Should Doctors in Public Hospitals Be Allowed to Run Private Clinics?

The Beijing Municipal Health and Family Planning Commission recently said that doctors in state-owned hospitals in the capital will be allowed to set up their own clinics， a measure to allow the public to have easier access to medical resources.

Supporters of the policy think that it will break public hospitals perceived monopoly over the best medical resources. But it seems to have been less well received by doctors themselves. They think when a doctor takes up the responsibility of a private clinic， he or she has to sacrifice some of their personal time. As a result， patients may be worried whether overworked doctors can ensure the quality of their medical services.

In Beijings larger hospitals， one doctor could receive an average of nearly 100 patients every day， and sometimes even around 200. If they run their own private clinics， their performance at both hospitals and their own clinics is likely to deteriorate. The following are excerpts of opinions：

Song Wenzhi （www.cnr.cn）： I dont think private clinics will help relieve the difficulty of seeing a doctor. Is it really so difficult to get medical services？ I dont think so. Its not difficult to see a doctor in normal hospitals， but if you want to see a good doctor at a prestigious hospital， you will find yourself frustrated. Why？ First of all， there is a shortage of quality and excellent medical services on the whole. There are not enough capable doctors or capable hospitals. Beijings hospitals also have to receive a huge number of patients from outside the city. Those who come to Beijing for treatment will not go to private clinics.

Im worried that this new policy will trigger conflicts between doctors formal jobs and their private work. When doctors run their own clinic， their work will be affected either in terms of quality or quantity， no matter how much time is spent on their second job.

Li Qi （www.kq36.cn）： This is a good idea， but I dont think it can go far. When a hospital has a limited number of good doctors but also a lot of patients， I dont think the hospital would let their doctors leave.

The control on doctors can be relaxed in some areas. Dentists may be allowed to run private clinics， but doctors of surgery should not be casually permitted to do so.

Fang Laiying （The Beijing News）： We have already realized that， to meet the publics demand for medical services， its impossible to only rely on expanding already existing hospitals by adding beds and prolonging doctors hours and so forth. What we need now is to further expand community medical services.endprint

Community hospitals have remained underdeveloped for many years. A big reason for this is the shortage of doctors. Its almost impossible to bring in new medical graduates to work in community clinics. Therefore， we have to make full use of our existing pool of doctors， who are all on-the-job doctors in public hospitals.

Doctors are excellent medical resources， and are supposed to operate in accordance with the rules of the market and not be restricted to the current personnel system in public hospitals. However， how can we persuade patients， who prefer big public hospitals， to go to community medical agencies？ The answer lies in mobilizing on-the-job doctors from these big hospitals. If doctors from public hospitals are willing to open their own clinics， policy support should be offered to them.

Private clinics enjoy their own advantages. Their doctors have accumulated a lot of experience from big hospitals and are usually capable of communicating with patients. These clinics dont need medical inspection equipment， or other expensive hardware， as they can entrust a qualified third party to do the necessary physical examination for patients. We hope that once these clinics are opened， they will act well and actively in communities， benefiting more and more people.

Jiang Hua （www.xilu.com）： Its a good idea to allow on-the-job doctors to open their own clinics， but its not easy to run such a clinic. Beijing is not an easy place for a doctor to start his or her own clinic. Even if the doctor has successfully opened a clinic， he or she has to consider how to manage and operate it. A doctor may be professional at medical treatment， but management is a different skill. Doctors in Beijings big public hospitals， particularly excellent doctors， are usually very busy， and thus they have little extra time to manage their own private clinic.

Guo Changsheng （www.mszz.cn）： The reality is， the countrys best doctors and medical experts are serving in public hospitals in big cities， and as a result， patients from around the country rush to these hospitals for medical treatment.

To encourage on-the-job doctors to open clinics means medical resources will be distributed in accordance with market rules， which will mobilize current medical resources to the largest extent. The major objective for this policy is to cushion the conflicts between the publics huge demand for quality medical treatment and the limited medical resources， particularly excellent doctors.endprint

When doctors run their own clinics while keeping their posts in big hospitals at the same time， conflicts between doctors and their hospitals will come up easily. Thus， its important to balance interest sharing between the two. Another problem is that private clinics are unlikely to be covered by the countrys medical insurance system. A major obstacle for the establishment of private clinics is the complicated and strict approval procedure. Compared to public hospitals， these clinics will bear heavy tax burdens and difficulty in purchasing medical equipment.

Lei Hongpei （Xuzhou Daily）： Most doctors feel they will not choose to operate a private clinic. The evaluation of their professional titles as well as pensions and all kinds of benefit after retirement depend on the hospital that employs them. Although the policy grants individual doctors the freedom to run their own clinics， hospitals tend to hold on to their best doctors and prevent them from leaving.

However， if doctors and hospitals can reach a balance in terms of economic interests and various other aspects， medical capacity will be improved， and this is beneficial to the public. Private clinics are mostly operating in communities， where doctors are badly needed. Patients who usually find it difficult to see a doctor in big hospitals will now have easy access to quality doctors in community clinics. On the basis of doing well in hospitals， doctors can make extra money in their private clinics.endprint