On the message board of the leadership of People's Daily Online, a proposal for hospital reform by Shanghai citizens has attracted attention.
The citizen suggested that the basic salary of chief physicians in Shanghai be set at 100,000 yuan per month, and the coefficients of deputy chief physicians, general physicians, and intern doctors should be multiplied by 0.8, 0.6, and 0.2 respectively. At the same time, according to the job level of different departments, different reception indicators are customized, and bonuses are given in proportion to the overtime part, or exchanged for leave.
Source: Screenshot of People's Daily Online leadership message board
"Completely cut off the phenomenon of prescribing drugs and getting commissions, and let doctors have food and money to get, don't think about relying on your own professional knowledge and technical barriers to set up medical insurance funds every day. The citizen said in a message.
At present, this message has received a reply from the Shanghai Municipal Health Commission.
Source: Screenshot of People's Daily Online leadership message board
100,000 a month for the Shanghai director, more or less?
At the same time, the netizen's suggestion sparked a discussion among many medical staff.
An ear, nose and throat doctor from Zhejiang said: 100,000 a month is a lot, and my deputy chief physician is only 150,000 a year!
A respiratory physician from Jiangxi also said: Whether this netizen overestimated himself or underestimated others, this suggestion is obviously unreasonable.
In fact, I don't blame everyone for such a big reaction.
According to the 2021 China Hospital Salary Survey Report, the average annual fixed salary (basic salary and employee benefits) of senior high, deputy high, intermediate and junior public hospitals in first-tier cities was 107,000, 93,000, 84,000 and 78,000 respectively.
2021 China Hospital Salary Survey Report
However, in addition to the fixed salary, the overall income of a doctor also needs to take into account performance.
According to the 2021 China Hospital Salary Survey Report, the proportion of performance-based pay in doctors' income shows such a pattern: where the average salary is higher, the proportion of fixed salary is lower – which means that in first-tier cities with higher overall income, the majority of doctors' income is more on performance.
Therefore, how much money doctors can get depends not only on the different percentages of rank, length of service, proportion of drugs, and satisfaction, but also on the secondary distribution ratio of hospitals and department directors.
From the data alone, in 2020, the average annual salary of Shanghai hospitals was 351,000 yuan, of which the average annual salary of Zhenggao in Shanghai was about 450,000 yuan.
2021 China Hospital Salary Survey Report
Although the annual salary of 450,000 yuan is nearly twice the national average, it is clear that there is still a big gap with the 100,000 per month of the director mentioned in the above proposal.
Is paying doctors according to their job titles the same as the annual salary system?
Although there is a gap between the specific figures and the actual situation, the citizen's message proposed that doctors with different titles be paid according to different coefficients is actually not unfamiliar in today's salary reform.
As early as 2021, a public hospital in Sanming City, Fujian Province, took the lead in implementing an annual salary system for doctors, which not only had a profound impact on the local area, but also attracted widespread attention and praise across the country.
The basic annual salary of public medical institutions is not divided into hospital grades, but is paid according to professional titles, and the basic annual salary of all types of medical personnel is approved as follows:
1. The basic annual salary of the staff of the village clinic is 100,000 yuan;
2. The basic annual salary of chief physician is 300,000 yuan, the basic annual salary of deputy chief physician is 250,000 yuan, the basic annual salary of attending physician is 200,000 yuan, and the basic annual salary of resident physician is 150,000 yuan;
3. The basic annual salary of technicians and pharmacists shall be approved according to 80% of the basic annual salary of doctors at the same level;
4. The basic annual salary of nurses shall be determined at 70% of the basic annual salary of doctors of the same level;
5. The basic annual salary of administrative and logistics personnel shall be approved at 40% of the average annual salary of physicians.
However, the annual salary system is not a "dead salary" that only depends on the job title.
As for the specific amount that each doctor can pay, it should be calculated through the "annual salary calculation work point system": taking into account the responsibility burden and work intensity of each department, different positions are assessed with different "work scores".
According to this provision, the salary of doctors is composed of three parts: basic work (30%), workload work (70%), and reward and punishment work, and finally the salary is calculated according to the work points.
Not only that, Sanming also stipulates that the hospital can neither exceed the approved total salary, nor can it cash in at a loss. If the hospital is unable to cash in the salary, the shortfall will be made up by the local finance to ensure the normal payment of the doctor's salary.
After Sanming, Fujian, Guangdong, Jiangsu, Shenzhen and other places have also issued documents to encourage the exploration of the annual salary of the head of public hospitals.
