Investigation And Research On Social Security Of Rural Doctors Based On "Professionalization"

The problems of agriculture,rural areas and farmers are the fundamental problems of the country,which directly affect the foundation stability of the country and the sustainable development of the society.Village clinics are the first-class institutions at the end of medical services in China.The "village doctors" who practice in village clinics are the medical workers closest to the masses of farmers.They undertake the heavy basic public health service projects and basic medical security tasks in rural areas.There are many factors that affect the career choice and team stability of rural doctors.The external factors include the acceleration of urbanization,the increase of rural residents' access to the city for medical treatment,the low occupational income,the inadequate social security,and the low social identity and social status of the occupation.The internal factors include the high turnover intention of rural doctors and the low entry intention of medical students.According to the survey,rural doctors are more dissatisfied with their own social security problems than with their incomes.It is found that the professional will of rural doctors is positively related to social security,while the degree of "professionalization" of rural doctors is closely related to social security."Village doctor" is a kind of occupation on the surface,but in fact,it has not realized "professionalization".The survey found that nearly 90% of rural doctors participated in the basic endowment insurance for urban and rural residents or did not participate in any form of endowment insurance;95% of rural doctors participated in the basic medical insurance for urban and rural residents;due to the constraints of the status of farmers,lack of unit support,almost no rural doctors can participate in work-related injury,unemployment and birth insurance.Most of the country's retired rural doctors can only receive a subsidy of 300 yuan per month.It can be seen that the existing system design still classifies them into the farmers' groups.They mainly enjoy the social security of farmers,rather than the social security of doctors or workers.,this is different from the current social security and social insurance design.Similarly,the occupational risks of urban doctors are shared by the units behind and the perfect social insurance design,while rural doctors have to face the risks alone.The survey found that in order to solve the problem that the social security level of rural doctors does not match the importance of their work,some regions have begun to explore solutions,including Jiangsu Province,Guangdong Province,Gansu Province,Guizhou Province and Wuhan city.These areas combined with the actual situation of the region,made some useful experience in solving the social security problems of rural doctors,but at the national level,there is still a lack of top-level design and response to this problem,which makes the problem still not be properly solved in most parts of the country.It is believed that the main reason for the social security problem of rural doctors is their "identity" defect.To solve this problem,it is necessary to complete the professionalization of rural doctors.At the national level,we need to take the courage to solve the problem of rural teachers,improve the top-level design,and solve the problem in a unified way.First of all,it is necessary to solve the problem of rural doctors' identity positioning with the construction of "professionalization";Secondly,we should make clear the employment units of rural doctors,establish labor relations,and solve the "defects" of their insured subjects;Third,we should give priority to policies and promote the extension of commercial medical liability insurance to rural doctors;Finally,to solve the social security problems of rural doctors in different categories,we should implement "plan guarantee" for rural doctors who undertake basic public health service projects,and promote the free practicing rural doctors to the market as freelancers.