The new version of the Physicians Law comes into effect! Experts interpret these 4 sentences, which have a great impact on doctors

On March 1, the Medical Practitioner Law of the People's Republic of China (hereinafter referred to as the Physician Law) came into effect.

The Physicians Law is a comprehensive and systematic revision of the Law of the People's Republic of China on Practicing Physicians (hereinafter referred to as the Law on Practicing Physicians), which came into force in 1999.

"This is also the first major revision of the Physicians' Law in 23 years." Deng Liqiang, executive director of the China Health Law Society, told the health community that for more than 20 years, the background of medical reform policies, the management system of physicians, and the political, economic, and cultural environment have undergone great changes.

"The revision of the Physicians Law is problem-oriented. Give guidance on the problems that exist in practice." Zheng Xueqian, an expert in the revision of the "Physician Law" of the National People's Congress Education, Science, Culture and Health Committee, and executive vice chairman and secretary general of the Medical Legal System Professional Committee of the Chinese Hospital Association, told the health community that it is also a better experience in reality to the legal level, so that it is more operable and enforceable.

Zheng Xueqian revealed to the health community that "in this process, experts carefully considered all aspects as much as possible".

So, what considerations have been made in the process of revising the Physician Law? With the implementation of the Physicians Law, how will it affect the medical industry?

Improve the political, social status and occupational safety of physicians

"Protecting the legitimate rights and interests of physicians" is the first sentence of the opening chapter of the Physicians Law. This sentence is in the third sentence of the original Practicing Physicians Act.

Zheng Xueqian introduced that the attitude of most experts in the revision is that it is not only necessary to use the phrase "protecting the legitimate rights and interests of doctors" as the opening chapter, but also to add a special chapter to clarify the relevant safeguard measures from the aspects of salary and treatment, team building, commendation and reward, good practice environment and medical order maintenance, occupational safety and health protection, and medical risk sharing mechanism.

"Everyone believes that safeguarding the legitimate rights and interests of physicians, enabling them to practice the lofty goals of the profession, and protecting physicians from being harmed in their practice are also the protection of the rights and interests of the public." She revealed.

Deng Liqiang also believes that the biggest breakthrough point of the "Physician Law" is that it clearly protects the rights and interests of doctors.

"Whether it is to integrate the prevention and handling of medical disputes into the comprehensive management system of social security, or to emphasize the responsibilities of medical institutions and even the news media, including the legalization of Doctors' Day, it is to improve the political treatment, social status and occupational safety treatment of physicians as a whole." He said that this is a clear social norm message transmission, without ambiguity and balance.

In order to better protect the legitimate rights and interests of physicians, the Physicians Law has added a new chapter on "Safeguard Measures", which adds issues related to personnel and salaries. For example, in Article 44, it is pointed out that the state has established and improved a system of personnel, salaries, titles, and rewards that reflect the professional characteristics of physicians and the value of technical labor.

"This is an open legislative expression", Zheng Xueqian introduced, as for what is the personnel, salary, title, and reward system that reflects the professional characteristics of physicians and the value of technical labor, it is necessary for various ministries and commissions and medical institutions to study and then formulate specific regulations. The law writes this sentence to give the medical industry a space to explore and encourage everyone to explore.

Regulate physician behavior, but do not limit normal professional exploration

"The other side of the right is the obligation." The second sentence of the opening chapter of the Physicians Law is "to regulate the practice of physicians". For the relevant content, Zheng Xueqian hopes that doctors will not be resistant: the law is the bottom line that must be observed, and the bottom line is clear before freedom can be discussed.

For the first time, the Physicians Act establishes a "lifetime ban" system at the legal level. Where physicians seriously violate professional ethics or medical ethics, causing a bad social impact, the competent department of health of the people's government at the provincial level or above shall revoke the physician's practice certificate or order the cessation of illegal practice activities, and shall be prohibited from engaging in medical and health services or medical clinical research for 5 years until life.

As for how to regulate the practice behavior of physicians, many people are concerned about the fact that Article 31 points out that physicians must not take advantage of their positions to demand, illegally accept property or other improper benefits; they must not carry out unnecessary examinations and treatment of patients.

