Establishing Appropriate Agency Relationships for Providers in China

Liu, Yu; Saltman, Richard B.

In summary, the post-1978 Chinese health care system's development has had the overall effect of making Chinese physicians more the agents of hospitals rather than of their patients. Substantial evidence has shown that the financial tie between physicians and tertiary-level public hospitals is a critical reason for much of existing inefficiency or even misuse of health care resources. 11, 12, 16 More recently, the existing strong financial relation between senior physicians and tertiary public hospitals also has jeopardized efforts to create competition from emerging private hospitals as well as reform measures that allow physicians to practice among multiple health care facilities. The eventual goal of current Chinese health care reforms is to create a market with providers of numerous ownership, including public and forprofit private hospitals, and to redistribute physician resources from currently dominating public hospitals to other settings. To achieve this long-term goal with sustainable physician-patient and physician-hospital agency relations, a systematically well-developed physician professionalism system will also be necessary.