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医生“揽私活”被暂停执业资格 盘点各国如何避免医患冲突

2017-08-11 14:41:38   央广网

据《全球华语广播网》澳大利亚观察员胡方介绍,澳大利亚医生可以在不止一个地方上班,比如一个医生既可以在几所私立医院工作,同时也可以在公立医院任职。比较明显的例子是妇产科名医,因为准妈妈们经常会交流谁的医生是谁,有时候她们经常会发现,虽然她们的待产医院不是一家,但是医生很可能是同一个人。虽然一个医生可以在不同的医院就业,但是并不会产生医生和不同的医院的利益冲突。总体来看,澳大利亚医院和医生的关系更像是一个舞台和舞者的关系,舞者可以在不同的舞台上舞蹈,而不同的医院就像不同的舞台,为舞者提供最好的平台服务和声光电等设施的配合。

患者在选择医院的时候会根据自身的情况来决定。比如如果你是没有购买私人医疗保险的患者,一般你会选择不需要支付治疗费的公立医院;而如果你购买了私人医保,你会更多地选择服务更为便捷的私人医院寻求医生的帮助。一个在私人医院工作的医生如果同时在公立医院工作,并不会在非必要的情况下鼓励病人转投另一家自己所在的私人医院去就医,除非是因为公立医院实际的条件所限制。当然就算是要随着医生更换医院,最终的选择权也在于病患自己,比如他需要考虑自己是否有购买私人医保或者在无医保的情况下直接去私人医院就医。而且从另一个角度来看,医生不管是在哪个医院为患者治疗,最终对他的收入也没有什么大的影响。一个有声望的医生并不会冒着失医德的风险去做为某一个医院揽活这样的事情。

一般来说,虽然在澳大利亚医患矛盾问题非常少,但是一旦发生,医院伦理委员会的处理也会相对公允,是医院或者是医生本身的责任会界定得较为清晰,而且更重要的一件事是澳大利亚的每一位医生和医院都拥有巨额的医疗保险,所以如果他的确被界定为是医生或者是医院的责任,在赔付问题上并不会互相扯皮,该如何赔偿自然由最终的鉴定结果而决定。因此,医生与医院,医生与患者之间的冲突相对就比较少。

接下来,视线转向德国。德国医师的执业类型主要有三种,分别是:院外医师制度、急救值班制度、开业医师代理制度。其中,院外医师制度也就是开业的专科医师与特定的医院订立契约,利用医院的设备和医院职员等诊治自己的患者。总体来说,德国在医院供职的医生中有6%是院外医师,他所收取的诊疗费的一部分应按照合同规定上缴医院。

中新社驻德国记者彭大伟观察发现,如果关注近几年德国媒体上关于医疗腐败的报道,可以看到所谓的多点职业相关的这种涉及到利益冲突的案例是不常见的,比较常见的医疗腐败是医生和药店之间可能存在的利益输送。比如德国之声就曾经报道过一个案例,一位癌症患者到医生推荐的药店去买药,如果买卖交易成功之后,药店可能会给医生提成或者分担医生诊所的人力或运作成本,提供变相的医疗贿赂。

在德国相关的法律框架是由医生职业法来约束医生的行为,打击医疗腐败,相关的执法机构是职业法院,他们最高可以吊销医生的执照并且罚款。还有一种可能存在的医疗腐败案例,在德国新药开发研究当中,如果医师受制药公司委托检验新药疗效,制药公司可能会支付给医生费用,比如每个患者可以支付两百欧元的金额给医生,这样有时就是会存在医生实际上只是给患者开药方,然后就坐等收钱这种形象,有关机构会认为这属于掩人耳目的变相行贿。

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