Business Club March 29th

Some "famous doctors" were sent to court for kickbacks - greed, heading towards Hell.

The core message: After triggering the “Edaravon” drug rebate case for earthquakes in many hospitals in Zhejiang, one doctor involved in the case started to appear in the dock after unraveling the layers of mystery. In the face of these "medicine" defendants with excellent medical skills and excellent reputation, it is deplorable and even more convincing: How can we completely shut down the medical rebate so that it will no longer harm society?

Describe a good doctor, people are accustomed to call it a double happiness.

In fact, many doctors are indeed highly skilled, treat illness, and are respectful. However, some doctors have been pulled into the water because of the “rebate door” and even went on the road to crime.

Chen Guozhu, former deputy director of the Department of Neurology of Ningbo Second Hospital, and Yang Shenggang, former deputy director, recently sued the Shaoxing County Court of Justice for prosecuting bribes of more than RMB 180,000 and more than RMB 260,000 respectively. Previously, Yu Yangguang, former chief physician of the Department of Cardiology of the Provincial Hospital of Traditional Chinese Medicine, was sued by the Procuratorate of the Shangcheng District of Hangzhou City for the alleged bribery of more than 210,000 yuan.

Pulling these "famous doctors" into the water was all the same thing - the "Edaravone" (a kind of brain protection agent) drug rebate case which triggered the earthquakes in many hospitals in Zhejiang two years ago.

Medical ethics and medical skills, how important is it?

Phenomenon: Ming won credibility with a rebate

For many patients who visited the neurology department of Ningbo Second Hospital, the name “Yang Shenggang” should be familiar.

Through Baidu search "Yang Shenggang", except for the first search result is about his trial report, the other is almost all of the medical website for him, the patient's praise and advice to him.

However, these consultations have not been answered by the doctor himself for a long time. Because on February 9, Yang Shenggang was prosecuted in the Shaoxing County Court for allegedly accepting drug rebates.

Even if he stood on the dock, many people familiar with him could not associate the gentle Dr. Yang with the identity of a criminal. This drop, even Yang Shenggang himself is also difficult to accept.

He was born in 1962. Prior to the incident, he was Deputy Director of Neurology and Deputy Chief Physician of the Second Hospital of Ningbo City. Before 50 years old, Yang Shenggang's life can be said to be bright. According to him, from elementary school to high school, he has always been a squad leader and his academic record ranks first. At the age of 17, he was admitted to the university and he joined the party at the age of 22. For more than 20 years since he had been a doctor, he could not remember how many critically ill patients he had saved. He only knew that he had received a letter of thanks from the patient and the pennant had never been interrupted. Yang Shenggang has a very good reputation among patients because of his skillful skills and his responsible and responsible work. For this reason, his outpatient amount has also been ranked in the top 3 hospitals.

Yang Shenggang, a successful businessman, did not expect that he would fall off at the peak of his career.

At an annual meeting around 2007, he met with Mao, a medical representative from the former Ningbo Office of Jiangsu Xiansheng Pharmaceutical Co., Ltd., and one person who claimed to be Zou. After the meeting, Mr. Zou took Mao to the office of Ningbo No. 2 Hospital to find Yang Shenggang and introduced him to Bidush Edaravone Injection Drug. He hopes that he can use this drug in his usual work. When they met again later, Maomou promised Yang Shenggang that he would give him a rebate of 10 yuan for each use of a Bicid brand of medicine. Yang Sheng just acquiesced.

Since then, Yang Shenggang facilitated the use of his own and his medical team member Jiang to prescribe prescriptions and facilitate the use of the Blessed Card Edaravone. According to the account of Yang Shenggang at the public security stage, from 2008 until he was arrested, he and Jiang both issued 34,968 must-have brand drugs and received cash rebates of over 340,000 yuan from Mao.

In February 2010, a post appeared on the local forum in Ningbo. The poster claimed that he was a salesman of a pharmaceutical company. He was dissatisfied with the employer’s deduction of wages and decided to make the ugly public to the public. In the post, the poster revealed that more than 30 doctors from several hospitals in Ningbo received the rebate amount, and Yang Shenggang was among them. Later, the matter became more intense and spread to many hospitals in Hangzhou and other places.

At the same time in the Department of Neurology, Ningbo Second Hospital, because the former director Shen Guozhu received a request from Yi Dasheng Brand Edaravone Injection Pharmaceuticals and Pharmaceuticals Representative Building, and each use of a medicine can obtain a rebate of RMB 18. Therefore, Yi Dasheng is Dara has become a preferred choice for medical teams that lead him in daily medications. A case handling prosecutor told reporters: "According to the comparison of the three medical teams in this hospital, it can be clearly seen that drug rebate has greatly affected the doctor's choice of medication."

Tracking: Feelings are Virtual Benefits

This “rebate gate” is not isolated. In recent years, similar incidents have occurred in and around the province.

As early as the beginning of 2004, when the Rui'an City Procuratorate sampled drugs from the People's Hospital of Ruian City, it discovered that 56 of the more than 200 doctors in the hospital received a rebate from the medical representative for a total amount of more than RMB 1.1 million.

More than a year ago, a whistleblower who claimed to be a “ticket driver in Jinhua Yiwu City” had faxed materials to the media, saying that the passengers were found to have fallen in the vehicle: including “Hu Zhida Fenghai Pharmaceutical Co., Ltd. Medical Representative Hu Zhiqing” The business card and a list entitled "Five-November Fructose Consumption Expenses Summary in Lu'an People's Hospital", which lists the names of 31 medical personnel, departments, drug usage, and "doctor's fees."

