Research On The Professional Identity Of Rural Doctors From The Perspective Of New Institutionalism

As the supplier of primary medical and health resources in my country,rural doctors are of great significance.In 2009,the issuance of the "Opinions of the Central Committee of the Communist Party of China and the State Council on Deepening the Reform of the Medical and Health System" marked the beginning of a new round of medical reform in my country.In the context of the country’s promotion of the equalization of basic public services and the continuous downward shift in the focus of governance,the role of rural doctors has become increasingly prominent.However,as the country has increased its inclination towards primary medical resources,the professional identity of rural doctors has been declining.By combing policies and literature,this paper selects the M Township Health Center and 19 village clinics in Heilongjiang Province as the research objects,conducts interviews with the employees,village doctors and villagers of the M Township Health Center in Heilongjiang Province,and finds out the results.Guided by the relevant theories of neo-institutionalism,this paper summarizes the reasons for the continuous decline of rural doctors’ professional identity,and puts forward countermeasures to improve rural doctors’ professional identity on this basis.The study concluded that the professional identity of rural doctors is affected by both individual cognition and social identity.Starting from the logic of social recognition,on the one hand,rural doctors are based on the cognition of the role of village sages.They have to bear the responsibility of treating villagers and patients,which is expressed as "natural legitimacy".On the other hand,they must accept the leadership of their superiors and complete the assigned task indicators are expressed as "system legitimacy".The contradiction of the legitimacy mechanism has led to the continuous decline of rural doctors’ professional identity.Specifically: First,the state has continuously improved the professional level of the primary medical and health system and the conflict between the social identity of rural doctors.The improvement of the professional level has limited rural doctors.The number and scale of the team of doctors make their work separated from medical consultations,unable to meet the social expectations of the profession,and the sense of professional identity declines;the second is the conflict between incentive tools and service goals,and the failure of incentive tools is manifested in performance appraisal.Formalization,lack of fairness in salary design,and ambiguity of career orientation make rural doctors doubt the value of their work and become burnout at work.The quality of primary medical service supply and rural doctors’ professional identity decline with the misplacement of incentive tools.This paper believes that the ways to enhance the professional identity of rural doctors are as follows: First,cooperate with rural doctors to participate in the formulation of medical and health policies,so that the goals of rural doctors are synchronized with the policy goals.The second is to introduce a market mechanism,so that rural doctors have enough material incentives to return to diagnosis and treatment services.The third is to establish a professional remuneration system to ensure that work input and work income match.The fourth is to formulate practice thresholds in a gradient manner to deal with the current situation of uneven distribution of urban and rural medical resources.Fifth,improve the performance appraisal mechanism to ensure the fairness of the distribution procedures and distribution.