Big-name doctors ＂hold a group＂ to start a business (focus on visiting doctors group (I))
In 2014, China’s first doctor group outside the system was established. Subsequently, various forms of doctor groups such as outside the system, inside the system and online have emerged. According to incomplete statistics, there are 160 famous doctor groups on the list, which shows the vitality of the development of doctor groups. Doctor group is a new thing in the process of promoting the construction of healthy China and deepening the reform of medical and health system in China. From today, we will launch a special report on "Visiting Doctor Group", focusing on the development status of doctor group, hoping to attract everyone’s attention.
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The doctor group provides one-stop and continuous service, which is completely different from the doctor’s "going to the hole" and "flying knife"
Ms. Shen, 61, discovered atrial fibrillation in 1999. She has undergone three operations and her condition has not been alleviated. She learned that Hartrim Cardiologist Group can do one-stop hybridization surgery, so she found Liu Xingpeng, an expert of the group. Liu Xingpeng organized a team of experts in the group to carefully analyze Ms. Shen’s condition, worked out a feasible surgical plan, and performed surgery in October 2016. Since then, Ms. Shen has bid farewell to atrial fibrillation that has plagued her for 17 years.
Ms. Shen had the operation in Hebei Yanda Hospital. Liu Xingpeng is a cardiologist at Beijing Chaoyang Hospital and one of the co-founders of Hartrim Cardiologists Group. Yanda Hospital is the second practice place of Liu Xingpeng and one of the cooperative hospitals of the Group.
"It truly reflects the patient-centered and gathered many experts in cardiac surgery. As a patient, I simply can’t invite so many well-known experts. " What Ms. Shen is talking about is the characteristic of Hartrim Cardiologist Group-multidisciplinary expert group collaborative diagnosis and treatment mode, that is, a group of relatively fixed experts from more than two disciplines discuss a patient’s organ or system diseases in a normal way, form a diagnosis and treatment plan, and execute it by members of the corresponding disciplines.
"Unlike the consultation with administrative departments in public hospitals, this is a multidisciplinary expert group collaboration initiated on the initiative according to the needs of patients, which is completely considered for patients and does not involve the interests of departments." Fan Rui, CEO of Hartrim Cardiologist Group, said. The hybrid surgery mentioned by Ms. Shen is a new type of surgery developed by the group, which can enable multiple specialist teams to cooperate and provide patients with various necessary surgical treatments during one operation, thus reducing the pain of patients undergoing multiple operations.
Doctors of the doctors’ group practice in Yanda Hospital, which is not the so-called "flying knife". In 2015, the doctor group cooperated with Hebei Yanda Hospital at the beginning of its establishment, and in 2016, the "1+N" cooperation mode was launched, that is, doctors from large 3A hospitals in the group went to the cooperative hospital full-time to be responsible for the daily diagnosis and treatment of the cardiac department, and many experts in the group fully supported it. Tan Chen, the chief physician from the Army General Hospital, has been stationed in Yanda Hospital full-time since March 2016, and led a cardiac ward. With the support of many experts such as Mei Ju, a professor of cardiothoracic surgery at Shanghai Xinhua Hospital, more than 400 cardiac operations were completed in the first year of its opening. There is another model "N+1", that is, there are many experts in the system to help the same hospital collectively. "1" refers to the leader of the cardiac discipline of the cooperative medical institution itself.
"We not only helped cooperative institutions in terms of discipline development, but also set up a team of follow-up nurses. Follow-up nurses are mainly responsible for supervising patients to take medicine, reminding them to review regularly, follow-up and other services. The general consultation needs of patients can be met by asking the follow-up nurse, and doctors can be found through the follow-up nurse when treatment is needed. The group provides one-stop and continuous services, which is completely different from the doctor’s’ walking the hole’. " Fan Rui said.
In the form of a company, the doctor group absorbs doctors with high technical level to practice in a managed and organized way, and is strong and powerful.
In addition to Yanda Hospital, Hartrum Cardiologist Group also cooperates with five hospitals, and the experts of the group make house calls or provide technical assistance in the cooperative hospitals with the advantage of "N" to jointly build a cardiology discipline.
In May 2015, Liu Xingpeng and other seven first-line cardiologists from six top-three hospitals in Beijing jointly established Hartrum Heart Rate Specialist Group, which is the first specialist group in the field of heart disease in China. In 2017, it was renamed Hartrim Cardiologist Group. The services mainly include arrhythmia, coronary heart disease, heart failure, structural heart disease and other diseases, and there are four sub-professional expert teams and nurse teams to provide diagnosis and treatment and technical output services for cooperative hospitals. Due to the multi-disciplinary cooperation of heart disease and the characteristic hybrid surgery, the group’s diagnosis and treatment volume and business income have soared year after year.
The Donglei Brain Doctor Group, which was established in the same year as Hartrem, was initiated by Song Donglei, an expert in neurosurgery at Huashan Hospital affiliated to Fudan University, and is also a specialist doctor group. The group has very high requirements for doctors’ professional skills and academic level. Most of the group experts and cooperative experts have overseas study and study backgrounds, focusing on the diagnosis and treatment of brain neurological diseases. The founders and experts of Donglei Brain Doctor Group are mostly full-time doctors who leave the system. When cooperating with the hospital, the full-time doctors of the group need to sign a labor contract with the hospital and register the cooperative hospital as the practice place; If it is an identity within the system, it is enough to carry out multi-point practice filing.
