Legislation Research On Law Of The People's Republic Of China On Medical Practitioners

ObjectivesBased on researching on the Law of the People's Republic of China on Medical Practitioners (Law of Medical Practitioners, for short), its supported regulations, regulations of medical practitioners in foreign countries and other related literatures, this study analyzed the qualification of medical practitioners, practice rules, practice monitoring, legal duties and responsibilities, etc, in domestic and abroad, learned theories of legislation on medical professionals and experiences, and combined the results of field investigation and basic rule for legislation, then found out the major problems existed in the law of Medical Practitioners. After that, scientific legislation suggestions which are fit for the situation of our country were supplied to further perfect the law system of medical practitioners in China, then promote the development of the health industry and give the proofs and ideas for those legislation bureaus when they are revising and perfecting the law.Methods1. Literature review: Literatures were seriously reviewed, focusing on the basic legislation situation of medical practitioners in domestic and foreign countries, and related theories; the problems mentioned in literatures were systematically collected, which could be useful in the questionnaires.2. Questionnaire survey: Multiply sampling method was adapted, and 99 participants were investigated by questionnaire including doctors, administrators of hospital and officers in health administration department; accumulation-queue chart analysis was used to find out the major problems, and difference opinions among participants with different occupations, duties, posts and other variations were compared by non-parameter test.3. Field interview: Some participants were deeply interviewed, fully considered the opinions on the Law of Medical Practitioners and the implementation process, to add the problems missed during the questionnaire survey in timely;4. Expert advice: Experts in health law were invited to advise on the propriety of law terms, legislation basic and suggestions made in this study;5. Comparative Study: Compared law of medical practitioners in China with those abroad and with laws of related industries, and give some suggestions to improve Law of Medical Practitioners.Results1. Basic of legislation theory: After considering the characters of this law, that taking into account both rights of the public and medical practitioners, balancing rights and obligations of physicians, and adjusting activities of doctors and officers in health administration departments, the experts suggested that the"Theory of balance"should be the basis of law revision.2. Since the promulgation of law of medical practitioners in 1998, a set of supporting regulations were implemented to make sure the execution of the law.3. The main problems in law of medical practitioners showed in the results of field research were: lacking sufficient protection of physicians'rights and interests; complicate procedures of registered place change and no permission to practice outside the registered place, which were obstacles to sharing medical resources; inconsistence of regulations on academic qualification for examination in law of medical practitioners with that in other policies leaded to that some medical staffs can not get the license, who had strong capacity but without some certain education backgrounds, and caused the time conflicts between graduation and practice for medical students; non-standard execution when taking operation part of the licensure examination, in which using oral description instead of actual operation; and unsoundly implemented assessment and training, and so on.4. There were differences in the views of different personnel on the law of medical practitioners. Discussion1. Analyze the faults of Law of Medical Practitioners using legislation theory: although the Law of Medical Practitioners has embodied the idea of balance, there are still some shortcomings, such as the main idea of the law is to guarantee the rights of government departments, supplemented by the right and benefit of administrated subjects; the Law of Medical Practitioners and its supporting regulations lack protection of the legitimate rights and interests of physicians.2. No legislation item about the status and function of the Medical Practitioners Association: In the law, there is no item about the status and function of the Medical Practitioners Association, and it does not compulsively require physicians join, while lawyers and accountant must join their associations required by law; the innovation of government department is the motivity to implement industry self-management, and if health administration departments involved in too many daily management, it is not benefit for them to conduct macro-control. And in foreign countries, physician management mainly relies on industry self-management.3. Legislation does not adequately protect the rights of physicians: medical disputes impair the right of physicians and patients; no clear claim about the patients'right of being informed-and-consent and inadequate protection of the rights of physicians results in medical disputes.4. The legislations on registration locations change and remote registration requires improvement: the procedure of changing registration of the place is complex, increases the cost and is not conducive to healthy flows of medical human resources; reducing the approval items by administrative department and simplifying the procedures to improve the administrative efficiency is an inevitable trend of reform.5. The regulation on the qualification of medical practitioners'examination is inconsistent with other policies: in the aspect of legislation on education qualification of medical practitioners'examination, there is inconsistence between and within departments; and the time difference between the graduate and practice causing inconvenience for medical students.6. There are some problems in the execution of medical practitioner examination: when taking operation part of the licensure examination, oral description is adopted instead of actual operation, and the exam is quite impacted by the invigilators'subjective factors; a fixed proportion of pass in result of dynamic score line leads to unqualified people entering ranks of doctors on one hand and would also lead to the qualified can not join the party of medical practitioners on the other hand.7. The regulation on training and assessment of medical practitioners are with little maneuverability;8. Under the uniform standards of doctors management, medical practitioners (or medical assistant practitioners) are in shortage in rural area: according to the Law of Medical Practitioners and its supporting regulations, those who provide treatment, prevention and health care services in China's rural health institutions must obtain licenses of Medical Practitioner (or Medical Assistant Practitioner), to improve the quality of rural doctors; however, once the doctors in rural township hospital get the license, they migrant to urban areas.Suggestions1. Add some items about improving the status of Medical Practionners Assciation and its function in the Law of Medical Pracitioners;2. Perfect the related items about patients'rights to be informed-and-consent and definition of injury classes to medical staff to guarantee the right of doctors;3. Graduatelly cancel the rehibition of registration place to improve the sharing of medical resource;4. Adjusting the qualification of medical practitioners'examination;5. Rationalize the implementation of medical practitioners'examination and make it objective;6. Standardize physician training procedures and make strict assessment to physicians;7. Education programs and compulsive strategies combines to ease or solve the problem of health human resource shortage in rural area;8. Strenghten the propagandization of the law and the education to some related person.