制度经济学语境下的医师行为与和谐医患关系

The Physicians' Behaviors and Coherent Doctor-patient Relationship in the Context of the Institutional Economics

在我国医疗制度变革时期,医疗服务出现市场化倾向,医患信任出现危机,其部分原因在于制度缺位或者制度的设计导向出了偏差。重建医患间和谐的信任关系,不但要注重医务人员的自身素质和职业道德,还应进行相关的制度和法制建设,包括:建立基于声誉机制的医务人才市场,合理配置卫生资源;建立强制性医疗服务信息披露制度,减少医患之间的信息不对称;健全医院的绩效评价标准与薪酬制度;加强对医疗准入的控制和医疗行为的管理等。

In the time of change in our medical system,there are marketized tendency in medical service and the crisis in the trust between doctor and patient.Some of the reasons lie in the system vacancy and its design oriented deviation.The reestablishment of the coherent trust between doctor and patient lies in the focus on the self quality,professional ethics of the medical personnel and the construction of the relevant systems and legal system,including the establishment of the markets of medical personnel basing on the fame mechanism and the reasonable allocation of health resources;the establishment of the compulsory information disclosure system of medical service to decrease the unmatched information on both the doctor and patient;perfecting the standards for performance evaluation and remuneration system in hospitals;and strengthening the control of medical admission and the management of medical behaviors.