国家控制与医生临床自主性的滥用:对公立医院医生执业行为的分析

Abstract

Abstract:

Medical doctors enjoy a high degree of professional autonomy because of their highly specialized knowledge and skills that cannot be easily scrutinized by untrained outsiders. Thus,the question of effective social supervision of medical profession remains an important issue in sociology of occupations. This study compiles government statistics,existing literature as well as fieldwork data from Beijing public hospitals to provide an analysis of the working conditions and clinic practices of medical doctors in urban China. The study finds that Chinese medical professionals are dependent on public hospitals,the dominant healthcare delivery system in China. They have no corporate autonomy enabling them to negotiate with the state over working conditions,service compensations and salary. This resulted in a distorted market value of medical professionals. However,the monopoly of public health system places hospitals and physicians in a position of control over both patients and pharmaceutical companies,making possible for doctors to turn their prescription privilege into means for personal economic gains. "Red Envelops",kickbacks and over-prescriptions become standard compensations for doctors' state regulated relatively modest salaries. This abuse of clinical autonomy by medical professionals has been pervasive and persistent in China,a clear indication of not just the failure of the state supervision and regulation but also the failure of self-monitoring professionalism. The study suggests that reforms in ending the monopoly of public healthcare system,encouraging medical professionals' participation in policy decision making process,and allowing for private practice are some of the necessary steps to deal with the problem.

Key words: clinical autonomy, corporate autonomy, social control, the State, the medical profession

YAO Zelin. State Control and Doctors' Abuse of Clinical Autonomy: An Empirical Analysis of Doctors' Clinical Practice in Chinese Public Hospitals[J]. Chinese Journal of Sociology, 2017, 37(2): 166-192.

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State Control and Doctors' Abuse of Clinical Autonomy: An Empirical Analysis of Doctors' Clinical Practice in Chinese Public Hospitals

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