Doctors look to break public system shackles

A woman holds her baby in a crowded public hospital in Nanjing, Jiangsu province. [Yu Tian/For China Daily]

Rising salaries

Kang said allowing doctors to register at more than one hospital gives patients improved access to treatment, and helps underpaid doctors earn more, because they can work at private hospitals, which offer better pay than the public system.

Patients have lambasted doctors in public hospitals for commissioning needless scans and other tests to make more money.

However, Kang pointed out that an appointment at a public hospital with an associate senior doctor, such as himself, would cost 15 yuan ($2.20) - less than a haircut - and he would receive a "negligible" share of that.

In private hospitals, a consultation costs 450 yuan, and he receives half of the fee.

Kang admits he had no idea how much a consultation should cost at first: "We left the decision to the market."

He used the example of a female doctor who often works late because her consultations last longer than those conducted by other colleagues. Even though her consultation fee has risen from 450 to 800 yuan, she still has many patients.

"Doctors wouldn't take kickbacks," Kang said.

High fees discourage price-sensitive customers, but Kang argued that patients see doctors much more quickly than they would in a public hospital.

University teacher Jia Hong gave birth this year at a private hospital in Beijing. The medical bill was 30,000 yuan, more than 10 times that in a public hospital, but she didn't care. "It's expensive, but it saves time, and I did not have to prepare a red envelope (a gift of money)," she said.

However, few doctors are throwing off their "shackles". By last year, just 3,000 doctors had applied for extra registrations, less than 5 percent of the total number in Beijing. In Jiangsu province, only 1,000 doctors have applied since 2010.

Public hospital administrators have mounted strong opposition to the move, because they fear doctors will take patients and profits to private hospitals.

Last year, two ophthalmologists made headlines after being fired from a leading public hospital in Beijing for "stealing patients".

Doctors now worry that public hospitals will extract retribution by affecting pay, promotion prospects and professional titles.

Many doctors who joined Kang's group were persuaded to abandon their move by their hospital bosses.