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谢汝石:医疗投资需要躲开这些陷阱

2017-09-06 谢汝石 搜狐健康

2030年前中国的健康产业将会超过20万亿,这么大的市场,需要更多的医疗专家+管理人的角色。

第一,医院不是越大越好

医疗投资,在中国没有小打小闹。起码现在阶段不行。但是,所谓大不是大在单体,是合理的布局。作为商业化的医疗服务模式不是拼命追求一间医院要变成“巨无霸”,几千张床位,而是需要利用有限的资金进行合理的布局,根据医院运行规律,一个单体的医院最佳的运行规模是300~500张床位。

大家知道,一个完整的医疗服务生态包括了门诊、检查和诊断、住院、手术和其他治疗、院后康复和管理。此外医生成长的生态中包括:全科、专科、从低年资向资深培养,代代相传。在医疗服务的团队中需要老、中、青结合起来的三级管理。这就意味着我们的医疗布局中,需要合理的布局。在医疗的整体布局中,不但病人的治疗或者健康管家需要有一个服务闭环,医生的培养和提高更加需要有一个完整的培养体系,得名医者得天下不错,但是得到了名医不是要求名医去多做几台手术,多看几个病人,而是让名医建立好一个科室的文化和学科体系,带出一代又一代的名医。每一位做医生的人,都有名医梦,我们给医护回报的不单是体面的收入,还需要有足够的成长空间,给医生圆梦的机会和条件。为什么很多社会办医找不到好的医生?因为大家还没有进来就已经看到了医院把他(她)们当成了赚钱的工具。

第二,只有名医办的医疗才是有持续发展的医疗

大家都知道,美国的知名医院都是由名医创立,名医带领的。大家知道的梅奥、克利夫兰、凯撒医生集团都是由名医发起,直到现在还是由医生来管理。

医学,或者说医疗服务是一个集医学和社会科学、人文和经验的学科。每一个流程或者做法都需要科学的,专业的决策。有一次,一个大型民营医院的董事长找我去他们医院讨论如何提高他们的管理效率,我到医院走了一圈后回到董事长办公室准备讨论,结果,医院的所有文件,包括新开的项目都需要拿给董事长签字。虽然,这个医院已经请了几个从著名的三甲医院退下来的院长当管理者,可是没有管好。董事长问我的建议时,我直率地说:“你的办公室搬离医院了,这个医院就发展起来了!”虽然医院请了高人管理,但是高人也知道所有的拍板权在董事长,久而久之,干脆就不动脑了,把所有问题都拿给董事长,而董事长只是一个资本投资人,根本不了解医疗内在的特点和规律。这样,管理者变成了执行者,高人变成了打工一族。

医学,还是一个论出生、论资排辈的行业。大家都说医生难管,其实,所有的医生在自己的长辈和老师面前,在权威的同辈面前都是恭恭敬敬的。在学术会议上,别人尊重你,不是因为你是院长,而是你造诣越深,别人越尊重你。主流学界站位是有“江湖”的。

此外,邀请名医参加自己的团队,首先需要让对方认同你,接受你,最好是佩服你,这样你才会一呼百应。还有,现在的名医都在公立医院,说实在话有市场意识和接受市场规律的还不多,给这群“大咖”培训市场意识,尊重市场规律,不是他(她)们心中的偶像你可以做到吗?这也许是办医疗、投资医疗最大的门槛!

名医主持医院,主持医疗还有一个很大的优势:第一,把控医疗安全;第二,制定培训计划已经督促计划的实施;第三,很清楚自己的业务优势,如何利用优势争取最大的业务发展。总之,这里有太多玄机。大庙,一定需要一个好的方丈!

第三,中国大陆市场中的医院已经超出了市场价值。

最近有几个上市公司找我帮忙去看医院,我看完材料后我提出了一个很严肃的反对意见。因为很多表面上看来经营的“不错”的医疗机构,市场的PE已经是20~25倍了。我为什么建议这些上市公司不去收购医院呢?

