Thoughts on improving the multiple-site physician practice from the perspective of institutional change / 中国卫生政策研究

ABSTRACT

As an important policy, the multiple-site physician practice system is expected to promote the flow of physicians and optimize the distribution of health resources, though it is difficult to enforce in practice. From the perspective of institutional change, the fundamental reason lies in path dependence existing in system, organization and mindsetFirst, the government regulation system has a strong inertia to restrict the flow of physicians, and the multiple-site physician practice lacks the unity of legitimacy and rationality. Secondly, fierce competition between hospitals and the distribution pattern of rights and responsibilities between hospital and physician cause the hospitals to oppose multiple-site physician practices. Third, the stability tendency in mind and the desires for profit restrain the flow of physicians. Therefore, the institutional change of the multiple-site physician practice requires improvements in three aspectsthe innovation of government systems to unlock the multiple-site physician practice must be accelerated to realize the unity of legitimacy and rationality;a change is needed in the operation logic of hospitals to control the profit incentives and management of practices by contract;the thought-pattern of physicians must be changed to con-front the proper demand for interests and build innovative incentive mechanisms.