10 years ago, he also received kickbacks and thought that doctors should take kickbacks.
Seven years ago, he reported to People's Daily that doctors in this hospital received drug kickbacks, and became the focus of the medical and health system in Anhui Province and the "traitor" of the hospital. In 2003, he received kickbacks again, and began to use the pseudonym of "Li Cuntian", donating all the kickbacks collected to Anhui Women's Federation or its subordinate institutions to help out-of-school girls.
He is small and thin, speaks quickly and has a loud voice. A pair of broken socks that showed his heels didn't bring him embarrassment. Talking about kickbacks, 5 1 year-old Zhang Shu felt deeply.
From identification, disgust, reporting individuals, silence, reflection, taking kickbacks, media appearance and reporting the whole medical system, cutie said that he experienced perceptual knowledge of drug kickbacks to rational thinking, and made profound reflection and research on the roots of kickbacks and the current medical system.
It is understandable to get a little kickback for rational drug use, but it is a bit excessive to get a kickback for prescribing drugs.
Zhang Shu was born in the countryside of northern Anhui, young and poor, and graduated from 1982 Medical University.
1993, drug rebate sneaked into the hospital. At this point, Zhang Shu has only heard of it and never seen it. From 65438 to 0996, there were traces of drug kickbacks in his emergency department, and he also received a kind reminder from the medical representative to "earn some pocket money".
"At that time, I felt that the doctor was very hard, the salary was not too high, and the risk was high. It is also appropriate to get some kickbacks. " Zhang Wei said.
At that time, there were few drugs with kickbacks, and the kickbacks were low, which was 5% of the drug price. The rebate for a box of medicine is only one or two yuan. Doctors don't pay attention to which drugs have kickbacks and which don't when prescribing drugs. Drugs with kickbacks are expensive, so doctors will try to choose cheap and effective drugs when prescribing, and will prescribe expensive drugs if they have no choice. Even if drugs with kickbacks are prescribed, doctors will not take the initiative to find medical representatives, but medical representatives will take the initiative to send kickbacks.
At that time, the hospital banned kickbacks and advocated learning from Bethune and carrying forward the spirit of dedication. Only a few doctors get kickbacks, and many doctors are disgusted with doctors who prescribe drugs indiscriminately and get kickbacks.
Occasionally get a little kickback, ten or twenty dollars a month. Zhang Shu didn't feel anything wrong at first. But gradually, he found that some doctors began to prescribe drugs with kickbacks, those that should not be used for medicine, and those that should not be tested. Some doctors can get a rebate of 1000 yuan a month.
In the face of individual doctors' outrageous behavior, other doctors show different reactions, some envy, some acquiescence and some disgust. In cutie's view, it is understandable to get a little kickback for rational drug use, but it is a bit excessive to get a kickback for prescribing drugs.
He began to condemn these doctors in public and some informal occasions, thinking that they had lost their professional ethics.
Rebates will turn good people into bad people.
1998, the drug rebate has risen to 10%, the types of drugs with kickbacks have increased, the number of doctors who take kickbacks has increased, and the phenomenon of prescribing drugs indiscriminately has begun to spread. Some doctors can get a rebate of 2000 yuan every month.
After taking kickbacks for two years, at the beginning of 1998, Zhang Shu gradually realized the harm of kickbacks and withdrew from the ranks of kickbacks.
At that time, he saw that many rural people could not afford medical expenses, and some doctors prescribed drugs to get kickbacks, which made the patient's situation worse. Many people have to endure illness and leave the hospital.
Cutie found that at this time, the hospital is changing from a public health social responsibility institution to a profit-seeking enterprise, putting the pursuit of economic benefits in the first place, and the responsibility of saving lives is no longer the main task of the hospital. In order to increase income, hospitals invest a lot of equipment and increase the cost of patient examination.
"kickbacks will turn good people into bad people." Cutie said that he was shocked by the behavior of a respected old professor.
Just one day in the summer of 1998, Zhang Shu received a patient with hematemesis in stool and was critically ill. After examination, it was learned that the patient had heart disease and gastric ulcer, and the patient clearly informed the doctor when he went to see a doctor, but the doctor prescribed a drug clearly marked "Use with caution for patients with gastric and duodenal ulcer", which led to bloody stool and hematemesis.
Zhang Shu learned that this patient was treated by an old professor in the hospital, with excellent skills, honesty and integrity, and was deeply respected by everyone. He prescribed a drug rebate of 10 yuan, and he * * * prescribed 10 for this patient.
Zhang Shu judged that this was definitely not a technical mistake. The old professor won't make such a low-level mistake. It is kickbacks that make people lose their nature.
Zhang Shu said that the old professor has always been poor and he can understand the difficulties of the old professor. He has worked hard all his life and his income is not as high as that of an ordinary doctor.
After the report, the hospital thought he had damaged the reputation of the unit, and his colleagues cursed him behind his back.