At the same time, Xiangya Hospital, which enjoys a good reputation in the domestic medical community, also exposed several staff responsible for the procurement of drugs and medical equipment for commercial bribery; another whistle-blower sent the media a CD containing 8 videos and related texts. The materials pointed to two doctors at Beijing Cancer Hospital receiving medical rebates and bribery...

The analysis of frequent occurrences of such incidents is closely related to accidental factors such as internal disclosures and netizens’ disclosures. Why does this happen? From Yang Shenggang's case, we can find some clues.

According to Mao’s medical representative, Mao, they often contact the doctors. “They will invite these doctors to go out to eat each month. There are several times a month. When the Chinese New Year is over, they will send something to the doctor. There is seafood. , tonics, supermarket cards, shopping malls, shopping cards, digital products, etc.; doctors will also be organized to travel, mainly by taking part in national annual conferences, academic conferences and other opportunities,” and even some doctors participate in annual conferences, academic conferences, and The costs of the project, articles, and other expenses are also borne by the medical representative.

And this type of approach has become commonplace. An industry insider who has been working as a medical representative for 17 years revealed that many medical representatives have changed from secretive methods such as secretly plugging red envelopes into departments to travel abroad and taking accounts with public accounts.

According to the memories of a retired doctor, some medical representatives have been working hard to achieve a long-term mission in one place. For example, a representative of a pharmaceutical company in Xi'an is obliged to go to a certain department of the hospital to clean up every day and it takes more than one week. Later, the medical representative bought gifts for department doctors. Please eat and focus on treating the doctors. In the end, the medical representative finally negotiated successfully.

According to industry insiders, the “emotional contact” through such a non-cash way now has a paralyzing effect on many doctors. Many people are even unaware of the way they committed crimes; And for other doctors who have become accustomed to this, through such multi-channel and comprehensive "liaison", it is even more subtle, which greatly increases the difficulty of supervision and investigation.

Meng Yao: external strong supervision of the root causes of internal governance

"I can say that it is a veritable legal blindness. I have been erroneously thinking that taking drug rebates is not an offence. At most, it is a violation of rules and regulations. Together with herd mentality and chance, I gradually pick up the rebate."

“I am sorry that the party and the organization have cultivated and educated me for many years. I am sorry for the earnest expectations my family and friends and relatives have given me. I am also sorry that many patients have paid my hopes and responsibilities. For this reason, I myself have paid a huge price and lost. Freedom, loss of a superior working environment, and stopping the work of the doctors I worked for, all of this is my own, and I find myself insulting. I should be severely sanctioned by the law..."

Yang Shenggang dissects himself this way in a penitent book submitted to the court.

"There are many deeper issues behind drug rebates and we cannot avoid them." In the face of repeatedly exposed doctors receiving kickbacks, a "previous doctor" who graduated from a medical school in Shanghai and has now left the hospital, could not help but tolerate it. "Tucao" on a web forum in Wenzhou.

“Actually, people engaged in the medical industry rarely pay attention to the ethical issues from the beginning of the selection. Medical ethics education is merely a superficial article. It is only an irritating problem. I graduated from a medical school, the level of medical education can not say that the domestic top, the first-class level can be considered However, I basically have not received any systematic education on medical ethics. You can imagine the medical ethics education of other institutions."

The "previous doctor" also pointedly pointed out that the doctor's profession is facing a common predicament: high risk, great responsibility, and great pressure. "After eight years of study in Coban, master's degree, about 28 years old, the doctors who just joined the work income are about 3,000 to 4,000 yuan, which is equivalent to a barber who has been in the company for 3 years. If you strictly implement the current income distribution system, In the past few years, no doctor is willing to engage in clinical work again.” He pointed out that it is in this context that certain doctors are ignoring the sacredness of their careers in order to make small profits; and those hospitals are under pressure in infrastructure, equipment investment, etc. In the case of an increase, we adopt an attitude of indulging in which one eye closes one eye.

“As long as such a system is unchanged, there is no way to get kickbacks from the root cause.” A doctor who has been engaged in medical work for more than 10 years and is well versed in the industry state pointed out that it is important to strengthen moral medical ethics education and supervise the self-discipline of medical personnel, but they must be resolved. The key to the problem is still to start with the historical roots and solve the problems of the system.

In addition, there are people in the industry who believe that the commercial bribery of pharmaceuticals has continued to be banned for many times and that there is a great relationship between the punishment is too weak. At present, there are few cases in which the domestic practice qualifications have been revoked due to the withdrawal of deductions. The Chinese law imposes less penalties on the behavior of doctors to collect kickbacks, and there are also various problems such as administrative, lack of civil, and minor criminality. Some doctors therefore have the luck of "law not to blame." Hospitals and other relevant administrative departments, which were originally beneficiaries, lacked the enthusiasm for punishment, making some doctors fearless and risk-taking. Therefore, the Commission for Discipline Inspection and the Procuratorate must strengthen their participation in the remediation of commercial bribery in the medical field.

Yang Jianhua, director of the Research Center of the Provincial Academy of Social Sciences: There are two major problems in the current regulatory system. First, the system is not strict. Both sides of the pharmaceutical industry belong to the alliance in the interest chain and medical rebates. There is a common difficulty in investigation and punishment. Second, penalties are not severe. Some medical kickbacks penalize lack of deterrence. Even if investigated and dealt with, the doctor will be deducted from the bonus for a few months or within a certain period of time. (Reporter Lu Wei correspondent Wei Jinjin Wang Jing)