Approval becomes filing, and only two steps are needed: application and certification.
Running a Chinese medicine clinic, the "door" is wide
In a Chinese medicine clinic on Zhongshan Avenue in Wuhan, there are more than 50 old Chinese medicine practitioners, most of whom are retired experts from major hospitals. The picture shows an old Chinese doctor feeling his pulse.Photo by ZhangChang
This year "Government work reportPut forward "supporting the inheritance and development of Chinese medicine". According to the provisions of the Chinese Medicine Law, the opening of Chinese medicine clinics has been changed from licensing to filing, and folk Chinese medicine practitioners can obtain certificates after examination, which is a major benefit for the Chinese medicine community. With the promulgation of supporting laws and regulations, such as the Interim Measures for the Administration of Filing in Chinese Medicine Clinics and the Interim Measures for the Administration of the Examination and Registration of Physicians with Expertise in Chinese Medicine, the development of Chinese medicine has ushered in a new spring. Starting from today, we will launch a special report on "How to implement a good policy of Chinese medicine", hoping to attract more people’s attention.
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Run the permit at most once.
Simplify the procedures, reduce the links and time limit, and provide convenience for the applicant.
"I didn’t expect to get the certificate so soon!" Recently, Jiang Fuguo, Jianggan District, Hangzhou City, Zhejiang Province, obtained the first Chinese medicine clinic registration certificate issued by the District Health and Welfare Bureau.
Jiang Fuguo was originally the legal representative of a chain pharmacy in Hangzhou, with more than 20 years’ experience in drug management. He found it difficult for pharmacies to meet the needs of ordinary people, so he wanted to open a Chinese medicine clinic. However, to apply for a medical institution’s practice license, it needs to go through seven steps, such as application, publicity, establishment approval, environmental protection, fire protection, acceptance and certification. The process is complex, time-consuming and the threshold is high, which is prohibitive.
On December 1, last year, the Interim Measures for the Record Management of Chinese Medicine Clinics was formally implemented. Jiang Fuguo went to learn about the materials and procedures that need to be submitted for filing in Chinese medicine clinics. After he handed in all the materials at one time, he filled in the "Information Form for the Record of Chinese Medicine Clinic", and the environmental protection and fire protection met the requirements. The personnel had the qualification certificate of Chinese medicine doctors and worked for 3 years, and the materials were complete and met the record requirements. The window accepted it on the spot and passed the record review. On the same day, he received the record certificate of Chinese medicine clinic, and he could carry out his practice activities. Jiang Fuguo said that the Chinese medicine clinic has changed from the examination and approval system to the filing system. Now, it only needs two links: application and certification, and the certificate can be run at most once. In the past, it took three months or even six months to get a certificate.
"In the past, there were strict regulations for opening a clinic, and the venue must be fixed for a long time. If it is not the property owned by the applicant, it needs to have a lease agreement for more than 5 years. Regardless of whether or not the clinic can be opened, you must first invest in renting the venue. It takes more than half a year to review the location and venue of the clinic alone. If the approval of the clinic is delayed for one more day, the rent will be paid for one more day, and a lot of money will be spent on Shui Piao. The filing system makes Chinese medicine clinics no longer spend money. " Jia Haizhong, chairman of Beijing Cifang Hospital Management Company, said.
Chinese medicine sits in the classroom, listening and asking questions, unlike western medicine, which needs to be equipped with corresponding instruments and equipment. The Law of Traditional Chinese Medicine has reformed and improved the management system stipulated in the Regulations on the Management of Medical Institutions, which is conducive to Chinese medicine practitioners to open distinctive Chinese medicine clinics according to their own expertise and advantages, to stimulate the enthusiasm of social forces to run medical services, and to enrich and improve the medical service system.
"The change from examination and approval to filing simplifies the procedures, reduces the work links, compresses the time limit and provides convenience for applicants." Zhang Jianfeng, deputy director of Henan Provincial Administration of Traditional Chinese Medicine, said that filing management is a special legal arrangement for clinics that only provide traditional Chinese medicine diagnosis and treatment services, which is obviously different from examination and approval management.
Jia Haizhong believes that in the past, the most irritating thing about setting up a Chinese medicine clinic was not the complicated process, but that all other conditions met the requirements, but it was eventually rejected because of the high density of surrounding medical institutions. In fact, people look for people with real medical skills when they see Chinese medicine. Even if Chinese medicine clinics are one by one, it will not affect the choice of ordinary people.