From 65438 to 0998, Zhang Shu began to report individual doctors to the hospital, but the report was fruitless. "Hospital leaders feel funny. Other hospitals are more serious than us. The situation in our hospital is nothing. Cutie said that the purpose of the initial report was mainly to oppose the hospital's one-sided pursuit of economic benefits, and to ask hospital leaders to improve medical management to facilitate patients to seek medical treatment.
1998 10, Zhang Shu complained to the Anhui Provincial Health Department about medical ethics, and complained to the Anhui Provincial Supervision Department the next month. However, these reports are not without the following, that is, they turned back to the hospital to "check and correct themselves" and went away.
1999 65438+ 10, Zhang Shu reported his real name to People's Daily Online and the Ministry of Health. When People's Daily learned about the situation, it published a report and caused a sensation.
However, the hospital did not think that the problem reflected by Zhang Shu at that time was a fact. 1in March, 1999, at a working meeting in the hospital, the then secretary of the discipline inspection commission of the hospital said that the problems reported to the media were unfounded.
1April, 1999, Zhang Shu reflected the kickback problem to the relevant leading offices of Anhui Provincial Party Committee. Soon, two responsible comrades of the provincial health department and the competent leaders of the hospital talked to Zhang respectively, hoping that he would stop reflecting the problem to the above. "Individuals can ask themselves what they want."
After the People's Daily published cutie's tip-off, the hospital leaders thought that he had damaged the reputation of the unit, which led to the defeat of the "Top 100 Hospitals in China" that year. Some colleagues think that he has harmed everyone's interests and cursed him behind his back. Some people even shouted for revenge.
In the month when it was exposed, the activities of hospital drug dealers decreased. Although the rebate was given, it was hidden, and more than half of the hospital outpatient service was lost. This situation lasted for nearly a month.
Although the incident was exposed, no one was punished because it was difficult to investigate. Soon, the drug dealer returned to the hospital and the patient returned to the hospital. Since every hospital has a rebate, why not choose a hospital with good technology and equipment to see a doctor?
As a result, kickbacks have become a competitive means for drug dealers, with more and more drugs with kickbacks, and doctors have begun to prescribe large prescriptions and prescribe drugs with more kickbacks. Those who don't take kickbacks have become a minority.
The report did not curb kickbacks, but kickbacks intensified. Zhang Shu is also depressed.
Rebates have spread all over the country, and Zhang Shu began to doubt himself. "Am I really wrong?"
1at the end of 999, the hospital sent Zhang Shu to Beijing to study. He also wants to take this opportunity to leave the hospital, change the environment and avoid the trouble of kickbacks. However, it backfired. After talking with doctors in Guangdong, Sichuan, Tibet, Xinjiang and other parts of the country, he found that kickbacks have spread all over the country, and in some places, kickbacks are more severe, with more varieties and larger amounts.
Cutie, who is studying in Cardiovascular Department, learned that the price of a heart stent abroad is 300 dollars, equivalent to 2400 yuan, while the domestic price is 20,000 yuan. In Beijing, doctors can get a rebate of 2000 yuan for using stents. Some doctors can install more than 100 heart stents a year, and this rebate alone amounts to 200,000 to 300,000 yuan.
Through communication and discussion, he found that most doctors recognized the rationality of kickbacks, everyone thought that his reporting behavior was wrong, and some doctors even envied doctors in Beijing.
Everyone thinks that doctors have high academic qualifications, high technical requirements and high risks. They have to go to work 365 days a year and study and improve all their lives. They are also doctors and masters, and they can easily engage in other industries with considerable income. Why do doctors get so little pay for saving lives? Besides, other industries also have gray income, so why can't doctors have gray income?
"Am I really wrong?" Zhang Shu began to doubt himself and his own practice.
"A dead fish is a fish problem, and a dead pool is probably a pond problem." Zhang Shu began to reflect on the current medical system and thought that he was right to oppose kickbacks, but it was wrong to point the finger at doctors and report individuals.
Cutie chose to stay in the hospital. He feels that this is the case all over the country, and he can't escape kickbacks wherever he is transferred. He still works with peace of mind and mind his own business. Don't take kickbacks as long as you don't prescribe drugs with kickbacks.
I tried to clean myself up, but in the end I failed to escape from the drug rebate network, and even gave the rebate to my relatives.
According to the principle of medication, choose drugs with good curative effect, small side effects and low price. Cutie treated patients in his own way, trying to get rid of drug kickbacks. However, "kickbacks leave me nowhere to hide." Cutie said that although he wanted to get rid of himself, he failed to escape from the drug rebate network in the end, and even gave kickbacks to his relatives.
At the beginning of 2002, Zhang Shu treated his relatives and prescribed a prescription. However, when paying the bill, he found that it was clearly his own prescription, but the prescription doctor on the bill of payment became "Qi Deru". There is no such person as "Qi Deru" in the hospital. Later, Zhang Shu began to pay attention and found that every prescription he opened was printed with the name "Qi Deru". He thought about it. Isn't "eat like" a homonym for "eat full" (local dialect)?