Zheng Xueqian recalled that "unnecessary examination and treatment" were written in the previous drafts as "excessive medical treatment".

She said that experts consider that doctors in clinical practice, there are some treatments that need to be explored, at this time, if the doctors are held accountable with excessive medical treatment, they will shrink their hands and feet and dare not explore, which is not the effect that the "Physician Law" hopes to achieve, "the law hopes to regulate the behavior of doctors, but also does not limit their normal exploration in the profession."

"Over-prescribed medication" is incorporated into the law, and rescue in public places is exempted from liability

"Over-the-label medication" was originally a term that violated the norm. However, in the treatment work of doctors, the update of drug instructions cannot keep up with the pace of clinical practice, so that doctors dare not use drugs, or thus cause doctor-patient disputes.

Article 29 of the Physicians Law points out that in special cases such as the absence of effective or better treatment methods, physicians may, after obtaining the patient's explicit informed consent, use drug usage that is not specified in the drug label but has evidence-based medical evidence to carry out treatment.

"It's actually giving doctors certain rights." Zheng Xueqian said that in the treatment, in special cases such as the absence of effective or better treatment methods, doctors cannot be restricted in the treatment of exploratory medical treatment after obtaining the patient's informed consent.

The specification has a certain legal effect, but the "Medical Practitioner Law" passed by the Standing Committee of the National People's Congress has a higher legal rank and effect. Zheng Xueqian said that in this way, the doctor's over-instruction medication behavior has a legal basis, "can be used with a tight waist bar."

In Article 27, the State encourages physicians to actively participate in emergency services in public places such as public transportation; physicians who cause damage to the recipient due to voluntary implementation of first aid shall not bear civil liability.

"This is to make doctors dare to lend a helping hand and actively rescue them." Zheng Xueqian said that doctors have professional knowledge and technology, and participating in rescue is more beneficial to patients, and should be encouraged, especially stipulating that doctors should actively participate in rescue in public places, not statutory duties, and should be exempted from liability.

"In the new Physician Law, the scope of practice of physicians is more flexible." Zheng Xueqian introduced that article 14 proposes that physicians can increase the scope of practice after passing relevant professional training and assessment.

She said that according to the past regulations, doctors have a scope when registering in practice. Physicians, for example, can only provide internal medicine services.

But now there are many interdisciplinary disciplines, such as physicians also need to do interventional treatment for patients. This is with the development of the new situation, the law also needs to give some expansion.

Open multi-site practice exploration space

Keeping up with the pace of the development of the times, the Physician Law also provides standardized guidance on new formats, new situations and new problems that have emerged in the development of the times such as multi-point practice, Internet medical treatment, and telemedicine.

All along, the state has advocated the equalization of medical resources. To this end, there have always been voices in the industry that support open and free practice. For multi-point practice issues, article 15 of the Physician Law points out that where physicians practice regularly in two or more medical and health institutions, they shall mainly use one medical and health institution and go through relevant procedures in accordance with the relevant provisions of the State.

Deng Liqiang introduced that some experts in the discussion did ask whether it was no longer necessary to restrict the place of practice. However, considering the situation in our country, doctors are all unit people, and the unit provides them with training, promotion, welfare and other guarantees, then from the perspective of managers, the release of doctors into free people does not meet the management norms of employers, nor does it meet the actual national conditions of medical personnel in our public hospitals being uniformly allocated by the state.

The provisions are also interlinked. Zheng Xueqian introduced that this is why when talking about the issue of industry organizations, the word "can" is used instead of "must". (Article 7 of the Physician Law: Physicians may organize and participate in relevant industry organizations and professional academic groups such as physician associations in accordance with law.) ）

She introduced that the difference between doctors and lawyers is that lawyers are not unit members, they are all a partnership of a firm, equivalent to "single-handed households", so it is necessary for lawyers to join the industry association, and the lawyers association also has a certain degree of actual management power of the association, requiring all lawyers to register here. At present, physicians are all unit people, there are units to manage them, the main responsibility of industry associations is self-discipline and rights protection, so it is not yet mandatory for doctors to join.

Sources | the health community

Written by | Liu Wenyang