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UPDATED: July 15, 2013 NO. 29 JULY 18, 2013
For Doctors, What Matters Most?


Since 2001, Yu Ying practiced medicine in the emergency department of the prestigious Peking Union Medical College Hospital. Her candid and humorous stories about her work as a doctor won her a measure of fame in the microblog community as Emergency Department Superwoman, with 2 million followers.

However, she recently announced her resignation from the hospital, claiming that she could no longer conform to the current criteria for evaluating doctors based on the number of academic papers they have published; the additional pressure of publishing articles meant securing a promotion, which could only come at the expense of her clinical practice.

She said her dream is to become a general practitioner and provide health consultation to patients. Her resignation ignited controversy in the country's medical community about emergent scientific evaluation systems for medical professionals. The following are excerpts of some opinions:

Liu Zhiyong (Health News): If not for Yu's influence in cyberspace, this old topic would not trigger such widespread debate within hospitals, where so many doctors share almost the same feeling as Yu. The problem existed long before her resignation.

The number of papers published and research programs they have participated in are becoming increasingly decisive factors in professional evaluations of doctors. These assessments determine their job positions, so the system is urging doctors to write papers to earn promotions. As a result, some doctors game the system, to the detriment of both academic quality and clinical capacities. It is a truly worrying trend.

We don't want to deny the important role of scientific research in assessing doctors. Without clinical and basic research, progress would be impossible, and evaluations based on academic papers seem more scientific and fair than a system hinging on public opinion.

However, the focus on papers published hinders doctors who excel at clinical treatment but lack time for research. Under such an unfair incentive system, few doctors will be encouraged to devote themselves to frontline treatment.

A diversified assessment system is badly needed. It should consider more than just a doctor's achievements in publishing. Those doctors who spend the majority of their time on clinical treatment may not have enough time to do academic research. If they are assessed in other ways instead of the number of papers, these doctors may concentrate more on treating patients.

We are pleased to notice that some provinces have already started to reform the assessment system on doctors' professional title evaluation. The proportion of a doctor's clinical competence is expanded in the assessment while frontline doctors are required to finish much fewer academic papers in the process of being promoted to a higher professional title. This is good news for ordinary clinical doctors.

Many patients choose to go to big and well-equipped state-run hospitals. For doctors already struggling with daily clinical tasks, the requirement to author an academic paper could be the straw that breaks the camel's back.

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