Chapter 21 4. Social medical care: a black topic

In any case, this is unbelievable—according to the report of the monthly magazine "Earth" sponsored by "People's Daily", the total number of private hospitals in the country has exceeded 100,000, and more than 300,000 people eat the food of private hospitals .According to some surveys and statistics, there are 335 private hospitals of various types in Beijing alone; Zunyi City, Guizhou Province, with a population of more than 400,000, has more than 200 private hospitals alone; There are actually 8 hospitals on the street... This is just enough to say that they are "grade" hospitals. If you count the "clinics" and "specialties" that are flooded in the streets and alleys, in front of and behind houses, etc. Including, the total number of private hospitals across the country may no longer be countable.In a building rented out as a private hospital in Tianjin, there are more than 40 outpatient clinics (clinics) of various types, and the regional hospital in Yuncheng, Shanxi is surrounded by more than 10 clinics...

The emergence of the form of socially run hospitals has been developed in the past ten years. Its original idea is indeed to alleviate the objective problems of difficulty in hospitalization and medical treatment.After liberation, although China's medical and health services have undergone earth-shaking changes, with the improvement of people's living standards, people's demand for medical care is also increasing, so that by the early 1980s, China's medical and health conditions were still far from It cannot meet the needs of the people, whether in urban or rural areas, there are still serious problems such as difficulty in seeing a doctor and hospitalization.In this case, the health department issued a policy to allow a limited number of social hospitals.The first batch of individual medical practitioners not only won the recognition of the society, but also created remarkable economic benefits, so many people followed the trend and got involved in the ranks of social medicine.For a while, those with conditions will be implemented, and those without conditions will also be implemented; those with approval will be implemented, and those without approval will also be implemented... After more than ten years of abnormal development, in China today, hospitals are no less than restaurants, and pharmacies are no less rare than toilets. .Practicing medicine and making money are equated here.The Shanxi Provincial Department of Health has conducted a survey on the purpose of running medicine in more than 3,000 private hospitals in the province. Half of the people said that they practice medicine to make money. Only a small number of retirees answered that they wanted to save patients from suffering or develop their professional expertise.

Let's take a look at the various social forms of running hospitals: hospitals run by companies and enterprises, hospitals run by neighborhoods, hospitals run by government agencies, hospitals run by schools, hospitals run by troops, etc.Looking at the hospitals (clinics) opened in the name of individuals, there are all kinds of hospitals (hospitals) opened by medical staff, non-medical staff, and even clinics (hospitals) opened by witch doctors.Look at the location of those hospitals (clinics) or outpatient clinics (specialties), some are located in guest houses, hotels, some are located in basements, some are located in residences, some are located in temporary construction sheds, and even There are also shots to change places.

Those who do business and earn money from medicine naturally have their own shortcuts to "doing business" and the means to make money. According to the "Health Daily" report: A farmer in Hebei Province suffered from pancreatic head cancer. He came to a large hospital in Beijing full of hope, but he didn't want the hospital to run out of beds. A "kind" doctor introduced him to a private hospital, where the doctor admitted him without careful examination, and then prescribed "Pioneer B" for intravenous infusion for three days.In a few days, he has spent more than 1,000 yuan.After several days of hospitalization, the patient found that the wards and medical conditions in this hospital were extremely simple, so he hurriedly settled the bill and found the big hospital again.At the beginning, a colleague of the "good-hearted" doctor watched his film and introduced him to another private hospital.He stayed for less than five days, and spent a lot of money... Most of the private hospitals like this are located near the national large hospitals, and most of them have established some secret contacts with the outpatient doctors of the hospitals. It is precisely because of these " Contact", these private hospitals receive a steady stream of patients introduced from large hospitals.When patients come, money is earned.Of course, these private hospitals know how to "report with kindness", and they will naturally express it to those doctors who "guidance" to patients in large hospitals.Generally speaking, they can get 50 to 100 yuan or more "benefits" for each patient they introduce.For the patients, due to their passivity when seeking treatment and their urgency to get treatment, they eagerly hope that the doctor can "point out the maze": what medicine is good to use, and where there is a better way, etc., which just makes those who work in large hospitals Doctors' "medical trustees" "manage patients" without showing any signs of publicity, and share the results with private hospitals.

