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Oath for a medical student
医 学 生 誓 言
Health entrusted. Lives confided.
健康所系，性命相托。
On my admission to the Practice of Medicine, I swear to fulfill, to the best of my ability and interpretation, this oath:
当我步入神圣医学学府的时刻，谨庄严宣誓：
I will dedicate myself to medicine with love for my motherland and loyalty to the people. I will scrupulously practice my profession with conscience and dignity. I will discipline myself and give my teachers the respect and gratitude that is their due. I will strive diligently for continued excellence and my full development.
我自愿献身医学，热爱祖国，忠于人民，恪守医德，尊师守纪，刻苦钻研，孜孜不倦，精益求精，全面发展。
I will do my utmost to alleviate human suffering and promote human health, safeguarding the sanctity and honor of medicine. I will heal the wounded and rescue the dying regardless of the trials and tribulations. As long as my life endures, may I commit myself to advance the nation's medical science and research as well as the well-being of the entire human race.
我决心竭尽全力除人类病痛，助健康之完美，维护医术的圣洁和荣誉。救死扶伤，不辞艰辛，执着追求，为祖国医药事业的发展和人类身心健康奋斗终身。
近日，来自北京大学以及哈佛大学的研究人员在《Health Policy and Planning》上发表了题为“Understanding medical corruption in China: a mixed-methods study”（《中国医疗腐败的基本特征和反腐败成效》）的研究论文。
这项研究采用混合研究方法收集和分析定量和定性数据，整合三个来源的数据集，利用从中国裁判文书网(CJO)提取的医疗腐败案件数据集，中国健康与退休纵向研究(CHARLS)中具有全国代表性的数据集，以及与知情人士的访谈资料探究了中国医疗腐败的基本特征、腐败行为的驱动因素和近期反腐败斗争的成效。研究结果将有助于其他研究者和政策制定者更好地了解中国的医疗腐败特征，为制定反腐败干预措施提供参考，同时也为其他发展中国家提供经验借鉴。
文章通过统计分析2013-2019年中国裁判文书网上的判决书信息，加上一项全国调查(CHARLS）数据，外加对17名关键人物访谈，来分析当下中国的医疗腐败问题。
摘几个重要信息供参考。
1、红包越来越少
数据显示，病人给医疗服务人员的红包比例逐年下降，门诊病人2011的比例是0.7%，2018年降到0.4%，住院病人略高，从2.2%降到1.4%。
2、医疗腐败有哪些形式？
可以说，“红包“只是小问题，不是医疗腐败的重点。
裁判文书网的案例数据显示，医疗腐败最多的形式是受贿，占68.1%，其次是贪污，占22.8%，最后是诈骗（主要是骗保），占比9.1%。
受贿主体，最多的是医疗机构（占79.8%），政府只有14%，医疗保险单位是6.2%。
受贿涉事领域中，药品相关受贿最多，占1/3，其次是耗材、设备、基建、个人、保险。
3、为啥受贿？
访谈结果显示，医疗机构人员的受贿的原因，最主要的有两个。
一是正常收入钱少，经济压力大。
大部分医生抱怨，医院的工资奖金太低，不够养家，只能想办法赚外快。
In our county hospital, more than 60% of doctors can- not support their families if they solely rely on salaries and bonus from hospitals. (P14, hospital director, male, Central region)
The prices of health care services relying on labor inputs are relatively low. For example, the price of removing foreign objects from a patient’ eye is only 10 yuan, and the outpatient diagnosis fee is only 14 yuan per patient. But drugs and tests are lucrative. (P12, attending physician, female, Western region)
二是周边同行压力，不受贿不行。
一些年轻医生说，他们一开始也不想收回扣，但迫于周边压力，不收就有可能被孤立，最后只能下水。
When most doctors in my department receive kickbacks, I cannot refuse these kickbacks. I will be isolated if I don’t follow them. (P4, Attending physician, female, Central region)
另外，一些骗保行为，也是迫于医院生存压力。特别是小医院、私人医院，经营困难，就动了医保的坏心思。
Because some small hospitals and private hospitals have trouble in making ends meet, they are prone to partici- pate in medical insurance fraud and to make fraudulent insurance claims, forming a complete industrial chain of insurance fraud. (P6, official from local health security bureau, male, Central region)
文章还讨论了国家集采的影响，医疗腐败的新形式，医疗腐败对医疗行业发展的影响，提出了一些解决方案建议，比如改革薪酬体系，坚强监管等。
相关报道
Most corruption in Chinese public hospitals is about drugs and medical devices, and bribes are the most common form of fraud, according to an academic paper based on more than 2,000 cases.
