Analysis On The Role Of The Motivation Mechanism Reformation In The Organizational Change Of Public Medical Organizations

A saying"medical department should also abide by the economic laws"started structural reforms in public medical system (SR for short), which has been widely debated. Public medical organization (PMO for short) has been changed greatly after the reformation. Expenses for medical service have been increasing and the morals of doctors has declined, though the technology and machines have been modernized. Medical department declared that SR is unsuccessful. After that, Chinese government put a series of policies into practice. However, the policies with the purpose of cutting down expenses for medical service eliminate the cheap medicine out off market through competition. The policy that rack down business bribes led to the"big inspection"from"big prescription". Supporting doctors with inspection and prescription is a model that keeps SR from the primary purpose of policies. Therefore, analyzing the guide function from motivation mechanism (MM for short) to each person in organization may helps us put forward a rationalization proposal.The paper describes the progress and current situation of structural reforms in public medical system. Then it draws the conclusion that the chief causes to nature evolution of PMO are insufficient input from government and alienation of MM. The alienation of MM is inevitable due to nature evolution of public organizations. It is alienation of MM that keeps PMO further away from its public nature than ever before. Theoretical inspiration with MM can be drawn from the fair theory, expectation theory and the theory of double elements. Fair theory supports it is reasonable for doctors to get a relatively high payment. Expectation theory emphasizes the guide function of MM. The theory of double elements points out emphatically motivational element in motivating doctors in PMO. MM not only determines the behaviors of everyone in organizations but also the organization culture. Consequently, increasing governmental input to draw it back to public nature is external environment, while reforming a new MM corresponding to the public nature is internal environment for PMO evolution. Reforming a MM with principle of reflecting everyone's value in organization is a useful way to return the public a new PMO with public, sociality and public spirit.Doctor is an occupation that needs great previously payment for education, high responsibility and risk in working, and unstable working hours. Doctors need high repayment for their hard-workings and high risks. Therefore, doctors need relatively high payments, welfares and rewards to avoid their unfair feelings. In public hospital, doctors'payments always depend on economic benefits they created for hospitals. It makes doctors feel that their value is only to prescribe. Hence, the MM in public hospital is not effective. The effective MM should emphasize motivational element and admit the value of doctors in payment system.The government responsibility to public medical system is increasing the financial input and regulating organization behavior with policy. It is a way to make PMO back to public nature. Furthermore, it is the foundation to reforming MM in PMO. Regarding these factors, the system and culture should also back to public nature and establish corresponding MM and organization culture. If effective MM could not be established to resist potential regulation in public hospital, new beneficial chief will form rapidly. It is essential and critical for public hospital to reform a motivation mechanism which is able to ensure doctors to get a reasonable and lawful earned income and an organization culture with public spirit. The current MM do ignored the value of doctors'skills and services. So firstly, the charging system in public hospital should admit the value of doctors'skills and services. Then the payment system should be reformed as well. Doctors ought to get their pay just for their skill and service, rather than only prescribing. It is essential principle for reforming MM. Supporting doctors only by themselves, rather than prescribing, may keep PMO with public, sociality and public spirit.