RESUMO
ObjectiveThis paper analyzed the punishment situation of unlicensed medical practice in recent 7 years in Jinshan District of Shanghai, then suggested the countermeasures to prevent and combat unlicensed medical practice in the future. MethodsA total of 190 cases of unlicensed medical practice from 2016 to 2022 were investigated. The basic situation of the punishment,legal basis,subject distribution,clue source and individual characteristics were analyzed. ResultsThe case-filing number of unlicensed medical practice showed a decreasing trend,but the amount of fines increased obviously. The clues of investigation and punishment of unlicensed medicine practice were mainly found by inspection(32.11%) and transferred from other departments(28.42%), while the number of complaints and clues reported from grassroots increased year by year. Medical and dental were the two major unlicensed practice,accounting for 35.79% and 33.16%, respectively. In addition, unlicensed medical cosmetology practice was increasing year by year. 78.62% of the unlicensed medical practioners are immigrants, 62.76% of them aged between 31 and 50 years old, among them 70.34% are men, and 62.76% of them have a fixed place. ConclusionThough the prevention and crack-down on unlicensed medical practice has achieved significant achievements,it is still necessary to enhance the responsibility of local administration,strengthen the inspection,investigate and deal with cases jointly by multiple departments,and implement the comprehensive supervision mechanism of the health care industry.
RESUMO
The medical system is turning into a general health care system recently. The change in the system increases the cooperation between the physicians and the non-physicians in reality. So it is inappropriate to punish every cooperative work between the two for unlicensed medical practice control program anymore. In order to readjust the control over the unlicensed medical practice, critically dismantling and reconstructing the concept of medical treatment must be done. The three elements of the concept of medical treatment can be constructed socially in relation to disease. When this is done under social subsystems, the ideological functions of disease and medical treatment concepts can be explained. There are three aspects to the current unlicensed medical practice control program. There is a large gap between the legal judgment and the medical rationality. Moreover, the government unnecessarily has a full control over all dimensions of the medical treatment concept, and the license system only emphasizes the status, not the essence of the medical treatment itself. The dermatologists and cosmeticians' work must be divided but done cooperatively. A way to legislate this is to draw the cosmeticians into the area of medical skin treatment. Rather than solving the problem by giving cosmeticians another status, it is important for them to cooperate functionally with the dermatologists. The government should control the `cooperative division of work' between the two indirectly, so that the civil society can function on its own disciplinary mechanism.