药品和医疗器械是公立医院腐败的主要环节，受贿是主要腐败方式，一篇基于超过2000条医疗腐败数据的学术论文揭示了这一事实。
The conclusion is from a paper that was published in the third issue of the Chinese Health Service Management 2023. It analyzed around 2,000 verdicts involving medical corruption in China from 2013 to 2021.
这篇发表在《中国卫生事业管理》杂志2023年第三期的论文提取了2013年-2021年的约2000份涉及医疗腐败的刑事判决书。
Corruption in hospitals includes bribery, embezzlement of assets, and misappropriation of funds. Bribery accounts for more than 90 percent of the total. Hospital workers accept cash, vouchers, and trips from medical representatives, patients' families, fund companies, and insurers, per the paper.
数据显示，公立医院内涉及的腐败行为包括受贿、挪用公款、职务侵占等，其中受贿占比超过90%。医院工作人员收受来自医药代表、患者家属、基金公司、保险公司等的现金、回扣、实物、卡券、旅游等。
Graft is common particularly in the fields of medical devices and pharmaceuticals because hospitals have a high demand for these products that are quite profitable. But the group also includes cases regarding consumables, insurance, and medical infrastructure.
公立医院在医疗器械、药品、耗材、医保和基建领域都存在腐败问题，尤其是医疗器械和药品领域。主要是因为医院对医疗器械、药品需求高，且涉及的资金多，更有利可图。
Xu Yucai, a medical reform expert, told Yicai that China has been trying to stop corruption in the medical sector for over a decade but it still exists and there is a momentum of expansion and concealment. Fraud is extensive in several aspects including procurement, sales of medicines, construction engineering, and the selection of staff.
医改专家徐毓才对Yicai表示，十多年来医药反腐一直在进行，但腐败问题依然存在，而且呈现扩散蔓延和隐秘趋势。医疗领域存在的腐败问题比较广泛，包括医药购销、工程建设、物资采购、选人用人等。
Xu said that some associations use pharmaceutical sponsorship to arrange academic activities, a hidden form of corruption. Yicai learned that some hospitals require doctors to hand in the fees they receive from lectures, training, and seminars.
徐表示，一些管理不规范的协会学会可以利用医药企业赞助通过举办学术活动，成为一种隐蔽的腐败形式。Yicai了解到，一些医院要求医生上缴为企业站台讲课，收受讲课费、培训费、研讨费等。
The situation shows that the market is not perfect yet and the rule of law needs to be improved, Xu said, adding that the next step is to prevent corruption in the long term and to cleanse the work environment.
徐表示，医药领域反腐根源在于市场发育尚不健全，法治体系尚不健全，执法不严。下一步要长期推进全国医药领域腐败问题治理，进一步净化行业风气。
相关报道：
China's corruption watchdog has probed 176 hospital heads over the past few weeks during a "sweeping, more vigorous than ever" anti-corruption campaign in the healthcare sector, which experts said aims to eradicate corruption in the field and restore public trust in the healthcare system.
Since China started the sweeping anti-corruption drive in the public health sector in mid-July, a total of 176 Party secretaries or heads of hospitals had been detained, according to media calculations. In recent weeks, more than 20 provincial-level regions, including Shandong, Xinjiang, Tianjin and Jiangsu, have launched meetings on fighting corruption in the public health sector. Ever since the beginning of August, there have been daily reports of medical system officials being probed and removed from their positions.
Experts said that the anti-corruption campaign in the sector this year is different from previous campaigns, as it is sweeping and more vigorous than ever. Corruption in the medical sector is a serious issue that affects the credibility of the healthcare system and patients, said Zhong Chong-ming, an expert from the China Health Culture Association. Zhong said that medical corruption undermines the credibility of the healthcare system and erodes social trust. It also leads to unfair distribution of medical resources, as funds that should be used for patient treatment and improving medical facilities could be misused.
In July, the National Health Commission, the National Healthcare Security Adminis-tration, the State Administration for Market Regulation and six other government agencies launched a year-long campaign to rectify corruption in the pharmaceutical industry, according to a statement published on the health commission's website on July 21. It stressed that the authorities will conduct in-depth and systemic governance of the pharmaceutical industry, with key figures and key links such as manufacturing, supply and sales in focus, in order to weed out corruption.
On July 28, the Central Commission for Discipline Inspection held a meeting in Beijing to prepare for the campaign. Wei Zining, head of a Beijing-based research institute on hospital management, said that in the short term, the anti-corruption campaign has led to a slew of cancellations for medical conferences and events sponsored by pharmaceutical companies, which shows it has had a deterrence effect on pharmaceutical companies. In the long term, it can help regulate the marketing practices of pharmaceutical companies, allowing them to focus more on product research and development, internal deve-lopment, and quality improvement, said Wei, noting that it can also regulate hospital operations and management, enhancing the capacity and standards of medical services.返回搜狐，查看更多
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