Slashing the pusher of over-medicaltreatment

Excessivemedicalproblem, has become a widely criticized disease, and has become more and more seriousThe 93 Society attaches great importance to this realistic subject, and recently organized experts and scholars to hold a symposium on the theme of "The Over-
of Medicalof Modern Medicine and" and actively offer suggestions for reducing over-medical treatmentExperts at the conference agreed that the erosion of medical independence by commercial interests was an important cause of over-medical careSome pharmaceutical companies provide medical institutions and physicians with "benefits" such as sponsoring academic conferences, and these huge public relations costs are ultimately passed on to patients, laying the groundwork for over-medical treatmentIn June 2014, the Audit Office released the audit results showed that the relevant departments of the Commission in 2012 and 2013 three working meetings of 9985 million yuan of conference fees were sponsored by pharmaceutical companies; It is reported that, because the general academic conference has no financial subsidies, commercial sponsorship has become an international practiceIn China, the commercial sponsorship of the pharmaceutical industry also plays a practical role in making up for the deficiency of financial compensation, promoting exchanges at home and abroad, and enhancing the medical research and practical abilityExperts at the meeting helplessly pointed out that some conference organizers and participants have obvious tendency to collect money, doctors from the fame and fortune, medical enterprises take advantage of the promotion, organizers, doctors, commercial enterprises three-way formation of a gray chainMedical service is a highly specialized service, doctors have an absolute say in diagnosis and drug use, which provides doctors with rent-seeking opportunitiesIn this context, how to use good commercial sponsorship has become a serious problem we must seriously considerThe experts suggested that, in accordance with the principle of "making the market play a decisive role in the allocation of resources and better playing the role of the government" put forward by the Third Plenary Session of the 18th CPC Central Committee, we should not only respect the market-oriented mode of market-oriented relationship between pharmaceutical enterprises and medical institutions and doctors, but also draw the occupational bottom line and eliminate direct or implicit commercial bribery that may erode medical independenceIn April 2007, the former Ministry of Health issued the Interim Measures for the Administration of Social Donation Grants for Health Care Institutions, but its operability was greatly reduced due to a lack of rulesAt the same time, for what kind of academic activities can participate, different levels of experts need to unify the approval standards, etc , the hospitals also do not have a sound management method To this end, the experts suggested strengthening the construction of the drug regulatory system and improving the rules of the pharmaceutical trading market They recommended the development of the Guidelines on the Relationship between Hospitals, Physicians and Pharmaceutical Companies, regulating the forms of cooperation between pharmaceutical enterprises and medical institutions, and prescribing the principles of cooperation and precautions Weak regulation condones the abuse of new technologies and large-scale equipment at present, and many new technologies are quietly commercially promoted without large-scale clinical trials and rigorous scientific argumentation, bringing new forms of over-medicaltreatment Experts pointed out that any new medical technology needs to undergo a large number of practical tests, clear the scope of indications, understanding its limitations and shortcomings and possible side effects Many of the current new technologies claim to be of accuracy, sensitivity and specificity without scientific evidence of large-scale clinical trials, no exact efficacy, but because of inadequate regulation and promotion, in fact, this is also an over-medical Experts suggested that the supervision of new medical technologies such as gene diagnosis, targeted therapy and cell therapy should be strengthened The clinical application of new medical technology should follow the law of medical development and the relevant provisions of the state, in addition to the deliberations of the ethics committee, but also need peer judgment, in order to clarify the scope and technical requirements Similar to new technologies, many hospitals in China are also keen to introduce PET/CT (editor's note: positron emission computer tomography devices, mainly used in the early detection and diagnosis of major diseases in the fields of tumors, brains and hearts, at a price of 30 million-50 million yuan /taiwan) and other expensive medical equipment By the end of 2013, China had introduced PET/CT198 units, which are expected to reach 270 units by 2015 At present, the number of PET/CT has far exceeded market demand, most medical institutions PET/CT can not run at full capacity, the three days of the week within the hospital close to 30%, individual hospitals only once or twice a week Experts said that PET/CT helps with early detection of diseases such as tumors, but sometimes small tumors are found to be unable to make pathological diagnoses and can only continue to observe regularly, causing anxiety, causing unnecessary regular check-ups, leading to unnecessary surgery and increasing the chance of over-treatment In fact, at present, the determination of whether a malignant tumor still follows only one "golden standard", that is, the pathological examination of the diseased tissue Experts said that developed countries on CT (electronic computed tomography scanner), MRI (magnetic resonance imaging) and other large medical equipment will be strictly configured, a medium-sized city only one or two imaging centers, PET/CT such expensive and low-utilization equipment restrictions more stringent And almost all of our country's county-level public hospitals are equipped with complete CT, MRI and other large-scale equipment, in order to reduce idle, excessive medical treatment is inevitable To this end, experts suggested that the relevant departments should strictly control the number of large-scale medical equipment imported such as PET/CT, reasonable allocation of resources, and strengthen the management of large-scale medical equipment, to curb the public hospitalpet pettain for medical examination and included in medical insurance reimbursement and other unreasonable phenomena Clinical guidelines are not sound, not effectively standardized clinical guidelines for diagnosis and treatment of a disease to provide clinical diagnostic standards and clinical treatment programs, widely used to guide and standardize the clinical behavior of clinical personnel Experts pointed out that the current health care system in China's increasingly diversified and complex medical services, the increasing demand for health services, the rising cost of medicine, medical inequality and excessive medical problems gradually increase, these problems need to be issued clinical guidelines to solve Experts noted that transparent, cost-oriented, patient-centered clinical guidelines help to create more objective and comprehensive health quality and practice monitoring indicators, thereby reducing waste of resources and preventing over-medical care For example, in response to widespread over-medical problems, nine major American medical academic communities, including the American College of Physicians, the American College of Cardiology, and the American Society of Clinical Oncology, have launched a health campaign called "Smart Choices", which advocates for doctors to avoid over-medicuation, encourages doctors to communicate, and achieves informed medical choices So far, more than 70 medical professional organizations have participated in the campaign, and each association has published a medical guideline that has strongly curbed over-medical problems At present, China has also formulated some clinical guidelines, which have played a certain role in guiding clinical work However, experts noted that most clinical guidelines were of poor quality, less independence and authority Of the 327 clinical guidelines developed, published and included in our country from 2006 to 2010, only 68 declared conflicts of interest for members of the guidelines development team, 29 of which were funded by pharmaceutical companies Although many standards have been set by professional societies or associations in our country for the professional situation, the clinical application is not satisfactory As of June 2012, the International Guide Collaboration Database contains more than 7,200 clinical guides, and the National Guide Library contains approximately 2,300 clinical guidelines, none of which are from China From international experience, national clinical guidelines should be completed by relevant specialized agencies, academic communities and relevant personnel The European Hypertension Management Guidelines are issued jointly by the European Society of Hypertension and the European Society of Cardiology, and the American Guidelines for Hypertension are issued jointly by the American Heart Association, the American Heart Association and the Centers for Disease Control and Prevention To this end, the experts suggested giving full play to the role of the Chinese Medical Association and affiliated professional associations and other medical academic communities, and gradually establish a system of development and revision of clinical guidelines, and promote the localization of clinical guidelines in order to effectively curb over-medical treatment.