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黄帅:记住!医生不参与创收

2017-08-03 黄帅 健康时报

《关于建立现代医院管理制度的指导意见》落实后,医生可专心看病,不用再在隐性收入上动歪脑筋,这会让坚持医德的医生得到更多尊重与保护。



医生收入与“开药”挂钩的现象或将在2020年终结。

7月26日,国务院办公厅印发《关于建立现代医院管理制度的指导意见》,首次提出各级各类医院应制定章程,明确医院决策机制,提出到2020年基本建立现代医院管理制度的目标。

这是医改进程中的一件大事。根据要求,建立现代医院管理制度,需要坚持以人民健康为中心,坚持公立医院的公益性,坚持政事分开、管办分开,坚持分类指导,鼓励探索创新,把社会效益放在首位,实行所有权与经营权分离,实现医院治理体系和管理能力现代化。

此前,医生参与创收的现象得不到强力规范和监督,与之相关的管理方式也简单无效:出了什么公共事件,最后总是浅尝辄止、不了了之;要么就是“上有政策,下有对策”,从医院领导和管理层到医生,只按照“潜规则”行事。《意见》的发布,就是要把医院的社会效益、公益性放在首位。不是不追求经济效益,而是要让医院和医生的收入透明化、规范化。

值得注意的是,《意见》提出,“医院可以探索实行目标年薪制和协议薪酬,医务人员薪酬不得与药品、卫生材料、检查、化验等业务收入挂钩。”这个措施符合现实需要,发达国家已有成功探索。比如美国实行医药分家制度,患者去独立药店取药,而且是先看病后交钱。日本则在1995年便设置了医疗评估机构,督导医疗机构向患者提供优质服务,医生的信息公开透明。这些方法都能维护患者的合法权益,减少医患矛盾,也能增进医生的工作效率,实现医患关系的良性互动。

美好的愿景在我国也越来越接近现实。正如“药王”孙思邈曾言:“医人不得恃己所长,专心经略财物,但作救苦之心”。《意见》落实后,医生可专心看病了,会把心思全放在救死扶伤上,不用在隐性收入上动歪脑筋,这会让坚持医德的医生得到更多尊重与保护。

与之相关,医院管理制度会更加科学公平,让那些真正医德高尚、医术精湛的医生能获得更多认可,形成良性的职位晋级和收入流动关系,进而改善医院工作风气,提升医院的公信力和公益价值。当然,受惠最大的就是老百姓了,医生和医院的“路子正了”,患者就医也不必有额外担心。

古人云:“为医者,须绝驰骛利名之心,专博施救援之志”。从长远来看,让医院回归公益性,让医患关系重回健康状态的“初心”里,这是各方多赢的事情。蓝图既已绘制,未来的实践过程更值得我们期待。

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    2017-08-03 1e0e5a1fm42(暂无匿称)

    henhao

    0

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    2017-08-03 楠博One

    现在医院也给医生制定任务和工资奖金挂钩

    0

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    2017-08-03 忠诚向上

    好好学习下吧

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=229639, encodeId=98fa22963938, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=7dcf1938111, createdName=1e0e5a1fm42(暂无匿称), createdTime=Thu Aug 03 17:08:41 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229601, encodeId=f08322960171, content=现在医院也给医生制定任务和工资奖金挂钩, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Aug 03 15:28:13 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229582, encodeId=8b0f2295827a, content=好好学习下吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 03 15:02:33 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229562, encodeId=cbc5229562aa, content=学习了,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 03 14:05:59 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229555, encodeId=d6af2295550c, content=不错的文章值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Thu Aug 03 14:01:40 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229551, encodeId=0c5f22955186, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5vZbLiaw0G6FFQ3J4obXJNXbFJZBOJIsBiasEmSFCxzhibZ2TT0xftAW5kV1SLyo6jg0hOMaJg1Alm15kbuoDUFIsUM4JP7bdvcA/0, createdBy=10082062447, createdName=医无止境。, createdTime=Thu Aug 03 13:44:42 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229550, encodeId=42382295501d, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ae02063908, createdName=152****8376, createdTime=Thu Aug 03 13:42:37 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229549, encodeId=fd8a229549c4, content=说了半天政府不把gdp投入进去都是空的, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=82e41724470, createdName=njjna, createdTime=Thu Aug 03 13:30:49 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229548, encodeId=3984229548c6, content=坚持以患者健康为中心。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Thu Aug 03 13:21:25 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-03 1ddf0692m34(暂无匿称)

