The "vaccine incident" exposed this year is still fresh in memory. At the "2018 Chinese Business Leaders Annual Meeting" held recently, the chairman and CEO of the Aikang Group, Zhang Li, again exposed the scandal in the medical examination field - "there are also in the industry." Real physical examination, fake medical examination."

The blood does not check and the result is directly

Zhang Ligang said: "Many business owners only look at the price when they choose a medical examination center for their employees. But the problem is, you don't know whether the ultrasound doctors who do your physical examination for your employees are nurses or ultrasound doctors, some colleagues will use nurses. Counterfeit doctors see ultrasound. Some of the peers have taken blood and do not check it, they are dumped, and the results are directly given. Why can they be mixed? Because the proportion of cancer actually is only three-thousandths, if the medical examination center draws Blood does not do, the highest error rate is three thousandths. Because the error ratio is so low, there are many irregular companies in our industry that do fake medical examinations."

However, Zhang Ligang excluded his company from the "critic list". He said, "In the past ten years, Ikang has adhered to the real medical examination."

The news broke the news easily to remind people of the “fake medical door” incident of a well-known medical examination institution that was screened a few months ago. At the end of July, the former employees of the well-known medical examination institutions broke the news that they had cancer missed and used a lot. The phenomenon of the doctor’s appointment to the post. Subsequently, relevant government functions involved in the investigation, saying that the report was partially true. At the same time, the well-known medical examination agency also said that it received the "Notice of Rectification", and the first time to station a special working group to station in the outpatient department, carry out in-depth self-examination, implement rectification item by item, and apologize to the public and investors.

The "fake medical door" incident also directly led to the evaporation of the market value of the above-mentioned well-known medical institutions.

The market is large and the supervision is difficult.

With the upgrade of healthy consumption, the market demand for the medical examination industry is strong.

According to the "China Health Checkup Industry Development Prospects and Investment Forecast Analysis Report" released by the Prospective Industry Research Institute, the data shows:

In 2017, the size of China's medical examination market is about 135 billion yuan, and it is expected to reach 240 billion yuan in 2020. The third-party professional medical examination market will reach 72 billion yuan.

In this rapidly growing market, three public companies have been born. They are Aikang Guobin, Mei Nian Da Health, and Rui Ci Medical . However, according to the market data in 2016, the medical examination companies of the US Health, Aikang Guobin, Ruici Medical Examination and Ciming Medical Examination (now acquired by Mei Nian Health) accounted for 39% of the private stereo inspection market, with the remaining 61%. % of the market share is held by private hospitals and other private medical institutions.

How to regulate such a large market.

In October this year, the National Health and Health Commission officially issued the "Notice on Further Strengthening the Management of Health Checkup Organizations to Promote the Standard and Orderly Development of the Health Checkup Industry", which further standardized the requirements for the medical examination industry, and clarified that by the end of 2018, local health supervision agencies should Carry out key supervision and inspection on the legal practice of health checkups in the jurisdiction, and discover illegal and illegal behaviors such as conducting unauthorised health checkups, over-scope practice, issuing false or forged health checkup results, fraudulent use of other people's identity or qualifications, and conducting illegal medical activities. Seriously deal with according to regulations.

However, even with the explicit provisions, the chaos in the medical examination industry is still endless.

In this regard, some analysts said that the investigation of the chaos in the medical examination industry is nothing more than two reasons: First, the industry is developing too fast, the radish is not washed, the rules are not clear, the standards are missing; the second is the industry supervision is lagging behind, many medical examinations The organization is basically in a state of "freeing itself". No one is in charge, no one asks, time is long, courage is fat, and chaos is not strange.

What's more to say is that the medical examination field is no more than the traditional medical institution, neither in the front line of doctor-patient disputes nor in the grass-roots level of the disease-saving. Therefore, the consequences of dealing with perfunctory are not serious, even if there is a small probability of technical omission, Hard to find, but also difficult to investigate.

Regular physical examination and user needs are being decoupled

According to Tencent's "Prisma" report, Zhang Ligang has been in the medical examination industry for many years. His public disclosure has put some market shady in the public eye, but this is not the only problem facing this fast-growing market.

Other problems include, first, the common set-style physical examination has limitations, it is difficult to achieve accurate detection.