The reporter found that these doctor groups are all in the form of companies, attracting doctors with higher technical level to practice in a managed and organized manner. They combine with each other with their technological advantages to obtain technical value returns in the market.
In June 2016, the practice license of medical institutions in the outpatient department of Shenzhen Bode Jialian Doctor Group was officially approved. Nearly 300 contracted experts of the doctor group can carry out disease diagnosis and treatment in the outpatient department, and the clinical disciplines cover 26 specialties, including gastrointestinal surgery, hepatobiliary surgery, congenital heart disease, asthma and chronic obstructive pulmonary disease.
Chuanpai Doctor Group is a specialist group specializing in the field of pain medicine. At present, it has purchased a second-class hospital of integrated traditional Chinese and western medicine and named it "Chuanpai Medical Prescription Museum".
There is also a kind of doctor group, which belongs to the management service type and is similar to the doctor broker, such as Everyone Medical Association and Zhongyu Doctor Group. This kind of doctor group is positioned as a doctor’s agent company, which is mainly responsible for providing management services related to doctors’ practice, such as establishing an information exchange platform, helping doctors choose contracted hospitals, centralized negotiation, and risk response.
In the management service doctor group, there are also some Internet doctor groups such as Xingxiangyuan. This kind of doctor group mainly relies on the Internet platform to become a professional assistant and multi-point practice platform for doctors, and relies on the Internet to achieve accurate matching between doctors and patients offline. On the one hand, it provides consulting, brand communication, customer development, service operation, payment system, legal risk control and other services for the doctor team; on the other hand, it serves as an information release and integration platform for doctors and patients and acts as an intermediary.
Doctors are not affiliated resources of public hospitals, but common resources of the whole society.
Most of the founders of doctors’ groups are already big-name doctors. Why should we start a doctor’s group? Huo Yong, the co-founder of Peking University First Hospital and director of the Department of Cardiology, said that the doctor group is an organizational form that adapts to the transformation of the social system, and it is more compact and efficient, which is convenient for doctors to better safeguard public health. "The situation that doctors only belong to hospitals will definitely change, and doctors should be freelancers." He said that it is a common phenomenon for doctors to go out from hospitals and form a doctor group to partner, sign contracts and engage in practice, but it has just started in China.
Huo Yong has been a cardiovascular doctor for 35 years. In the course of practicing medicine, he found that the interventional therapy technology of coronary heart disease in China is becoming more and more mature, but the mortality rate of coronary heart disease is also rising. Therefore, interventional therapy alone is not enough, and we must consider it as a whole and pay more attention to primary, secondary, tertiary or even zero prevention. "Through the organization of doctors’ groups, more hospitals, especially primary hospitals, will be promoted to join, and industry standards and standardized procedures for cardiovascular treatment will be established." He believes that the demand for cardiovascular treatment in county hospitals is the most urgent. Because the regional population is relatively stable, the concept of tertiary cardiovascular prevention can be well practiced and people’s health level can be improved.
It is one of the main reasons for the establishment of most doctor groups to better rely on technology to obtain sunshine income. "I founded the People’s Medical Association with the aim of establishing a mutual aid platform for multi-point practice. I am also a doctor in Fuwai Hospital of China Academy of Medical Sciences. I also have to go out for outpatient service and have surgery. Under the premise of not affecting my job, I will make the platform bigger and help doctors use their own technology to treat more people, especially grassroots people, so that they can enjoy quality medical services at home. " Hongtaosun, the founder of the All-China Medical Association, said that the profit of the All-China Medical Association is very thin, but the income of doctors who go out for an operation is very considerable, which greatly improves the income level.
The All-China Medical Association is the first doctor group within the system in China. Some experts have commented that it not only created a precedent for doctors to start businesses within the system, but also opened a door across the system for deepening medical reform. Hongtaosun said that Dr. China’s personal brand has not been established, and it is still difficult to practice completely freely outside the system. The best business model is to practice more within the system.
Nowadays, there are more and more doctor groups inside and outside the system, led by doctors, capitalists and pharmaceutical companies. After many investigations, Miao Yanqing, a researcher at the Health Development Research Center of the National Health Planning Commission, roughly counted that the number of well-known doctor groups in the country has reached 160, and a few doctor groups have just been established and are not known to the industry.
Miao Yanqing believes that the increasingly relaxed policy has created a good environment for the emergence of doctor groups. From 2009 to 2017, China has successively issued a number of policies to support and encourage the rational flow of medical personnel between different medical institutions, and gradually realize the goal of "one registration and regional effectiveness". In particular, "Healthy China 2030" Planning Outline clearly puts forward "actively exploring doctors’ free practice, individual doctors signing services with medical institutions or forming doctors’ groups".
"At present, a single mode of medical service supply is difficult to meet people’s diversified needs. From the aspects of medical platform, doctor’s practice mode, people’s choice of medical treatment, medical insurance, etc., the doctor group has promoted the transformation of medical services from a centralized supply mode to meeting diversified medical service needs, and explored new formats for building diversified medical service supply. " Miao Yanqing said.
Cai Jiangnan, director of the Center for Health Management and Policy of China Europe International Business School, believes that the problem of doctors has been the bottleneck of medical reform for many years. Doctors’ groups touch on a series of institutional issues such as graded diagnosis and treatment, doctors’ employment treatment, etc., which are likely to become the breakthrough of medical reform and should be supported and cared for. "Doctors are not affiliated resources of public hospitals, but common resources of the whole society, which should be well utilized."
People’s Daily (February 23, 2018, 20th edition)