Research Of The Problems And Countermeasures For The Conversion Of Rural Doctors And Clinical Doctors In Township Hospital To Licensed (Assistant) Doctors

ObjectiveThe aim of the paper was to study the current situation of the clinical doctors inthe township hospital and rural doctors in a systematic way with the focal points,toput forward the relevant policy recommendations based on the quantitative andqualitative analysis according to the national law,regulations and the relevantpolicies,and to provide the evidence for the policymaking on the transition fromrural doctors and clinical doctors in the township hospital to licensed (assistant)doctor.MethodsThe main methods concluded the quantitative analysis as well as the qualitativeanalysis.(1) Literature research.(2) The field investigation was done with speciallydesigned questionnaires in the six provinces,and the stratified clustering samplingwas applied to select two provinces respectively from the east,the middle and thewest part of China.(3)Focus group discussion was applied to discuss the policy,themain problems and the recommendations on the transition from rural doctors andclinical doctors to licensed (assistant) doctor by the leaders in the different relevantsectors of the government and the experts in the relevant fields.(4) The interview:the relevant leaders in the local health bureau,the head and two doctors of everytownship hospital,the two or a team of doctors in every village clinic were interviewed.(5) The policy analysis method:There were the analyses of the timebackground,the situation and trend of the development,the problems and the sectorpolicies on the transition from rural doctors to the licensed (assistant) doctors.(6)The typical case study.(7) The statistical analysis method:the descriptive study wasapplied to analyze the current basic situation of the rural doctor,the willingness tothe professional license examination,and the examination.Major Results1.The main information of the project counties were as follows.(1) The ruralhealth care net was basically sound because it could basically cover every village.(2)The rural health institutions at the basic level were mainly public owned and 75.37%of the village clinics were public owned.(3) The rural human personnel at the basiclevel was not sufficient.2.The results of field investigation of the doctors in the village clinics andtownship hospitals were as follows.(1) The doctors in the village clinics andtownship hospitals were not very qualified,the rural doctors faced the aging problem.(2) There was a low degree for the rural doctor to own the professional license:therewere 375 rural doctors who owned the professional license,which was only 9.13%of the total doctors in this investigation.(3) There was a low salary level for the ruralhealth personnel at the basic level:the majority of the investigated rural doctors hadthe low income,only 24.97% of whom purchased the aged insurance;theinvestigated clinical doctors in the township hospitals had average salary 984.61Yuan.(4) There was a high degree of willingness for the rural doctor and clinicaldoctors in the township hospitals to attend the professional training and they wishedto have the policy consideration of them.(5) The general reflection of theinvestigated personnel thought that the professional license examination wasnecessary,but the practical situation of the health personnel in the rural basic levelneeded to be taken into the consideration,therefore,the current policy on this aspectneeded to be adjusted in order to achieve the fixed goal in the long run.3.The results of the relevant policy on the transition fiom rural doctor andclinical doctor to licensed (assistant) doctor were found.(1) Although there were thedefinite policy and regulations on the transition from village doctor and clinicaldoctor in the township hospital to professional/assistant doctors with license,yet it'shard for the local health bureau to implement in the all rural areas.(2) The conflict ofthe different relevant policies led to the new problems.Such as the conflict betweenthe policy for the village doctor to receive the two-year college education and thepolicy for taking the professional license examination.(3) There was lack of soundpolicies to guarantee the training expenditure and its remittance.(4) There was lackof the social security policy for the rural doctors,such as the policy for their salaryand the aged insurance,etc.,and this impeded the process of professional licensedevelopment in the rural areas.(5) The local governments explored and made somepolicy to advance the transition from village doctor and clinical doctor to licensed(assistant) doctor according to their own practical situations,and these provided thetheoretical basis and experience support. Major ConclusionsAt present,the rural health personnel at the basic level still faced the embarrasssituation:there was a low quality of rural health personnel as a whole;it was hard forthem to obtain the professional license;there was no aged insurance for them,and itwas not guaranteed for them to have a stable income.The goal was hard to beachieved that the clinical doctors in the township hospital must have the professional/assistant license or higher certification,and other types of health personnel musthave the junior or higher professional license,and the majority of the rural doctormust have the professional/assistant license or higher certification.These were seenin the following aspects.(1) The process of obtaining the professional license wasimpeded by the low quality of the country health personnel in the current situation.(2) The process of having the professional licenses would be a long way with theslow change.(3) The main difficulty for the transition policy to be implemented wasthat the education level of the rural doctor was too low as a whole.(4) The conflictof the relevant policies on this aspect led to the new problems.(5) The contents ofthe professional license examination were not conformed to the practical healthsituation of the rural areas.(6) The stability of the rural health personnel wasaffected by the low income level.(7) There was a necessity to establish the agedinsurance system for the rural doctor.(8) The rural health personnel hoped to obtainthe supportive professional training and hoped that it could be a long-termedmechanism.Policy and SuggestionThere was a necessity to make the policy on the following aspects:1.To make and improve the relevant policy on the professional licenseexamination.2.To make the corresponding policy by the guiding principle of the classificationof rural health personnel.3.To establish a discipline of rural family medicine.4.To establish a long-termed mechanism of improving the quality of rural healthpersonnel.5.To improve the treatment of rural health personnel gradually6.To spread the integration management of township and village healthinstitutions by the employment of doctors by the township hospitals unified with thevillage clinics7.To gradually realize the goal of the transformation of rural doctor to thelicensed (assistant) doctor.Innovation1.It was the first time to do the sampling investigation and study of the ruraldoctors and the clinical doctors in the township hospitals on the professionallicense in the rural areas.2.There were some special conclusions besides providing the basic information for the policymaking of the government,such as:(1) Compared withthe clinical doctor in the township hospital,the village doctor had more activeattitudes towards the professional training and was more willing to bear morehigher expenditure for it.(2) The conflict of the different relevant policy on theprofessional license led to the new problems,etc.