The corruption in the industry has been tightened, and some private hospitals have followed the practices of restaurants and hotels, hiring solicitors to cheat patients. "China Youth Daily" reported that a soliciting woman cheated patients for a private clinic in Hunan Hengyang Maternal and Child Health Hospital.According to the director of the obstetrics and gynecology department of the maternal and child health care hospital, these soliciting women who are employed by others often pretend to be patients, take the opportunity to make friends with other patients, and then recommend to the patients that she has a familiar old Chinese doctor or western doctor, and what kind of ancestral Secret recipes and so on, deceive patients and lead them to private clinics for treatment, so that most patients spend a lot of money, and some even treat minor illnesses into serious illnesses.

Some social medical units, some individual clinics, and specialized outpatient clinics often make a fuss about difficult and miscellaneous diseases in order to achieve the purpose of attracting patients to seek medical treatment.An individual doctor surnamed Dong casually shared the secret of his "management" of patients: We treat all difficult and miscellaneous diseases, especially the difficult and miscellaneous diseases that have been proven to have no good treatment. Most of these patients have long medical histories. Seeking treatment for many years has basically no effect, and the national regular hospitals often tell them truthfully that there is no way, which is actually the last thing patients want to hear.They would rather be deceived than be told that he is terminally ill.Therefore, we dare to say that any disease can be cured.Patients often need this sentence. As for whether the cure is good or not, there is no need to worry. Let them pay all their money, and they will naturally take the initiative to say, I am dead.Generally, no one will accuse us of bragging and talking big.

After understanding the psychology of patients, some private medical units, individual clinics, and specialist outpatient clinics dare to brag and use any method as long as they can attract patients and increase economic income.The most commonly used method is to use deceptive means to use the newspapers and periodicals published by the state to publish false medical advertisements.These false medical advertisements were not only published in central-level newspapers, but also printed in street tabloids, broadcast on TV and radio.Its advertising content is mainly characterized by the promise to treat various difficult and complicated diseases, from cancer, mental illness, epilepsy, and rheumatism to skin diseases, sexually transmitted diseases, infertility, sexual dysfunction, and dwarfism disease etc.The writing methods of these advertisements are both introductory and close-up; both news and popular science... The essence of these false medical advertisements lies in their irresponsible promises of therapeutic effects.The effective rate and cure rate are just nonsense. Any disease can be cured, and it is especially good at treating cancer. It has the effect of "curing the disease with medicine".In a word, these social medical units, these individual doctors are almost to the extent that no disease cannot be treated, and no disease cannot be treated. They should all be winners of the Nobel Prize in Medicine.

As for the disadvantages of social medical services, the relevant departments have already noticed and attracted attention.National health agencies and local health administrative departments have also adopted some practical and effective rectification measures, and some abnormalities in the social running of hospitals have been curbed to varying degrees.On January 1, 1988, the Ministry of Health and the State Administration of Traditional Chinese Medicine jointly issued the "Interim Measures for the Administration of Individual Practice of Physicians and Chinese Physicians", which regulated the practice of individual medicine. In 1994, the "Regulations on the Administration of Medical Institutions" was promulgated, which clearly stipulates the establishment, approval, registration, practice, supervision and management of social medical institutions. On May 1, 1999, the "Law of Practicing Physicians" began to be implemented. All of this is to lead the social running of medicine to the track of legalization. Only in this way can the chaotic situation of social running and unlicensed medicine be controlled and medical accidents be blocked Vulnerabilities occurred.

Doctors shoulder the great responsibility of treating diseases and saving lives, and saving lives and wounds. Therefore, the state must strictly examine those who are engaged in the profession of doctors. On February 26, 1994, the State Council promulgated the "Regulations of the People's Republic of China on the Administration of Medical Institutions" and its implementation rules. The regulations stipulate that medical institutions must register and obtain a "Practice License for Medical Institutions".Any unit or individual that has not obtained the "Medical Institution Practice Permit" shall not carry out diagnosis and treatment activities.Only those who meet the conditions stipulated by the state will be granted the qualification to practice medicine by the national health administrative department, and those who do not have such qualifications will not be allowed to practice medicine.

