【摘要】：民間中醫(yī)生群體是我國(guó)衛(wèi)生醫(yī)療事業(yè)中不可忽略的群體,但是現(xiàn)在民間中醫(yī)生的執(zhí)業(yè)狀態(tài)不容樂(lè)觀。具體體現(xiàn)在:擁有合法執(zhí)業(yè)資格的民間中醫(yī)生人數(shù)遠(yuǎn)遠(yuǎn)不能滿足廣大人民群眾日益增長(zhǎng)的醫(yī)療保健需求、民間中醫(yī)生因?yàn)闊o(wú)法取得合法的執(zhí)業(yè)資格導(dǎo)致大量非法的行醫(yī)現(xiàn)象存在,這既給監(jiān)管帶來(lái)困難和權(quán)利尋租的空間,又使得大量民間中醫(yī)生無(wú)法在陽(yáng)光下行醫(yī),經(jīng)濟(jì)收益不穩(wěn)定,內(nèi)心無(wú)比自卑,因此很多民間中醫(yī)生最后都轉(zhuǎn)行另尋其他的發(fā)展道路、民間中醫(yī)生在開(kāi)辦中醫(yī)診所時(shí)遇到很多政策阻力,使得中醫(yī)診所無(wú)法普及到廣大的基層群眾,或者使得很多中醫(yī)診所處于非法營(yíng)運(yùn)的狀態(tài)。之所以產(chǎn)生這種不容樂(lè)觀的現(xiàn)狀,主要原因是長(zhǎng)期以來(lái)針對(duì)民間中醫(yī)生執(zhí)業(yè)的相關(guān)制度存在諸多不完善、不合理。制度的不合理容易把執(zhí)行制度者和制度實(shí)施對(duì)象都引導(dǎo)到不道義的方向,這不僅使得制度想要達(dá)到的目的無(wú)法實(shí)現(xiàn),而且容易引發(fā)整個(gè)行業(yè)的制度性道德崩塌,這對(duì)整個(gè)行業(yè)的發(fā)展都會(huì)產(chǎn)生不良的影響。通過(guò)從制度倫理的角度對(duì)我國(guó)民間中醫(yī)生執(zhí)業(yè)狀態(tài)進(jìn)行研究,發(fā)現(xiàn)要想突破現(xiàn)在民間中醫(yī)藥事業(yè)發(fā)展的困局,就必須從制度倫理的角度對(duì)民間中醫(yī)生執(zhí)業(yè)制度進(jìn)行改革。在制度設(shè)計(jì)的主體、對(duì)象和執(zhí)行三個(gè)方面要充分考慮到中醫(yī)本身的發(fā)展規(guī)律和民情國(guó)情,包括地區(qū)差異性,更特別要關(guān)注制度設(shè)計(jì)所帶來(lái)的民間中醫(yī)生行醫(yī)的臨床有效性和便利性。民間中醫(yī)生的執(zhí)業(yè)制度在現(xiàn)階段更多要以鼓勵(lì)和開(kāi)放為主,在堅(jiān)守真誠(chéng)的最基本底線的前提下,讓監(jiān)管更多起到引導(dǎo)作用,而盡可能少一些強(qiáng)迫性措施。隨著首部《中醫(yī)藥法》的即將出臺(tái),本文對(duì)如何改革民間中醫(yī)生現(xiàn)行的執(zhí)業(yè)制度,使民間中醫(yī)生能夠更好地為廣大人民群眾的健康服務(wù)或有一定的啟發(fā)意義。
[Abstract]:The community of doctors is a group that can not be ignored in the field of health care in our country, but the practice status of doctors in the civil society is not optimistic. Specifically, the number of doctors among the people with legal qualifications is far from being able to meet the growing medical and health needs of the broad masses of the people. Due to the fact that doctors in the civil society are unable to obtain legal qualifications for practicing medicine, a large number of illegal medical practices exist, which not only brings difficulties to supervision and room for rent-seeking, but also makes a large number of doctors in the private sector unable to practise medicine in the sun, resulting in unstable economic benefits. Because of the inferiority complex in the heart, many doctors in the private sector ended up looking for other ways of development. Doctors in the private sector encountered a lot of policy obstacles in setting up Chinese medicine clinics, which prevented them from reaching the broad masses of grassroots people. Or make many TCM clinics in the state of illegal operation. The main reason for this unoptimistic situation is that there are many imperfections and unreasonableness in the related system of practicing doctors in the civil society for a long time. The irrationality of the system can easily lead the executor and the object of the system to the direction of immorality, which not only makes the purpose of the system impossible to achieve, but also easily leads to the collapse of the institutional morality of the whole industry. This will have a negative impact on the development of the entire industry. Through the research on the medical practice status of Chinese folk doctors from the point of view of institutional ethics, it is found that in order to break through the difficulties of the development of folk Chinese medicine, we must reform the medical practice system of folk doctors from the perspective of institutional ethics. In the three aspects of system design, including the main body, the object and the implementation, we should fully take into account the law of development of TCM itself and the national conditions of the people, including regional differences. We should pay more attention to the clinical effectiveness and convenience brought by the system design. At the present stage, the practice system of doctors in the civil society should be more encouraged and open. Under the premise of sticking to the most basic bottom line of sincerity, more supervision should play a leading role, and there are as few coercive measures as possible. With the coming out of the first "Chinese Medicine Law", this paper has some enlightening significance on how to reform the current practice system of doctors in the civil society and enable them to better serve the health of the broad masses of the people.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：D922.16

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