Fujian Province
On October 25, 2021, the Fujian Provincial Health Commission, together with the Fujian Provincial Medical Security Bureau, the Fujian Provincial Department of Finance, and the Fujian Provincial Department of Human Resources and Social Security, issued the Implementation Plan for Deepening the Reform of the Salary System of Public Hospitals in Fujian Province. The "Implementation Plan" requires that the annual salary system for the term of office of the party secretary, the president and the chief accountant be fully implemented, and the incentive and restraint mechanism for the salary distribution of the person in charge shall be improved.
Hebei Province
On June 3, 2023, the Hebei Provincial People's Government issued the Notice of the General Office of the Hebei Provincial People's Government on Further Improving the Implementation Plan for the Medical and Health Service System. Article 4 of the notice of the document emphasizes that by the end of 2023, all provincial public hospitals, 50% of municipal public hospitals, and 50% of counties (cities, districts) will implement the annual salary system of party secretaries and presidents, and the annual salary will be borne by the financial department at the same level.
Xinjiang Uygur Autonomous Region
On December 28, 2023, the General Office of the Party Committee of Xinjiang Uygur Autonomous Region and the General Office of the People's Government of Xinjiang Uygur Autonomous Region issued the Implementation Plan for Further Improving the Medical and Health Service System. It mentions that the implementation of the reform of the salary system of public hospitals, the expansion of the internal distribution autonomy of public hospitals, the improvement of the incentive and restraint mechanism for the salary distribution of the main persons in charge of public hospitals, and the encouragement of the implementation of the annual salary system for the main persons in charge.
Jiangxi Province
On January 20, 2022, the General Office of the Jiangxi Provincial People's Government issued the "Implementation Opinions on Promoting the High-quality Development of Public Hospitals in the Province" (hereinafter referred to as the "Opinions"). The "Opinions" mentioned that by 2025, the fixed part of the remuneration of public hospital personnel will account for about 40%, and the implementation of an annual salary system for the main person in charge is encouraged.
Shandong Province
On December 31, 2023, the General Office of the People's Government of Shandong Province issued the "Implementation Plan for Further Improving the Medical and Health Service System in Shandong Province" (hereinafter referred to as the "Implementation Plan"), which emphasizes the need to improve the internal salary distribution system of public hospitals, and explore the implementation of flexible and diverse distribution methods such as the annual salary system, negotiated salary, and project salary for medical staff in public hospitals.
Guangdong Province
On July 17, 2018, the Guangdong Provincial People's Government issued the Action Plan for Deepening the Comprehensive Reform of Public Hospitals in Guangdong Province, which mentions "the implementation of a target annual salary system for the main persons in charge of public hospitals. In 2018, Shenzhen, Zhuhai, Huizhou and Dongguan took the lead in piloting the annual salary system for the main persons in charge of public hospitals, and in 2019, the experience of the pilot project was summarized and gradually rolled out to the whole province to reasonably determine the salary level of the main persons in charge of public hospitals."
Jiangsu Province
On January 5, 2024, the Jiangsu Provincial People's Government issued the "Implementation Plan for Further Improving the Medical and Health Service System", which mentions that "the implementation of an annual salary system for the main persons in charge of public hospitals is encouraged, and diversified distribution forms such as annual salary and negotiated salary are implemented for high-level talents, and the required salary is not included in the approved base of the total salary of the unit." ”
Sichuan Province
On July 7, 2023, the Sichuan Provincial Department of Human Resources and Social Security issued the Implementation Plan for Deepening the Reform of the Salary System of Public Hospitals in Sichuan Province (hereinafter referred to as the "Plan"). The plan mentions that the competent department of public hospitals should establish and improve the incentive and restraint mechanism for the salary distribution of the main person in charge of the hospital, pay attention to the long-term incentive for the main person in charge, and encourage the implementation of the target annual salary system for the main person in charge of the public hospital.
In early September 2023, the Sichuan Provincial Health Commission issued the "Recent Key Work Tasks for Deepening the Reform of the Medical and Health System in Sichuan Province" (hereinafter referred to as the "Task"). The "Mission" requires that the internal salary structure be reasonably determined, pay attention to the stable income and effective incentives of medical personnel, and encourage the implementation of an annual salary system for the main person in charge.
Guizhou Province
On December 1, 2023, the website of the Guizhou Provincial People's Government issued the "Implementation Opinions on Deepening the Construction of a Close-knit County-level Medical and Health Community in the Province" (hereinafter referred to as the "Opinions"). The "Opinions" mentions that "the salary level of general practitioners in township health centers should be increased, and gradually brought into line with the salary level of clinicians with the same conditions in local county-level public hospitals." Encourage the implementation of an annual salary system for the heads of medical and health institutions within the medical community. ”
Back to the beginning, in the suggestions put forward by this netizen, although the specific amount is still far from reality, the pilot implementation of various salary reform plans such as the annual salary system also indicates that in the future, the income structure of doctors may undergo many changes.
Source | The official website of the local health commission, the physician newspaper, and the medical Weida