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2015年1月19日,国务院常务会通过了《全国医疗卫生服务体系规划纲要(以下简称“纲要”)》,从而拉开了新一轮医疗体制改革的序幕,同年11月1日,贯彻《纲要》精神的“新医改”方案正式在全国落地实施。在新医改政策落地实施的大环境下,执业医师在整个医疗体系中的定位和作用,也在发生着悄然的变化,医师执业责任保险对于执业医师而言将会变得更加重要,执业医师在医疗事故发生之后的风险控制,以及这种管控风险的手段能否间接对患者稍有裨益,也将直接影响到医患关系的走向。本文拟通过新医改方案入手,对于医师执业责任险的作用、核赔及理赔大致框架进行必要的阐述,以为这个关乎执业医师命脉的险种勾勒出一个大致的轮廓。
On January 19, 2015, the State Council executive meeting approved the “Outline of the National Health Service System Plan (hereinafter referred to as the” Outline “), which opened the prelude to a new round of reform of the medical system. On November 1 of the same year, The program of ”new medical reform“ to carry out the spirit of the ”Outline" officially took effect throughout the country. Under the environment of the implementation of the new medical reform policy, the positioning and role of practicing physicians in the whole medical system are changing quietly. Physician liability insurance will become more and more important to the practicing physicians. After the medical accident risk control, as well as this means of risk control can indirectly benefit patients slightly, it will also have a direct impact on the doctor-patient relationship. This article intends to start with the new medical reform plan, and makes the necessary explanations for the role of physician liability insurance, the principal part of the claims and the general framework of the claims settlement, in order to outline a general outline of the insurance covering the lifeblood of practicing physicians.