| Objective: In this study, the essay figures out the main issues and influencing factors theclinician may meet in the process of accessing by reserching and evaluating the fairness ofthe clinician`s access system and the awareness level of how much the clinician from thesample area know about the doctor law on the basis of the literature research and the policyresearch. According to the research results, combined with the revelation of the legalsystem and foreign policy experience, the essay gives some suggestions of the inproving ofthe clinician`s accession system and provide a reference for the development of fairness ofthe clinician`s accession system.Methods：On the basis of sociology, science of public management, policy analysis,health statistics and some other theories and methods, through theoretical analysis and fieldinvestigation of the status of implementation of the clinicians access system, the existingproblems as well as influencing factors are analyzed.(1) Documentary Research Method;(2)Field Survey, mainly is the questionnaire survey;(3) Statistical Methods: application to thestatistical analysis method to analyze the distribution of human resources for health, andcorrespondence analysis to understand the awareness level of how much the cliniciansknow about the doctor law and the comment to the fairness of clinician`s system theygive;(4) Comparison Method: through the comparison of domestic and foreign doctorstraining system, to improve the establishment of the clinician`s access system.Results：Results of analyzing the relevant laws and regulations and educationalpolicies:(1) Our clinician’s accession system has formed a relatively complete system.Firstly, the doctor law established the clinician’s accession system. Secondly, a specific setup of doctor’s qualifying examinations provide detailed access standards. Thirdly, the Professional qualification rules to the doctors in rural are a strong complement to theexisting access system.(2) Chinese medical education is divided into school education andgraduated education. The current school medical education is a multi-level structure ofeducation, including the four categories of three-year, five-year, seven-year and eight-year.On the part of graduated education, China now focuses on the implementation of thestandardization of residency training system, which means medical graduates of theBachelor degree or above are eligible to participate. Range of medical education andmedical training the students accepted, and the varying lengths of their study years, whilethe relatively single standard in the doctor’s access, all leading the doctor`s access system toa certain extent unfair.Results of analyzing the State department of health statistics data: The analyzingof the number of medical graduates and practicing (assistant) physicians from2005to2009shows a obvious increasing of the them. But the uneven distribution of the health personnelin the eastern, central and western turns to an extremly unfairness of people in differentplace in enjoying human resources for health.Results of questionnaire survey: The investigation involves5cities and provinces,including Hubei, Guizhou, Henan, Chongqin and Anhui, of which10medicalestablishments were surveyed. Among this medical establishment there are2tertiaryhospitals,3Second class hospitals,2health clinics in towns and townships and3community health service centres. All the respondents are clinicians and the investigationshows:(1) Analyses of how much the clinicians know about the Doctor Law and thecomments on the effects the Law have. Over80%the respondents know very well orcomparatively well about Doctor Law,17%the respondents know a little about it, and only2.5%the respondents know little about it. Which shows a good popularization effect for theimplementation of the Law in more than a decade, most clinicians has a camparativelycomprehensive and clear understanding of it. In addition, about90%of the surveyeddoctors believe that the implementation of the Doctor Law helps to improve theprofessionalism and moral qualities of the clinicians, meanwhile it has obvious effect onpromoting the doctor resources and medical services;(2) comments that clinicians have onthe Access System and the fairness of the doctor distribution. Most doctors believe that the practice access system in China is basically fair. About25percent of respondents believethat China’s Doctor Law need to be improved in terms of designing access. Furthercorrespondence analysis is showed that, doctors’ subjective views and evaluation of thefairness comes mainly from their cognitive degrees and cognitive approachs to the DoctorLaw. In the survey of the distribution of relevant human resources for health, almost all ofthose surveyed believe that China’s current doctor distribution is unfairness, of whichregion unfairness is especially serious;(3) Analysis of the will that to improve thedistribution of doctors. In the conditions on whether doctors would Work at the grassrootslevel,38.95%of which are willing to do some short-time job, which shows a greatpossibility that assisting the poor area may succeed. In the analysis of the primary healthinstitutions, about60%the staff unwilling to continue to work in the grass-roots, whichshows that China needs to take measures to improve the positivism of the floor guys, inorder to stabilize the primary care team. In the analysis of doctors work out of theirhometown, the vast majority of doctors shows their confidence, which shows working atallopatry is expected to become an important way to solve uneven distribution of doctorresources;(4) Analysis of influencing factors on the fairness of access.36%the respondentsattributed unfairness to the serious socio-economic imbalance,35%the respondents believethe cause of the social unfairness due to the broken policies and measures. Which showseconomy and policy reasons are key factors in restricting fairness of the doctors’ access.Conclusions: Analysis of the fairness on existing legal system:(1) different area hasdifferent standards of accessing leads unfair;(2) different period has different standards ofaccessing leads unfair;(3) the different standards of accessing between higher rank law andlower rank law leads to unfair.Analysis of the fairness on education policy:(1) China has a great number ofmedic but comparatively lower educational attainment;(2) The number of doctor increasesrapidly but the regional distribution is unbalanced.Analysis of the research:(1) How much the clinicians understand the DoctorLaw affect their cognition of the access system;(2) The comment on the fairness ofaccessing is not bad, but the training of house stuff still needs to be improved;(3) Thecomment on doctor resource distribution is not well, few doctor are willing to work at basement layers;(4) Multipoint operation promotes the talent flow, and economy hasbecome the main factor leads to unfair.Suggestions:(1) Unified laws and improving the doctor accession standards;(2) Establish the supporting provisions of the Law of Medical Practitioners,and ease the rural health workforce shortage;(3) Reduce the multi-level education system in school education;(4) Specify and standardized the resident`s training system;(5) Incent the rank and file;(6) Promote the multipoint operation of clinicians to improve the talentflow. |
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