According to Article 13 of the "Regulations on the Administration of Medical Institutions", individuals who set up clinics in cities must meet the following conditions: 1. Pass the examination of physician's practice skills and obtain the "Physician's Practice Certificate"; 2. Obtain the "Physician's Practice Certificate" Or have been engaged in clinical work of the same specialty for more than five years after the title of doctor; 3. Other conditions stipulated by the health administrative departments of provinces, autonomous regions, and municipalities directly under the Central Government.Those who do not meet the above conditions and engage in medical business are practicing medicine illegally.

The new "Criminal Law" officially implemented on October 1, 1997 added the "crime of illegal medical practice" for the first time.Paragraph 1 of Article 336 of the Law stipulates that if a person who has not obtained the qualification to practice medicine illegally practices medicine, if the circumstances are serious, he shall be sentenced to fixed-term imprisonment of not more than three years, criminal detention or public surveillance, and shall be fined concurrently or solely; He shall be sentenced to fixed-term imprisonment of not less than three years but not more than ten years, and shall be fined; if the patient dies, he shall be sentenced to fixed-term imprisonment of not less than 10 years, and shall also be fined. On May 1, 1999, China officially implemented the "Law of the People's Republic of China on Practicing Physicians", stipulating that doctors are not allowed to work without a license. This is another important measure for the legalization of China's medical management. The Law on Practicing Physicians stipulates that doctors must pass the medical qualification examination and be registered before they can practice medicine.Anyone who has not been registered as a doctor and obtained a practicing certificate is not allowed to practice medicine.Applicants for individual medical practice must continue to practice medicine in medical, preventive, and health care institutions for five years after obtaining a registered practice certificate, and go through the approval procedures in accordance with relevant state regulations.Those who set up medical institutions to practice medicine or non-doctors to practice medicine without approval shall be banned by the relevant departments, their illegal income, medicines and equipment shall be confiscated, and a fine of less than 100,000 yuan shall be imposed; doctors shall have their practicing certificates revoked; causing damage to patients If it constitutes a crime, it shall be investigated for criminal responsibility according to law. The "Law of Practicing Physicians" also stipulates corresponding penalties for doctors who have medical liability accidents during their practice, delaying patient rescue and diagnosis and treatment due to irresponsibility, taking advantage of their positions, extorting and illegally accepting patients' property, etc. Order to suspend their qualifications to practice medicine for not less than six months but not more than one year; if the circumstances are serious, revoke their practice certificates; if a crime is constituted, they shall be investigated for legal responsibility. my country currently has more than 1.5 million physicians with university degrees and 463,000 doctors with technical secondary education.According to the current system, after entering a hospital, graduates of medical colleges usually only need to pass a one-year internship and the assessment of the hospital or local health administration and personnel departments before they can see patients.The standards for measuring the level of doctors are uneven.Especially in recent years, some individual practitioners, wandering doctors, and fake doctors have engaged in illegal medical activities, especially in rural areas and remote areas where there is a lack of medical care. Medical accidents caused by poor or irresponsible doctors Frequent occurrence has aroused strong concern from all walks of life. For the safety of people's lives, China has taken serious steps in regulating the practice of medicine. On November 20, 1999, my country held the first national qualification examination for medical practitioners, and more than 300,000 people participated in the examination.The two-day medical comprehensive written examination is conducted simultaneously in nearly 400 examination centers in 31 examination areas across the country, and is divided into two levels: licensed physician and licensed assistant physician, and four categories: clinical, stomatology, public health, and traditional Chinese medicine.Previously, the test takers have passed the test to measure their practical skills such as practical operation, case analysis and judgment, and on-site handling.This examination is the first step taken by the national health department to establish a certification and registration system for medical practitioners across the country.According to the "Law of Practicing Physicians", only those who have passed the medical qualification examination and registered in accordance with the law have the right to practice medicine.Those who pass the examination will be awarded the national unified