Under the impulse of the Internet to transform everything, the Internet's investment in medical care is also increasing. For medical investment, Internet companies that adhere to the platform's thinking still hope that they will become a platform that can connect people and devices together, thus promoting various medical resources to open on the platform, and ultimately providing accessible services for ordinary users. However, good wishes are hard to turn into operational business models, and Internet companies will eventually lose their medical resources, especially doctor resources.
In the context of grading diagnosis and treatment, doctors at all levels, especially those at the grassroots level, do have the need to communicate with upper-level doctors to improve their business capabilities and expand the market. This also brings opportunities for companies that use the platform to cut into the Internet. If more and more doctors join the business discussion and cooperation platform, the value of this platform is very large, and it can really effectively mobilize medical resources. Serve patients.
However, the particularity and complexity of Chinese doctor resources have determined that such business model expansion cannot be met at least in the short to medium term.
First, the income model of Chinese doctors determines that the synergy between groups cannot form a strong relationship. The characteristics of China's medical system are medicines, and the doctor's core income is not on the clinic. Therefore, even if the cooperation can be reached in the consultation, it is impossible to transfer the income of the medicine. If you want to work together, you must pass the drug rebate that the doctor may get to the other party completely, and this gray area cannot be discussed and divided. If surgery or other relatively high-income services are required, synergy between different levels can be produced, but such collaboration is more about strengthening the existing division of labor. Basic medical doctors cannot carry out various complicated operations. However, now the graded diagnosis and treatment hopes to return the post-operative rehabilitation to basic medical care. However, considering that the benefits of drugs and inspections are still not transferable, doctors in large hospitals are extremely reluctant to sell this part of the consultation and the resulting product benefits, which seriously hinders the collaboration between the layers.
Second, the medical payment system cannot guide collaboration between doctors. In the highly market-oriented US medical service system, before the medical reform was officially implemented in 2013, the synergy between American doctors was not as good as imagined. However, the division of labor in the United States was relatively clear, and doctors did not rely on products to obtain income. Everyone can do their job. However, doctors did not develop into a patient-centered collaboration model or a doctor-centered operation. However, the US medical reform through the payment side to guide the cooperation between doctors, the assessment of the rate of visits and readmission rate has greatly promoted the cooperation between the various levels of medical institutions, especially in 2015 launched a slow disease management The CPT code makes it clear that doctors must work together to get the corresponding compensation.
In China, there is no such guidance from the payer. Moreover, the payer is very weak in China and cannot intervene and control the service party at all. At present, the core of the grading diagnosis and treatment through policy guidance is the division of labor rather than collaboration. As analyzed above, the mechanism of interest distribution among doctors severely constrains the possibility of collaboration, which leads to the current form of administrative-driven cooperation. The first step in grading diagnosis and treatment is to reduce the number of major hospitals in the fight against common diseases, rather than promoting collaboration among doctors. However, because the ability of the primary doctors is weak, it requires continuous training from superior hospitals, and this is not synergistic. Therefore, the collaboration between Chinese doctors still needs to first clearly define the division of labor before they can talk about the next step. If the division of labor can't be done, the needs of the grassroots patients are very weak, and it is impossible to talk about collaboration. However, the guidance of Chinese payers is also very important. At present, according to the proportion of reimbursement to promote patients to the grassroots level is one of the effective ways to promote the division of labor, but if we want to promote collaboration between doctors, it is difficult to carry out the payment measures of similar value medical care, and this is not a payment. The current focus of the party is also difficult to promote the synergy of doctors.
Again, the technical constraints are also very obvious. China still has a large number of primary medical institutions lacking electronic medical records, which directly restricts the synergy between doctors. But this is not the core issue. The separation of data between medical institutions is the biggest constraint on the cooperation between doctors. In the absence of valuable medical data, any so-called doctor cooperation is difficult to produce actual value and effect. The challenge of data access is resolved in the United States through legislation, and China has no relevant legislation to force medical institutions to open. Therefore, before the problem of data silos has not been resolved, the cooperation between doctors is still difficult to really develop, and more is still in the shallow level of training and business exchange, and it is impossible to cooperate in depth.
In addition, even if doctors do not rely on product income in the future, it is still a big difficulty to set clear standards for the distribution of benefits between medical institutions and doctors. This also restricts the large-scale development of doctor cooperation.
Finally, the management system of medical services has hampered the cooperation of doctors. The existing public medical institutions are public institutions, enjoying the certain benefits brought about by the preparation, but they are also greatly restricted by the establishment. Due to the clear administrative affiliation between various institutions, this hinders the development of their cooperation. Moreover, the doctor's title and income are mainly from the evaluation of medical institutions. If the willingness to cooperate among medical institutions is weak, even if doctors have the enthusiasm to collaborate with other doctors, they must first meet the preconditions that can meet their own development in medical institutions. All of this effectively constrains the connection between doctors and ultimately restricts the development of a business model that hopes to provide collaboration for doctors through the Internet platform.
Therefore, the doctors' collaboration promoted by the Internet platform can't really push forward. In the end, it is only possible to enlarge some of the star doctors, form a situation of strong and strong, and further increase the supply of medical resources, rather than weaken the unevenness of medical resources. The goal of graded diagnosis and treatment is contrary.
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