一、中国大陆已经不缺医院,新的一轮医改对中等大小的医院肯定不利。

其实,我们国家大城市中平均每1000人的床位数已经接近美国,而且我们的平均住院日是10天,美国是2.9天。如果,按照医改控费,日间手术中心的发展和医保支付的改善,我国的平均住院日下降到5天,我国大城市的医疗机构一定已经过剩了。

二、现在可以出售的医院多数没有资产。

由于种种原因,这些医院只是租用商业楼宇办起来的。这些物业没有升值空间,同时由于医疗改革的深入,医疗区域性布局限制取消,支持社会办医的政策落实,医疗的“牌照”已经没有价值。

三、改变这些医院的文化和管理制度是一件很艰难的事情。

我参加过几个医院的改造,虽然当时中山医投入了很多专家和领导,但是改变原来医院的落后习惯是收购医院的一个最大难题。

四、好女不嫁。

医疗服务是一个朝阳产业,这是大家都很清楚的事实,为什么要卖?如果一个租用地方办起来的医院,真的财产不是“牌照”,不是设备,是这个医院的文化和留住的技术人员。大家都知道,一个保险公司收购了南京一个著名的医院,结果技术人才跑了,这个医院变成了空庙,今后的经营将会困难重重。

第四,非盈利性医院不能收购。

这方面政策很快出台,又想不交税,又想拿走医院的利益,估计以后没有这等好事了。

最近不少人找我要投资医疗,而且大家都看到王健林要投1440亿,投资医疗一定是蓝海,而且我相信2030年前中国的健康产业将会超过20万亿,这么大的市场,需要更多的医疗专家+管理人的角色。这是一个英雄辈出的年代。

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    2017-09-07 136****0753赵

    复合目前现状.言之有理

    0

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    2017-09-07 lyh994

    医疗专家+管理人

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1946096, encodeId=93d3194609652, content=<a href='/topic/show?id=9e109211213' target=_blank style='color:#2F92EE;'>#谢汝石#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92112, encryptionId=9e109211213, topicName=谢汝石)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Mon Jan 29 14:02:00 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241571, encodeId=18b92415e125, content=复合目前现状.言之有理, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Thu Sep 07 23:25:50 CST 2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241402, encodeId=d7b2241402f6, content=医疗专家+管理人, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Sep 07 09:02:40 CST 2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241300, encodeId=5540241300d0, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Sep 07 06:45:22 CST 2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241083, encodeId=328824108359, content=很好.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Wed Sep 06 16:25:05 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241075, encodeId=8d1a2410e55b, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/30/dd6bade062cb598667f9f577194196c4.jpg, createdBy=422e1687020, createdName=Dr.jerry, createdTime=Wed Sep 06 16:06:00 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-07 131****1460

    学习了受益匪浅

    0

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    2017-09-06 136****0753赵

    很好.学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1946096, encodeId=93d3194609652, content=<a href='/topic/show?id=9e109211213' target=_blank style='color:#2F92EE;'>#谢汝石#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92112, encryptionId=9e109211213, topicName=谢汝石)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ef33504, createdName=wsusan1966, createdTime=Mon Jan 29 14:02:00 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241571, encodeId=18b92415e125, content=复合目前现状.言之有理, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Thu Sep 07 23:25:50 CST 2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241402, encodeId=d7b2241402f6, content=医疗专家+管理人, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/04/24/1c2dbd6706e64df33befd6663f1d6b37.jpg, createdBy=94f61661779, createdName=lyh994, createdTime=Thu Sep 07 09:02:40 CST 2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241300, encodeId=5540241300d0, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Thu Sep 07 06:45:22 CST 2017, time=2017-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241083, encodeId=328824108359, content=很好.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Wed Sep 06 16:25:05 CST 2017, time=2017-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=241075, encodeId=8d1a2410e55b, content=谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=105, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/30/dd6bade062cb598667f9f577194196c4.jpg, createdBy=422e1687020, createdName=Dr.jerry, createdTime=Wed Sep 06 16:06:00 CST 2017, time=2017-09-06, status=1, ipAttribution=)]
    2017-09-06 Dr.jerry

    谢谢

    0

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