Yu Haiyang, director of the Policy and Regulation Department of state administration of traditional chinese medicine, said that the original examination and approval of Chinese medicine clinics was mainly pre-examination, which examined whether it met the conditions of local regional health planning and medical institution setting planning. The Interim Measures for the Record Management of Chinese Medicine Clinics does not restrict the layout of Chinese medicine clinics and Chinese medicine clinics that only provide traditional Chinese medicine services, and cancels the specific number and location restrictions. According to incomplete statistics, as of January this year, 21 provinces across the country have registered 129 Chinese medicine clinics.
Chen Luojia, president of China Folk Chinese Medicine Research and Development Association, believes that the filing system of Chinese medicine clinics can effectively solve the problem of "seeking medical treatment nearby" for people at the grassroots level or in areas lacking medical resources, and better meet the multi-level and diversified Chinese medicine needs of the masses.
Full liberalization is a misunderstanding
The implementation of filing management in Chinese medicine clinics is not to lower the threshold for opening. For services with uncontrollable medical safety hazards and risks, Chinese medicine clinics may not carry out them.
Zhao Xiaohui, a traditional Chinese medicine practitioner in Hongqi District, Xinxiang City, Henan Province, is a clinician specializing in traditional Chinese medicine. She has been employed by a medical institution for more than 4 years, focusing on traditional Chinese medicine diagnosis and treatment. She has always had a wish to open a clinic.
After the implementation of the Interim Measures for the Administration of the Filing of Chinese Medicine Clinics, Zhao Xiaohui passed the filing examination and got her own Chinese medicine clinic filing certificate, and became the organizer of a Chinese medicine clinic. She received the first "Chinese medicine clinic registration certificate" in Henan Province.
Zhao Xiaohui didn’t know that she could get the registration certificate of Chinese medicine clinic, which originated from the adjustment of the qualification period of Chinese medicine practitioners. The former National Health Planning Commission and state administration of traditional chinese medicine have adjusted the practice period from five years to three years in the pilot projects to encourage the society to run Chinese medicine in 40 cities and Gansu Province.
The filing system relaxes the market access threshold, which is beneficial for professionals to jump out of the system and also gives a "green light" for folk Chinese medicine practice. The Interim Measures for the Administration of Registration of Qualification Examination of Physicians with Expertise in Chinese Medicine stipulates that those who have obtained the Practitioner’s Certificate of Chinese Medicine (Expertise) can engage in Chinese medicine medical activities in the form of personal practice or in medical institutions within the registered scope of practice. By then, a large number of folk Chinese medicine practitioners will be able to obtain the Qualification Certificate of Chinese Medicine (Specialty), thus having the qualification to practice medicine and run clinics.
The person in charge of state administration of traditional chinese medicine said that the implementation of filing management in Chinese medicine clinics does not mean full liberalization. According to the principle of "no entry is forbidden", all fields that are not explicitly forbidden by laws and regulations should be open to social forces. At present, the Chinese medicine clinics that have been put on record refer to clinics in pharmacy service that use Chinese medicine and non-drug therapies such as acupuncture, cupping and massage, as well as Chinese medicine dispensing, decoction and other Chinese medicines.
The person in charge pointed out that Chinese medicine clinics should not provide western medicine services, nor should they provide services with uncontrollable medical safety hazards and risks, such as minimally invasive techniques of Chinese medicine, Chinese medicine injection and acupoint injection.
"The implementation of filing system management in Chinese medicine clinics is not to lower the threshold for opening." Yu Haiyang said that state administration of traditional chinese medicine formulated the Interim Measures for the Administration of the Filing of Chinese Medicine Clinics, the Basic Standards of Chinese Medicine Clinics and the Basic Standards of Chinese Medicine (Comprehensive) Clinics, standardized the filing of Chinese medicine clinics from the institutional level, and clarified the conditions, procedures and standards needed for the filing of Chinese medicine clinics. The establishment of the filing system of Chinese medicine clinics not only has a practical basis in advance, but also has social needs. The state has improved the filing system of clinics to ensure the development of Chinese medicine, especially Chinese medicine clinics, to be more standardized and healthy.
Post-event supervision needs to be strengthened.
Filing management is a kind of management means, the essence of which is to simplify prior management and improve work efficiency, rather than to relax supervision.
