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Recently, the Sichuan Provincial Health Commission has made improvements to the performance evaluation of public hospitals throughout the province based on feedback from the first inspection team of the provincial party committee. The National Health Commission has ordered that indicators such as "consumption of hygiene materials costs below 20 yuan and medical examination income accounting for less than 25%" be prohibited from being included in the assessment. The indicator of "the proportion of consumption of hygiene materials and medical inspection income per 100 yuan of medical income (excluding drug income)" will no longer be included in the assessment scope. Drug proportion, 4+7, per capita cost, DRGS payment, new treatment plan not recognized by medical insurance, direct refusal to pay A mountain of medical insurance and various fines are weighing on doctors. To be honest, many doctors who used to be proficient in their familiar clinical fields are gradually feeling that they can no longer seek medical treatment. Because the essence of medicine is human learning, dealing with individuals who are fresh and diverse. The design of medical insurance involves various cold indicators and numbers. Both DRGs and DIP standardize patients. However, the patient's condition is constantly changing, which forces doctors to make a dilemma between cost and benefit. Is this what the doctor wants? No, this is a mandatory medical insurance policy that must be followed! Because of the total prepayment system of medical insurance, the single disease limit of departments, and the proportion of drugs assessed by hospitals, they are like three strings of strings tightly binding doctors! Also, how much should the proportion of drugs be less than, how much should the proportion of consumables be less than, how much should the proportion of antibiotics be less than, how much should the use of drugs exceed the limit, how much should the payment by disease regulations be violated, and how many times should the number of people exceed the limit There are many indicators, and once a doctor exceeds them, they will be punished. Under the framework of various restrictions, it is really difficult to be a doctor who purely treats and saves lives! China has a large population base, and medical treatment bears too much pressure. It is difficult to idealize medical policy in a short time. Take consumables as an example. When drugs and equipment are covered by medical insurance, hospitals will use them less or no longer. Many consumables are not allowed to be charged at all, but the problem is who will do the loss making business? Even if it emits light and heat, we can't lose money, can we. Therefore, there are often absurd incidents where patients go out to buy medicine and transfer to another hospital at their own expense, and even at the end of the year, many doctors dare not accept medical insurance patients. So, how can the clinical level of doctors be utilized and developed? So, doctors may be like swans, gradually losing their ability to fly. Do you know why swans can't fly? In medieval Europe, it was believed that the graceful and luxurious swans were the aristocrats among birds, so they competed to keep them in estates to show off their status. In order to prevent the swan from flying away, three methods were adopted: first, cutting off one wing of the swan to make it lose balance; The second is to bind the wings of the swan, preventing it from spreading its wings; The third is to reduce the water surface area of the pond where swans are kept in captivity, so that they do not have enough acceleration takeoff distance. In contrast, the third method is better than the first two methods because it neither affects the graceful dance of the swan nor allows it to fly away. Therefore, the third method is commonly used to narrow down the range available for the swan to spread its wings. Over time, the swan lost its ability to take off. Nowadays, our healthcare and medical insurance have fewer and fewer opportunities for doctors to freely utilize their skills. Some medicines are not safe to use, some consumables are not safe to use, and some treatments are not safe to try. Money has been saved, but is healthcare really better with less money? What about the patient's medical experience? How about improving the level of doctors? What about the clinical development of medicine? There is a doctor at a community health center who works in an area where the proportion of medication should not exceed 40%. He exceeds the target every month and is fined several thousand yuan. In fact, can you guess how many pills he prescribed per person? 25 yuan! Do you know why? A community health center that does not perform surgery, the cost is basically medication and examination fees. This doctor doesn't want patients to undergo unnecessary tests, so the proportion of natural medicines is high. This is a very conscientious doctor, so it's always himself who suffers the losses! This is also a funny thing, with a hint of black humor. So, this time the Sichuan Provincial Health Commission banned the inclusion of consumables indicators in the assessment, undoubtedly based on clinical practice, to loosen the restrictions for doctors. Worth promoting nationwide. Not only consumables, but also many ropes that bind clinical doctors and restrict them from exerting excessive force should be untied.