Research On Transition From Rural Doctor To Licensed Physician

ObjectiveThis study based on literature research and policy analysis, through surveying on the sampling areas, to find the main issues and their impact factors which hinder the process of transition from rural doctor to licensed physician in china.Then acoording to the issues, with the ellightenments of other policy experience, this paper will put forward policy proposals for the transition, which can make the goal by 2010 achieved as soon as possible.MethodsThe research used the methods and theory of sociology, public health management, and statistics, which aim is to analyze the status quo and policies of the transition from rural doctor to licensed physician. The main methods included:(1) Literature reasearch;(2) Spot investigation method including questionnaire and interview;(3) Policy analysis on the backgrounds, development and progressing tendency of the policies and strategies were analyzed in the research;(4) Statistical method: main use the descriptive statistics method to analyze rural doctors'status quo and their willingness of examination;(5) Experts consultation method or Delphi, this method mainly on interviews and group discussions to collate the information, and then conclude the main issues and find the solutions.ResultsRelated laws, regulations and policies: in order to solve the problems of low quality and nonstandard qualification of rural doctors, our country has set down a series of related laws, regulations and policies.(1) Policies on rural doctors'qualification certificationThe government has make the qualifying standard by the "Law on Practicing Doctors of the Peoples Rrepublic of China" and "Administrative Regulations for Rural Doctors'Medical practice", which has provide a legal basis for China's rural doctors'transition.(2) Policies on Education and TrainingThe implementation of"the Chinese rural doctors educational programming advanced by the Sanitation department from 1991 to 2000", signify that China's rural doctors from the primary medical education has entered a systematic, and regularization of the secondary education stage. To further enhance the academic education of rural doctors, the government enacted the second decade planning by 2001. Two decades of China's rural doctors'education plan not only make the quality greatly improved, but also make the transition possible.(3) The financial subsidy and awarding policyIn order to solve the treatment of rural health workers with reason, the"Decision on the Health Reform and Development by the Party Central Committee and the State Council"proposed village collective income of rural doctors should not be lower than the local village cadres income levels; To further stimulate the nation's rural doctors based on rural areas, service peasants, and better for farmers to provide basic medical and health services, "Administrative Regulations for Rural Doctors'Medical practice"regulate that give incentives to whom make outstanding acaievemment in the rural areas of prevention, health care, medical services and emergency handling of sudden events.Furthermore,According to their own situations, local government also has set down a series of policies which improve rural doctors obtain the qualification. All of above measures provide theoretic basis and policy support for the transition from rural doctors to licensed physician.The survey totally collected 4160 questionnaires from rural health rooms of six provinces,the results showed that:(1) Basic situation of village health posts in sample region: there are 1.04 clinics per village on average; the main form of village health posts is hold by village, accounting for 58% of the survey region, followed by private, accounting for 20%; there are 2.06 rural doctors per village health posts on average, 0.09 licensed physician, Less than 0.1, and even some counties have no licensed physician. (2) Basic situation of rural doctors in sampling regions: there are 47.13% of the rural doctors aged above 45; from the academic structure, 71.5% of which are secondary school education, 0.53% of which are undergraduate and postgraduate only; currently, only 9.13% of rural doctors have the qualification to be a licensed physician, contrast from age and academic structure, the greater the age, the lower the level of practice; the higher education, the higher the degree of practice; only 22.82 % rural doctors enjoyed the benefits in the staff subsidies, 24.97%of them took part in old-age insurance, Overall, the eastern part had the high rate of participation in insurance,the Western staff enjoyed a higher proportion of grants allowances.(3) Results of training and willing: the rate of awareness of the practicing examination up to 96.35%, but there are a few to take part in the examination and pass it. For such phenomenon, the research found that the examination is difficult and their age is old. Low educational level is another main reason. 69.62% of the informants hope the government can give some policy support. 50.62% of the informants hope a targeted training. ConclusionsAccording to the results of spot investigation and the related policy analysis, we can see that China's rural doctors are still faced with the embarrassing situation of "low quality, difficult access to quality, ageing, and no income security". So in the short trem, it is very difficult to achieve the goal, "by the year 2010 with the majority of rural doctors to become the qualified physicians."The problems obtained from the survey(1) Irrational structure of rural doctors is one of main difficulties; (2) Form and content of the examination is not in line with rural realities; (3) Lack of specialized training targeted rural doctorS; (4) Rural doctors unable to pay the high training costs; (5) the phenomenon of ageing is serious; (6) the rate on medical insurance of rural doctor is very low.The problems obtained from the current policy(1) The imperfect systerm is also an important reason of the problems; (2) The conflict between relevant policies make the new problems; (3) Current policy is not on the point; (4) Lack of social security policy; (5) Lake of incentive policy.SuggestionsIn order to achieve this transition goal as soon as possible, this paper made the follwing suggestions which comprehensively consider the national laws and regulations, and foreign policy experience on the basis of the survey results. The government should(1) Make the current relevant policies perfect, especially, "Law on Practicing Doctors of the Peoples Rrepublic of China" and "Administrative Regulations for Country Doctor'Medical practice";(2) Reform rural doctors'personnel system, which should take different strategies for different regions;(3) Continue to strengthen the academic education, incumbency training and continuing education, establish training networks, and develop targeted training method and layered training method;(4) Establish rural doctors insurance benefits fund, properly solve the problem of retirement and endowment;(5) Establish the integrated management systerm about rural health services, which to resolve the status of rural doctor;(6) Purchase public health services to solve the problem of rural doctors'compensation;(7) Establish the incentive mechanism to encourage medical personnel stay at rural areas;(8) Develop the policy that can change rural doctors to general practitioners.