Liu Jian: How to Deal with the "Separation Times of Post Medicine"

As a comprehensive pilot for the reform of Beijing's public hospitals, Beijing Friendship Hospital has taken the lead this year. After a series of combined actions such as the abolition of drug additions, the increase in medical service fees, and the reform of the implementation of payment methods, the friendship hospitals that once focused on the "magic spotlight" have recently appeared calm.

However, in the eyes of Liu Jian, chairman of the friendship hospital, this calm is rare. “This will allow us to do things more practically.” In his opinion, with the advancement of public hospital reforms, the reform of the Friendship Hospital has also gradually entered a deep-water zone, and the hospital's operation is also facing some new problems.

In this regard, Liu Jian proposed that the hospital began to enter the "era of post-medicine separation."

“Separation of post-medicine is the problem facing the medical field after medical separation, including the division of labor in the tertiary hospitals and primary and secondary hospitals, and between the communities in the medical market, and the grey income of doctors.” Recently, Liu Jian accepted During an exclusive interview with reporters, he said that the next step in the reform of friendship hospitals will gradually touch the interests of doctors.

Liu Jian believes that there should be no interest relationship between hospitals and medicines, doctors and medicines. From the point of view of the professional nature of doctors, doctors are not allowed to count the interests of patients while they are in the hospital. This will only make the social conflicts more and more intensified.

Let "medicine" and "medicine" really be separated Reporter: After the elimination of drug addition, is medicine and medicine really separated?

Liu Jian: Separate medicine does not stop at eliminating drug additions. Drugs are a kind of commodities, and they need costs in market circulation. This is a market law that no one can violate.

Friendship Hospital revolves around the pharmacy department's manpower, warehouses, and management, adding up to a monthly cost of about 2 million yuan. Regardless of whether the medicine is separated, the cost is there. Dividing medicine is not only a simple matter of eliminating drug additions, but if it does, it will already be all good.

Reporter: You put forward the concept of "The era of separation of post-medicine". How do you understand it?

Liu Jian: "Separation of post-medicine" mainly refers to some new problems faced by the medical field after separation, including the division of labor among the tertiary hospitals and primary and secondary hospitals and community hospitals in the medical market, how the pharmacy costs are transferred, and the gray of doctors. Income and so on.

After the drug zero-rate difference was implemented, the chain of the entire drug sales process was disconnected in hospitals, but it had not actually been disconnected in other areas. For example, the problem of high drug prices and high value of high-value consumables has not yet been resolved. In my opinion, apart from medicine, it is necessary to include “medical” separately from equipment and consumables. These are the “eras of post-medicine separation” and should continue to be done.

Reporter: After medicine is separated, medicine circulation, storage management, etc. have also become hospital costs. How can this part of the cost be resolved?

Liu Jian: Before the patient takes the drug to the hand, let the drug company go to control. The circulation cost of these drugs should not be borne by the hospital, and the cost of the hospital will not be counted until the patient takes the drug.

Reporter: Does the corresponding drug procurement method also need to be changed?

Liu Jian: According to the original channel, the medical division did not bring much change to drug purchase. However, I think that the “era of post-medicine separation” needs to be solved slowly.

Make Time for Level 3 Hospitals Reporter: Has the division of labor between tertiary hospitals and primary hospitals improved?

Liu Jian: Now that the patients have flocked to large hospitals, the communities and secondary hospitals are not fully functioning. If the war breaks out, there must be no commando team. In the future, our country must establish a reasonable medical network. Patients should be divided into tertiary hospitals.

In fact, disorderly medical treatment has exacerbated the difficulty of seeing a doctor and expensive medical treatment. The next step of reform should establish a new medical order, order of visits, visits at different levels, reasonable visits, and reasonable choice of hospitals. "The era of separation of post-medicine" is to do this, or else the tertiary hospital will always be an annoyance state now, and there will be no time to develop disciplines.

Reporter: How do you evaluate the current two-way referral system?

Liu Jian: Yes, but now the enthusiasm of the community and secondary hospitals is not high. Because they now "eat imperial grain", work and do not work, the difference is not significant. Moreover, we have their own different sources of finance. Both parties do not have financial jurisdiction or allocation of human resources. At present, this pattern is only cooperating with each other and it will not be a strong and tight pattern for the time being.

Reporter: How can we achieve two-way referral and establish a reasonable order for treatment?

Liu Jian: The establishment of treatment order is a long-term process. For example, the establishment of a medical group, a three-tiered hospital led by a large number of secondary hospitals in community medical centers, to package the health of the local people, this is fundamental. Which diseases belong to you and which diseases go to me? To a certain extent, you will transfer to tertiary hospitals. The treatment is almost reversed. This is called a two-way referral. Now that these have not really been realized, medical resources are still in short supply here. And wasted.