    学习了,很好

    0

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    2017-08-03 131****2916

    不错的文章值得学习

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=229639, encodeId=98fa22963938, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=7dcf1938111, createdName=1e0e5a1fm42(暂无匿称), createdTime=Thu Aug 03 17:08:41 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229601, encodeId=f08322960171, content=现在医院也给医生制定任务和工资奖金挂钩, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Aug 03 15:28:13 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229582, encodeId=8b0f2295827a, content=好好学习下吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 03 15:02:33 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229562, encodeId=cbc5229562aa, content=学习了,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 03 14:05:59 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229555, encodeId=d6af2295550c, content=不错的文章值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Thu Aug 03 14:01:40 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229551, encodeId=0c5f22955186, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5vZbLiaw0G6FFQ3J4obXJNXbFJZBOJIsBiasEmSFCxzhibZ2TT0xftAW5kV1SLyo6jg0hOMaJg1Alm15kbuoDUFIsUM4JP7bdvcA/0, createdBy=10082062447, createdName=医无止境。, createdTime=Thu Aug 03 13:44:42 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229550, encodeId=42382295501d, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ae02063908, createdName=152****8376, createdTime=Thu Aug 03 13:42:37 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229549, encodeId=fd8a229549c4, content=说了半天政府不把gdp投入进去都是空的, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=82e41724470, createdName=njjna, createdTime=Thu Aug 03 13:30:49 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229548, encodeId=3984229548c6, content=坚持以患者健康为中心。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Thu Aug 03 13:21:25 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-03 医无止境。

    谢谢分享受益匪浅

    0

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    2017-08-03 152****8376

    谢谢分享受益匪浅

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=229639, encodeId=98fa22963938, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NcXNhUvfhzd2VdicMnaLeK2Im5gKx4Ucxd8Bwu6S7RG0uILBFQx5HTW2bU4VricDYlQqN20ibASSMYAeGrZrrTpy2Q/0, createdBy=7dcf1938111, createdName=1e0e5a1fm42(暂无匿称), createdTime=Thu Aug 03 17:08:41 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229601, encodeId=f08322960171, content=现在医院也给医生制定任务和工资奖金挂钩, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/05/25/aee510ed68ce4736e9fe4ec7d03c01b1.jpg, createdBy=ce892064652, createdName=楠博One, createdTime=Thu Aug 03 15:28:13 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229582, encodeId=8b0f2295827a, content=好好学习下吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Aug 03 15:02:33 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229562, encodeId=cbc5229562aa, content=学习了,很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Thu Aug 03 14:05:59 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229555, encodeId=d6af2295550c, content=不错的文章值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Thu Aug 03 14:01:40 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229551, encodeId=0c5f22955186, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM5vZbLiaw0G6FFQ3J4obXJNXbFJZBOJIsBiasEmSFCxzhibZ2TT0xftAW5kV1SLyo6jg0hOMaJg1Alm15kbuoDUFIsUM4JP7bdvcA/0, createdBy=10082062447, createdName=医无止境。, createdTime=Thu Aug 03 13:44:42 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229550, encodeId=42382295501d, content=谢谢分享受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ae02063908, createdName=152****8376, createdTime=Thu Aug 03 13:42:37 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229549, encodeId=fd8a229549c4, content=说了半天政府不把gdp投入进去都是空的, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=82e41724470, createdName=njjna, createdTime=Thu Aug 03 13:30:49 CST 2017, time=2017-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=229548, encodeId=3984229548c6, content=坚持以患者健康为中心。, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Thu Aug 03 13:21:25 CST 2017, time=2017-08-03, status=1, ipAttribution=)]
    2017-08-03 njjna

    说了半天政府不把gdp投入进去都是空的

    0

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    2017-08-03 邓启付

    坚持以患者健康为中心。

    0

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