doctor qualification certificate, which together with the doctor's practice certificate will become an indispensable "passport" for practicing medicine in China. "Working with a certificate" is regarded as a breakthrough in improving the service level of doctors in my country, and it will be illegal to practice medicine without a certificate in the future. China began to raise the sword of law to illegal medical practitioners—— According to a report by Nanfang Daily on March 8, 1999, the People's Court of Yingde City sentenced the defendant Zeng Xiangde to 10 years' imprisonment and a fine of 3,000 yuan in the first instance for practicing medicine illegally without obtaining the doctor's qualifications and causing the patient's death. The court ordered compensation of more than RMB 80,000 for economic losses. Defendant Zeng Xiangde set up a private health clinic in Shijiao Village, Jiulong Town, Yingde City without obtaining the qualifications to practice medicine. In October 1998, a villager named Cheng went to Zeng's clinic for rectal and sigmoid colon and damaged his anal sphincter due to prolapse of the anus and frequent expulsion of the head of the large intestine.Although he was sent to Jiulong Town Hospital and Qingyuan People's Hospital for emergency treatment, Cheng died of exhaustion due to severe impairment of diet, digestion, and absorption functions, resulting in extreme malnutrition. "Henan Daily" reported that Fan Shuxiang, an individual doctor in Anyang City, Henan Province, illegally practiced medicine and caused the death of Zheng Xiaoya, a Taiwanese compatriot who came to Anyang to visit relatives. On December 23, 1998, Zheng Xiaoya, who was just over one year old, from Zhixue Village, Shoufeng Township, Hualien County, Taiwan Province, came to Anyang to visit relatives with her mother, and suffered from diarrhea.Fan Shuxiang gave Zheng Xiaoya infusion therapy, but there was no effect that day.The next morning, when Fan Shuxiang gave Zheng Xiaoya an infusion, he added large doses of lincomycin and gentamycin, 10 times more than normal, which caused Zheng Xiaoya's respiratory muscles to paralyze and the respiratory center to suppress and suffocate to death.After investigation, it was found that Fan Shuxiang did not obtain a license to practice in a medical institution, and it was an illegal operation without authorization.The Medical Malpractice Technical Appraisal Committee identified Zheng Xiaoya's death as a first-level medical malpractice. After the trial, the court held that the defendant Fan Shuxiang illegally practiced medicine without a license and caused death, which constituted the crime of illegal medical practice. He sentenced Fan Shuxiang to 14 years in prison and a fine of 10,000 yuan; compensated the plaintiff for economic losses and mental damages in total. 64968.55 yuan. On April 27, 1999, the People's Court of Ningxiang County, Hunan Province publicly heard a case of illegal medical practice. The defendant Yang Ruiming was sentenced to 3 years in prison and fined 7,000 yuan. Yang Ruiming is a villager in Xincun Village, Shuangjiangkou Town, Ningxiang County. He is 40 years old this year.Since 1993, without obtaining a doctor's license, Yang set up a "Xinqiao Village Health Center" in his village and began to practice medicine illegally. On March 4, 1998, Peng Ningchun, the only son of Peng Zhengxiang, a villager, asked Yang for treatment for a cold. The sciatic nerve was damaged, which was identified as a minor injury by the forensic doctor, resulting in a medical malpractice.The court made the above-mentioned judgment in accordance with the law. On May 25, 1999, He Daoliang, a villager in Hengshulong Village, Shiyangtang Town, You County, who was illegally practicing medicine without a license and caused death, was sentenced to 8 years in prison and fined 5,000 yuan by the People's Court of You County, Hunan Province on May 25, 1999. On April 5, He Daoliang went to the home of Ou Jianping in Zhutang Village, Taoshui Town to collect the arrears.During the chat, He Gu made a mystery, saying that Ou had a so-called "injury", and volunteered to say that he was from a family of herbal medicine and could treat him with herbal medicine, which Ou Xin believed to be true. On the morning of April 17, Ou Jianping went to He Daoliang's house and bought three packs of raw grass black medicine powder for 20 yuan.At about 12 o'clock that night, he took one pack of the powder with warm water. Only half an hour later, Ou felt unwell, and then developed symptoms such as numbness of hands and feet, tongue rolling, slurred speech, vomiting, palpitations, and dyspnea.Ou's family rushed to He's house for help, but He ignored him, saying that it was a normal phenomenon caused by herbal medicine.At around 6 a.m., Ou Jianping died after struggling for several hours.The forensic autopsy proved that Ou Jianping died of poisoning from an overdose of Aconitum aconitum.Ou Jianping went to the doctor indiscriminately without a disease, but he died in vain. He Daoliang practiced medicine illegally in order to covet 20 yuan, and ended up in jail.Such tragedies and farces cannot be repeated again! The law has opened the knife to illegal practitioners, and anyone who tries to defy the law will be severely punished by the law!