Some doctors use the rest time to receive online consultations after completing the offline high-load workload. Although some doctors are chief physicians, they only receive 9.6 yuan for one online consultation——
["Inquiry" Internet Hospital ③] How is the incentive mechanism "online" for doctors "online"?
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Some doctors are not very enthusiastic about Internet hospitals. On the one hand, offline medical services require a lot of time and energy, and on the other hand, the prices of diagnosis and treatment services in Internet hospitals are not reasonable.
Some doctors suggested that "sunshine income" should be provided for doctors' online medical visits, and relevant departments should also formulate corresponding norms and price standards for Internet hospital diagnosis and treatment in a timely manner, and improve the performance incentive evaluation mechanism.
"When receiving online consultation, you must first understand the patient's chief complaint, inquire about the medical history in detail, check the medical record data, and then give the patient treatment advice, issue a drug prescription and write the medical record." Ke introduced her online consultation process to the "Worker Daily" reporter.
Internet hospitals have built a new bridge for communication between doctors and patients. Relying on offline hospitals, many Internet hospitals have also settled in a powerful team of doctors, providing convenience for the masses to seek doctors and medicines.
However, the reporter learned from interviews in Beijing, Shenyang, Shenzhen and other places that many doctors are not very enthusiastic about Internet hospitals, and some doctors in Internet hospitals even have zero visits, zero evaluations, and zero responses.
The "2021 China Internet Hospital Development Report" shows that less than 10% of Internet hospitals can truly achieve effective and continuous operation, and most of them are in a state of being built without use or just trying.
Zhao Yongsheng, vice president of Peking University Shenzhen Hospital, said that the biggest difficulty in the real implementation of Internet hospitals lies in how to mobilize the enthusiasm of doctors.
Doctors use their spare time to respond to patients
In 2018, after strict training and admission assessment, Zhang Ke officially became a doctor of the Internet Hospital of the Third Hospital of Peking University.
In her view, Internet hospitals can not only keep patients and doctors in contact, facilitate timely and smooth communication, but also improve the doctor-patient relationship to a certain extent.
According to reports, many Internet hospitals have strict physician access mechanisms. Doctors must not only have physician certificates, physical hospital practice qualification certificates, and independent clinical experience, but also obtain Internet hospital practice qualifications.
Xu Xuedong, director of the Medical Department of the Third Hospital of Peking University and director of the Internet Hospital Office, said in an interview with the "Worker Daily" reporter that online consultation can meet the needs of patients for follow-up visits in a timely manner, thereby providing more offline outpatient resources to first-time patients. .
At the same time, through the integration of online and offline, the patient's health management and medical services can form a closed loop, making treatment continuous.
Internet hospitals provide a lot of convenience for patients to seek medical treatment, but many doctors are not very enthusiastic about this, and some doctors only regard the work of Internet hospitals as a "sideline".
Zhang Ke bluntly said that in her daily work, she must first ensure the time for offline medical services, and she mainly uses rest time or fragmented time to treat patients in Internet hospitals.
At present, she receives an average of more than 30 visits per week in Internet hospitals.
In April this year, the reporter saw in the Infectious Diseases Clinic of Peking University Shenzhen Hospital that Li Yaqin, the attending physician, was using his mobile phone to answer online patient inquiries through the Internet hospital platform.
She told reporters that when there is a patient consultation online, the doctor will receive a text message notification, and usually use the rest time to reply.
Unreasonable pricing of online medical services
In addition to the difficulty in guaranteeing working hours, a reporter from Workers Daily also found in the interview that the unreasonable pricing of medical treatment fees in Internet hospitals is also the reason why doctors are not highly motivated.
Zhou Wen, chief physician of the internal medicine department of a third-class hospital in Shenyang, told reporters that, in fact, it is not easier to visit an Internet hospital than offline, and doctors of different levels are charged at the price of general outpatient examination items when visiting a doctor. Yuan.
"The pricing of diagnosis and treatment services is unreasonable, and there is a 'one size fits all' phenomenon, which cannot fully reflect the labor value of medical staff, which also dampens the enthusiasm of high-level medical staff to some extent." Zhou Wen said.
Zhou Wen also bluntly said that compared to offline, she spends 20% more time on diagnosis and treatment for each patient online. Pre-consultation is free.
The "2021 China Internet Hospital Development Report" pointed out that taking online follow-up consultation as an example, Beijing charges 50 yuan, while the offline ordinary number of well-known experts in the hospital is 100 yuan, and the special account is 300 yuan.
The relevant person in charge of the Internet Hospital of Shenzhen Maternal and Child Health Hospital also felt the same, "The current online diagnosis and treatment fees are difficult to mobilize the enthusiasm of doctors. After doctors complete the heavy workload offline, they use the rest time to carry out online consultation services, which consumes a lot of money. It takes a lot of time and energy, and we can only charge the minimum diagnosis and treatment fee, which is 25 yuan, and it is difficult to mobilize enthusiasm."
Provide "sunshine income" for doctors to visit online
"To increase the activity of doctors, it is necessary to provide 'sunshine income' for doctors to visit online." Zhou Wen said that under the new crown pneumonia epidemic, offline diagnosis and treatment were limited, which played a catalytic role for doctors to go online and continue to provide online services.
"However, in order for doctors to truly embrace and participate in Internet hospitals, it is also necessary to meet the diverse needs of doctors."
The "2021 China Internet Hospital Development Report" emphasizes that the establishment of an effective benefit distribution mechanism and cost compensation mechanism for hospitals and an effective performance incentive evaluation mechanism for doctors are the first major prerequisites for the sustainable development of Internet hospitals.
The report also pointed out that Internet hospitals have integrated online and offline processes. Compared with traditional diagnosis and treatment services, the business model and the path for users to see a doctor have also undergone great changes. develop.
The "Guiding Opinions of the National Medical Security Administration on Actively Promoting "Internet +" Medical Services and Medical Insurance Payments" stipulates that designated medical institutions provide "Internet +" medical follow-up services that meet the regulations, and charge and pay according to the prices of general outpatient clinics in public hospitals. .
Zhao Yongsheng said that in order to improve the enthusiasm of doctors, Peking University Shenzhen Hospital regularly holds regular meetings of Internet hospitals every week, and at the same time, all consultation fees are used as performance rewards for doctors.
Zhang Ke suggested that relevant departments should formulate corresponding norms and price standards for Internet hospital diagnosis and treatment in a timely manner, and improve the performance incentive evaluation mechanism for personnel with different roles, so that the labor value of doctors, nurses, pharmacists and technicians can be reflected separately.