According to the white paper "Traditional Chinese Medicine in China", by the end of 2015, there were 452,000 practicing (assistant) doctors in traditional Chinese medicine (including ethnic doctors and doctors of integrated traditional Chinese and western medicine). There are 42,528 outpatient departments and clinics of traditional Chinese medicine, including 550 outpatient departments and clinics of ethnic medicine and 7,706 outpatient departments and clinics of integrated traditional Chinese and western medicine.
The current basic standards of Chinese medicine clinics stipulate that the treatment rate of Chinese medicine is not less than 85%, and a considerable number of Chinese medicine clinics provide both Chinese and western medicine services. Many people ask, Chinese medicine clinics used to implement the licensing system, but now they implement the filing system. One is to provide Chinese and western medicine services, and the other is to provide pure Chinese medicine services. How can the two systems be effectively connected?
Yu Haiyang introduced that the Interim Measures for the Record Management of Chinese Medicine Clinics stipulates that Chinese medicine clinics can only provide Chinese medicine services, and two types of Chinese medicine clinics with different standards implement independent selection of classified management. First, Chinese medicine clinics that have been set up before the implementation of the Measures to provide both Chinese and Western medicine services can choose their own management methods according to their own actual conditions after the promulgation and implementation of the Measures. Only the traditional Chinese medicine services provided in these Measures can be managed according to the requirements of the Regulations on the Administration of Medical Institutions before the expiration of the practice license of medical institutions, or they can be managed according to the filing requirements. After the original practice license of medical institutions is cancelled, they can be filed according to the provisions of the Measures. Second, Chinese medicine clinics whose services do not meet the service scope stipulated in the Measures or have uncontrollable medical safety hazards and risks are still subject to examination and approval management in accordance with the requirements of the Regulations on the Administration of Medical Institutions. The Chinese medicine clinics subject to examination and approval management are renamed as Chinese medicine (comprehensive) clinics, and their settings should conform to the Basic Standards for Chinese Medicine (comprehensive) clinics issued by the former State Health Planning Commission and state administration of traditional chinese medicine.
Chinese medicine clinics have changed from examination and approval to filing, and the first problem is how to strengthen post-event supervision. According to the "Measures", the competent department of traditional Chinese medicine needs to conduct on-site examination and conduct on-site inspections on the registered Chinese medicine clinics within 30 days from the date of filing. In view of the unreasonable charges, false propaganda, unauthorized practice and out-of-scope operation of Chinese medicine clinics, it is required to stop practicing activities, withdraw the Registration Certificate of Chinese Medicine Clinics and impose fines. In addition, Chinese medicine clinics are not allowed to sell, transfer or lease registration certificates.
"From the document requirements, it is to cut off the administrative licensing link; As far as the clinic is concerned, there is no relaxation of requirements. The core issue in the future is to strengthen supervision, especially to avoid medical accidents. " Lin Ruichao, dean of the School of Chinese Medicine, Beijing University of Chinese Medicine, said.
"Filing management is a management tool, the essence of which is to simplify prior management and improve work efficiency, rather than to relax supervision." Zhang Jianfeng said that at present, the number of Chinese medicine clinics registered for practice is still relatively small, and the pressure on county-level health (Chinese medicine) administrative departments that directly manage the registration of clinics is not obvious. With the continuous increase in the number of registered Chinese medicine clinics and the increasingly frequent practice activities, it will be an important task for county-level health (Chinese medicine) administrative departments to change the supervision mode and improve the supervision ability. The contradiction between insufficient supervision personnel, insufficient supervision ability and heavy supervision tasks will also emerge, which needs to be solved by expanding the supervision team, increasing supervision power and changing supervision methods.
Shen Lin, deputy director of the Health Planning Commission of Hongqi District, Xinxiang City, introduced that the district health supervision and Chinese medicine management departments conducted on-site approval, supervision and inspection in a timely manner to ensure the standardization of clinics, ensure the health rights and interests of the people, and ensure that Chinese medicine clinics are filed quickly and well managed, with more thorough decentralization, more effective supervision and better service to create a good environment for the convenience and benefit of the people.
Chen Luojia believes that after the filing system is implemented in Chinese medicine clinics, government departments need to improve medical quality control and strengthen the three-dimensional supervision system to ensure medical quality and treatment safety. (Reporter Wang Junping)