Licensed doctors practicing at multiple sites in Shaanxi province: analysis on status quo and obstacle factors

  Objective  To examine the status quo and obstacle factors of licensed doctors practicing at multiple sites in Shaanxi province and to provide evidences for promoting the practice of the doctors.

  Methods  We conducted a self-administered questionnaire survey among 366 doctors selected using stratified cluster sampling in 6 grade A tertiary hospitals locating at central, southern and northern Shaanxi province between September 2015 and May 2016. We explored obstacle factors for multi-site practice of licensed doctors with documentary analysis.

  Results  Of the participants, only 12.6% reported very understanding on the multi-site practice policy; 80.6% declared for the policy; 78.4% expressed the willing to conducted multi-site medical practice under favorable conditions; and 41.5% (152) reported having been carried out multi-site practice. The proportion of carrying out multi-site practice differed significantly by gender, age, professional title, and working years among the participants (all P < 0.05). The study identified 5 domain obstacles for licensed doctors practicing at multiple sites as following: gaps in related laws and regulations (lack of relevant legislation, imperfection in related laws and regulations, and great regional difference in administration management), adverse conditions attributed to practitioners′ full-time employer (managers′ negative attitude towards the multi-site practice, limitation of personnel management system, potential variation in salary, and possible career limitation in future), adverse conditions attributed to practitioners′ part-time employer (fewer patients, poor institutional capability for scientific research, backward instrument and equipment, and inefficient team collaboration), practitioners′ considerations (time limitation, professional role limitation, possible influences on salary or career promotion, and being worried about risk of medical practice), and medical liability insurance (less compensation, narrow insurance coverage, indistinctness of responsibility subject, and restricted insurance type selection).

  Conclusion  The proportion of doctors conducting multiple site medical practice is low in Shaanxi province, and effective measures are needed to promote licensed doctors practicing at multiple sites.