number of partnering physicians grows, management becomes increasingly complex due to diverse opinions and interests. Consequently, many such groups transition to a corporate structure, typically in the form of a hospital. A key distinction among individual practices, physician partnerships, and corporate hospitals lies in their differing income tax treatments.

The evolution from solo practices to physician partnerships and then to corporate hospitals is naturally a gradual process of growth. However, in China, due to the dominance of public hospitals, this trajectory has been forcibly reversed, shifting from public hospitals to physician partnerships and then to individual practices. Nevertheless, the ultimate outcome remains the same: the dissolution of the majority of public hospitals and the emergence of diversified, market-oriented physician practice models that align with patients’ interests.

Among all physician groups, only a small minority will ultimately evolve into large corporate hospitals; the majority remain partnerships comprising just two or three, four or five, or around ten physicians. However, those physician groups that do succeed in scaling up to become large hospitals invariably originate from the earliest cohorts of such groups. This is because these pioneering founder-physicians typically possess the keenest insight, the greatest resilience to setbacks, and the strongest commitment to patient-centered care. Moreover, having entered the market earliest, they are best positioned to establish industry standards and capture market share.

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