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Doctors at receiving end in medical reform

By Wang Shanshan in Beijing (China Daily)
Updated: 2010-03-25 06:44

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Doctors at receiving end in medical reform

Children and their parents wait for treatment at Suzhou Children’s Hospital in Jiangsu province. [WANG JIANKANG/FOR CHINA DAILY]

Doctors also charge a minimal service fee. In Beijing, patients pay about 5 yuan ($0.70) for an appointment - 4 yuan goes to the local government, 0.5 yuan to the hospital and 0.5 yuan to the doctor, said Chen Yan, a doctor specializing in respiratory medicine with Beijing's China-Japan Friendship Hospital.

If a doctor fails to meet his or her section's revenue target, it is reflected in their salaries and can affect their career in the long term, added Zheng.

The evaluation system has two direct results, say analysts: doctors tend to automatically make out prescriptions for expensive medicines and, in most cases, lose any incentive to improve their skill levels.

"After some checkups and tests, doctors don't even look at the results. They are carried out purely for the money," said Zheng, who explained that most prescribed drugs could be replaced by cheaper alternatives that are just as effective.

Doctors at receiving end in medical reform

A man suffering from a sore throat spent almost 650 yuan on a checkup and medicine at a hospital in Guangzhou, capital of Guangdong province, last November, Guangzhou Daily reported. He was prescribed a dozen different drugs - antibiotics, Chinese herbs and pills for liver disease - and was given several injections. He was actually diagnosed with a cold.

The charge is all the more shocking considering that the average wage in Guangzhou was just 1,800 yuan a month in 2008, according to the National Bureau of Statistics.

To cut medical costs, the Ministry of Health issued an "essential drugs list" last September. It contains the most common 307 Western and traditional Chinese medicines, which are all heavily subsidized so hospitals can sell them at cost price. The ministry said 30 percent of all State-run clinics in rural areas would be stocked with each essential medicine on the list by the end of last year.

As long as money is the main driving force behind healthcare, however, "bedside manner" will always take a back seat.

Doctors at receiving end in medical reform

"The medical profession has unlimited heights and a doctor always has new challenges to meet. They must be creative and hard-working," said Chao Enxiang, a doctor of Chinese traditional medicine at the China-Japan Friendship Hospital with three decades of experience. "Sadly, the space for creativity is very much limited and many doctors are abusing their profession to make money."

High profile cases of malpractice reported late last year, which were either blamed on a doctor's poor skills or lack of procedural care, have done little to instill confidence in China's hospitals.

Two patients were hurt in botched operations on two consecutive days in hospitals in Hubei province last November. The first case involved an 84-year-old man, who fell at his home in Tongcheng county and broke his left leg. His son complained after noticing surgeons had operated on the elderly patient's right leg by mistake, Chutian Metropolitan News reported. The next day, medics cut tissue from the wrong side of a farmer's stomach in the nearby city of Xiantao, according to Hubei Daily.

More shocking, perhaps, was an incident at the Nanjing Children's Hospital, in the capital of Jiangsu province, where a baby died last November because his doctor, ophthalmologist Mao Xiaojun, was playing go online instead of looking after his patients.

The 5-month-old boy died when an eye infection caused swelling in his brain. His mother knelt down to beg the doctor to help her child three times, Yangtze Evening News reported.