"This is specially compiled by the hospital to deal with doctors who are' unreliable' like me. The prescriptions prescribed by these doctors are included in the name of' Qi Deru'. In this way, the drug dealer can't find the prescription doctor, and the rebate will not be discovered by us. "
After the incident, through the theory with the hospital, in February 2003, Zhang Shu's prescription was restored to its real name. One night the following month, cutie received his "first envelope".
Zhang Shu said: "I have to stand up and report kickbacks. I have nowhere to run. "
He began to chase kickbacks, collect evidence, investigate kickback networks, and collect a large number of relevant documents on medical reform. He found that the whole medical system has formed a tight kickback network.
He found that although the drug rebate attracted the attention of the relevant departments and began to implement drug bidding, it actually put a legal coat on the rebate drugs and made the rebate drugs openly enter the hospital. At present, there are more than 400 kinds of drugs with kickbacks in hospitals.
With the increase of drug rebate varieties, some drugs that were originally sold well can't be sold. Once the drug wins the bid through price reduction, it means that it has reached a desperate situation. Puhong, an antibiotic produced in Shanghai, used to sell 7,000 boxes a month in 56 yuan, but later it dropped to 5.5 yuan, and the sales volume was less than 300 boxes.
In March 2004, Yin, general manager of Anhui Huaibei Pharmaceutical Company, was sentenced and interviewed by Anhui Daily. "In order to get these drugs to win prizes and enter the ranks of medical insurance drugs, I had to get through key positions and later succeeded. As a result, the same medicine was sold for 288 yuan a box. " At present, the price of cinobufotalin injection is 266.8 yuan after bidding. It is said that now a box of kickbacks is given to 50 yuan.
Zhang Shu said that he prescribed drugs strictly according to the patient's condition. In this way, he also got a rebate of 1000 to 2,000 yuan a month. "In the hospital, the average clinician receives a drug rebate of 1000 yuan to 5,000 yuan per month. It's easy for a doctor to spend more than 10 thousand a month. However, there are very few people who have the right to buy and sell drugs in hospitals, and kickbacks can only be described as huge. "
He believes that doctors are the last link in the interest chain of drug kickbacks, but doctors directly face patients and doctors become the focus of contradictions, which is unfair to doctors. "Rebate has become a social problem, so we should look at it outside hospitals and medical systems."
It is better to use the rebate in a reasonable place than to let others eat it.
One night in May 2003, cutie received an envelope containing kickbacks. Previously, he strongly opposed accepting kickbacks. This time, his colleagues were very surprised and thought that he had become "one of our own".
On May 16, Anhui Women's Federation received an anonymous donor and took away the donation receipt, leaving only the name of "Li Cuntian".
However, what the hospital colleagues didn't expect was that this "Li Cuntian" turned out to be Zhang Shu. He donated the recovered money to the Anhui Women's Federation to help children from poor families in poor areas in Anhui to complete nine-year compulsory education.
For three years, Zhang Shu kept his mouth shut and endured the sarcasm, sarcasm and incomprehension of his colleagues.
A staff member of the Children's Work Department of Anhui Women's Federation confirmed to reporters that in the past three years, "Li Cuntian" donated 45,000 yuan to nearly 100 poor children who dropped out of school. He basically donates money every month, ranging from several hundred yuan to several thousand yuan.
Zhang Shu said: "I take kickbacks to get evidence, and donate them to charity to give money to reliable people and use it in reasonable places." It is not noble for him to donate kickbacks. Money is gray, unclean and bloody. He just wants to prove his innocence.
Zhang Shu presented 30 donation receipts to the reporter, with a total amount of 46.5438+0.5 million yuan. He also presented more than 200 envelopes and more than 300 business cards to reporters.
The medical representative sealed the rebate with a letter. Each envelope is written with the drug name, 7×5, 6× 10 and the words "Director Zhang Ji".
Cutie said that these were written by medical representatives. The front number represents the number of drugs, and the back number represents the rebate amount.
The statistics on the envelope are all counted by people inside the hospital. How many drugs have been prescribed by the doctor? There is a special person to count the prescriptions. At the end of each month, print out a list according to the types of drugs and then provide it to drug dealers.
Cutie said: "The hospital has formed a complete rebate network. Drug rebates make doctors have nowhere to hide. As long as the medicine is prescribed to treat the disease, there will be kickbacks. Instead of letting kickbacks be given to others, it is better to use them in a reasonable place. "
"Drug rebates have discredited doctors, which is related to the development of the entire medical system and society and has reached a critical juncture." Cutie said that he appeared this time to make everyone aware of the seriousness of the problem, attract the attention of relevant departments and find a good medicine to treat drug kickbacks.