The Research On Physician Multi-sited Practice In Guangdong Province Based On The Stakeholder Theory

ObjectiveThe physician multi-sited practice policy has been implemented in Guangdong from the beginning of 2010.It has impacted the development of health care in Guangdong Province and the various stakeholders in the six years.To understand the current situation of the physician multi-sited practice in our province by the policy-oriented analysis of the New Medical reform in China,and investigation of the stakeholders'interests and behavior,which involved in the physician multi-sited practice policy.To study the macroeconomic factors of the physician multi-sited practice policy which include politcal,economic,social and technical aspects,as well as the microscopic factors of the physician multi-sited practice policy which include the government,large public hospitals,primary health care institutions,private medical institutions,practicing physicians and patients.To find out the advantages and disadvantages of policy implementation and market mechanism.And then to explore the hidden factors of institutional mechanisms after the liberation of the policy.In order to provide a decision-making reference to reduce the resistance and some direction of the stakeholders development.Methods1.Use of literature induction and public policy analysis.To summarizes the current situation and existing problems of the physician multi-sited practice in domestic and foreign.And analyze and summarize the characteristics and experience of practice mode of physicians in different countries and regions.On the basis of this,the author analyzes the policies of Guangdong Province from 2010 to 2016,and conclude the bright spot of physician multi-sited practice policy in Guangdong.2?Use of questionnaires,in-depth interviews,second-hand data analysis and statistical methods.To investigate the understanding of the current situation of stakeholders,which include large public hospital managers and physicians,primary health care institutions managers or physicians,private medical institutions managers,as well as the majority of patients.3?PEST Analysis and Stakeholder Analysis were used to analyze the macroscopic and microscopic factors that affect the physician multi-sited practice in order to give better advise on the implementation of physician practice.Results1?The policy of physician multi-sited practice in Guangdong is the most advanced in China.The practice of multi-sited practitioners is also more consistent with the idea which are inducing quality medical human resources flow to primary health care institutions and promoting Private medical institutions.2?The understangding of large public hospital managers on the physician multi-sited practice is still inadequate.They are inclusive but not active.Public practitioners in large public hospitals are supportive of policies,but are not satisfied with policy development and implementation.The most positive impact they thought is 'to promote the improvement of physician labor value'.The most negative impact they thought is 'disputes over the allocation of medical risk liability'.Primary health care institutions believe that physician practice is still subject to the flexibility of physician labor constraints.Private medical institutions actively through the practice of doctors to introduce more talent,improve the management mechanism and rapid development.The patient currently judgment of choosing the physician is based on the medical institution level and the physician title.ConclusionThe macro environment in Guangdong for the physician multi-sited practice is positive.The policy is supporting.Health services demand is in the growth phase.The development of information technology has brought the convenience of telemedicine and cooperative medical care.But the medical income structure is still unreasonable and needs to be improved.The impact of the micro-interests on the physician multi-sited practice are different.Some recommendations are given to the physician multi-sited practice:attention to the effect of economic incentives on physician behavior,reforming the management system of public hospitals,encouraging and Supporting the multi-sites practice by the physician team,implementing the medical liability insurance system,improving the physician industry management and supervision,implementing the third party inspection,increasing the government's investment in medical personnel training,and building physician personal brand.