Xie Yushi, the founder of the former doctor group "Bode Jialian", observed this limitation. As far as the number of items examined, he said that some individuals may not need to check so many, but other individuals may not be enough, "because everyone's physical condition is not consistent."

When the regular medical check-up package is insufficiently covered, it may cause a missed test. Previously, in the so-called "intestinal cancer missed detection" incident in the United States, the user's physical examination package "has no screening program for the diagnosis of intestinal cancer", so the routine medical examination did not provide early warning to the user.

Another industry person who does not want to be named said that consumers hope that value for money is high. In order to satisfy this mentality, there are often some inspection items in the regular medical examination package that users can use less, but the cost is not high - the medical examination institution Not willing to lose money to earn money."

Similarly, health inspectors tend to reduce the number of standard packages, but offer more "additional optional packages." From the user's point of view, the choice is naturally more flexible; from the perspective of the physical examination organization, the user's selection of a medical examination item means that it pays more attention to the corresponding disease, "it can be slightly more expensive."

In addition, the optional optional package also increases the interaction between the medical examination organization and the user, which facilitates the former to vertically explore user needs and increase revenue by promoting value-added products.

But this also raises the second question: the medical examination agency may use information asymmetry, and the “fudge” user pays for the immature medical examination products.

Deng Yong, a health law expert who is concerned about the medical examination market, said that some medical institutions are willing to "play the concept products of genetic testing." Deng Yong is an associate professor at Beijing University of Chinese Medicine and a consultant to Dacheng Law Firm.

The Science Journal of the Chinese Academy of Sciences quoted Han Jian, a researcher at the Hasen Alpha Institute of Biotechnology, as saying that genetic polymorphisms are not directly related to disease, which leads to a high proportion of “false positives” and “false negatives” in genetic examinations.

The report also quoted Liu Siqi, a researcher at the Beijing Institute of Genomics of the Chinese Academy of Sciences, as saying that the genetic examination provides "a very vague information, just a possibility. How much is this possibility, and who can not tell now."

The third problem lies in the fact that there may be a talent gap in the medical examination institution. "It is not a good doctor to simply do a physical examination."

Xie Yushi said, "The growth of doctors requires patient assistance and intervention in diagnosis and treatment." Hospital administrators hold similar logic. Yang Changqing, director of the operation of Nanjing Xianlin Drum Tower Hospital of Taikang Insurance, said that the maintenance and improvement of doctors' ability needs to be realized through the whole process of diagnosis and treatment. The medical examination business has natural defects in treatment.

Yang Changqing pointed out that, for example, in a hospital, if the position of a medical examiner can be used with a specialist post, "the doctor and the medical examiner will be relatively reliable." However, the current situation is that due to the lack of effective incentives, the medical examination departments of most public hospitals have difficulty obtaining sufficient support from other departments' medical resources.

The data shows that although the overall size of the public stereo inspection agency is larger, the concentration is inferior to that of the private medical examination institution.

According to data from the market organization Frost & Sullivan, in the 6500 medical examination institutions in China in 2015, there were about 4,600 medical examination institutions in public hospitals. Of the approximately 112 billion medical examinations in 2016, approximately 80% belong to public institutions.

According to government data, the number of medical examinations nationwide in 2017 was 456 million. In the same year, the United States health "layout more than 400 physical examination centers ... more than 21.6 million physical examinations throughout the year" - the United States called itself "health flow entrance leader"; and the number of medical examinations of Aikang Guobin was 5.49 million times, the two institutions total Has a share of about 6%.

In fact, public hospitals are not opposed to building their own medical examination departments. On the one hand, the benefits of medical examinations are relatively rich; on the other hand, the threshold is not high, the demand for doctors and equipment is limited, and sometimes the existing inspection equipment of the hospital can be fully utilized.

However, Yang Changqing said that the existing mechanism has restricted the joint and large-scale growth of the medical examination departments of public hospitals. The specific reasons include the lack of clear leadership, lack of a sustainable incentive distribution mechanism, and the long-term management of the hospital itself, and the inability to use capital leverage – the efficiency is lower than that of private medical institutions.

In fact, if the public stereotypes are difficult to retain good doctors, the medical institutions that lack treatment services are even more so. More than one industry respondent suggested that medical examinations go to public hospitals.

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