Physician group practice in China's healthcare reform: a national survey on physicians' perspectives and implementation challenges

TL;DR

Chinese physicians show moderate support for physician groups, driven by career and income opportunities but hindered by policy and institutional barriers.

Contribution

First systematic survey of Chinese physicians' perspectives on physician groups, identifying key facilitators and barriers to implementation.

Findings

75.1% of physicians view new career direction as a key facilitator for physician groups.

Major concerns include policies restricting physician mobility (69.7%) and lack of hospital manager support (57.8%).

Administrative staff and those with longer work experience show significantly higher support for physician groups.

Abstract

The physician group (PG) model, while well-established in the United States, is a relatively recent healthcare delivery innovation in China. Despite rapid growth in PG registrations, comprehensive understanding of physicians’ perspectives remains limited.

To investigate Chinese physicians’ perspectives and concerns regarding the PG model and identify factors influencing their support for its implementation.

A cross-sectional online survey was conducted among 535 Chinese physicians between October-November 2024. The survey assessed participants’ views on PG advantages, concerns, and overall support. Data analysis included descriptive statistics and variance analyses to explore correlations between physicians’ characteristics and their perspectives.

Key facilitators for PG development included “New career direction outside the existing system” (75.1%) and “Improved income levels” (74.4%). Major concerns comprised “Policies restricting physician mobility” (69.7%) and “Lack of support from hospital managers” (57.8%). Overall support for PGs was moderate (3.710 ± 1.241). Administrative position holders showed significantly higher support than non-administrative staff (p = 0.004), and longer work experience correlated positively with support (p = 0.037). Hospital level and specialty area showed no significant influence on support levels.

This first systematic study of Chinese physicians’ perspectives on PGs reveals moderate support driven by career development and income opportunities, while highlighting regulatory and institutional barriers. Results suggest the need for stable policies, enhanced income frameworks, and targeted support for early career physicians-who currently show less support than experienced physicians-to facilitate successful PG implementation in China.