There are very few doctors in the medical service industry.、Phenomenon of Excessive Medicine，How to understand the legal responsibility of the relevant subject，How to design an institutional design under the existing conditions to improve the quality of medical services、Improve the relationship between doctors and patients? This article attempts to analyze this important issue。

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Medical services have obvious "expert services" (or "credit product service") features，This feature determines the particularity of medical services。The so -called "expert service" refers to a type of product or service that is difficult to overcome between the providers of the product or service and the user。The provider of expert services not only determines which services are necessary and necessary，and directly provide services。Due to the complexity of the service，Users of the service (such as patients in medical services) are not capable of judging the specific quality of the service，It is unnecessary to judge which services are unnecessary (such as the maintenance service recommended by the car 4S store)。Medical、Law、Financial services and certain precision mechanical maintenance services are typical expert services。

Expert Service，Asymmetry of information is the key factor。Experience Show，As a party with information advantages，Medical staff often consciously and unconsciously abuse their information advantages，Recommended unnecessary treatment，or over -treatment。In other words，As a type of expert service，Medical services when there is a lack of appropriate institutional design and bet365 live casino games legal supervision，Improper medical behavior that will occur to some extent。Improper medical behavior can be manifested as a service that provides more than normal standards in some cases，or more time，For the purpose of seeking economic interests，Provide unnecessary、Excessive medical treatment with too high charges。For example, there is a period in my country，Because caesarean section has more benefits to the hospital，Unnecessary caesarean section surgery has increased abnormally，Many childbirths are encouraged to adopt the form of caesarean production。Similar improper medical behaviors include unnecessary CT、MRI checkup、Uncomfortable heart stent surgery, etc.。Recent research shows，The proportion of excessive medical care in my country's medical system may be as high as 70%。and the improper medical behavior caused by medical care as an expert service is not limited to our country，Many developed countries also have similar situations，For example, some data display in Western countries，In the relatives of medical staff，The ratio of caesarean section is much lower。A statistical data from Switzerland，The ratio of 7 common surgery accepted by the general patient group is 33%higher than that of doctors and their families.，and the ratio of the above -mentioned surgery accepted by the lawyer (and their family members) group is much lower than that of ordinary people，Keep the doctor and their family members basically consistent。If the ratio of the doctor's family undergo surgery is used as the judgment baseline，As a country with rich medical resources，The only explanation behind the above difference is that doctors have performed a considerable number of unnecessary surgery for ordinary patients。other，From the United Bet365 lotto review States、Japan、India、Norwegian data shows that medical personnel are under economic motivation，It will obviously provide more medical services，As a result, excessive medical treatment。So at least some doctors often do not fully blame，In the field of tumor treatment，Based on the reasons mentioned earlier，It is undoubtedly a field that is very likely to occur and other improper treatment。

　　The faithful obligation of medical service providers

The necessary faithful obligations for medical service providers are an effective means to deal with the issue of "expert service"。During the medical process served as an expert，The medical party is actually the health rights and economic interests of the patient's full control of patients，This full management reflects the patient's trust and commission of the medical party，Therefore, the core of the relationship between doctors and patients is trust relationship。Therefore，Xinyi obligations for trust design -legal obligations that the trustee needs to assume based on trust，Its core content is to prohibit conflicts of interest -it is the most targeted legal system。Xinyi obligations require medical staff to infringe the interests of patients and make a profit for themselves，Should bear the corresponding legal liability，It has become a "core" sexual legal system in many fields，But it has not been clearly established in the medical service field。

The good effects of improper medical behavior through legal responsibility can be seen in the relevant Swiss related research mentioned above，The lawyer group is rarely performed in this study.，The reason is that the lawyer group is considered a "risk" group，Therefore, medical service providers are more cautious when evaluating medical services required by lawyers。In other words，Improper surgery may cause legal risks and responsibilities to obscure unnecessary bet365 live casino games medical behavior。This kind of pairing lawyer、Be careful about yourself and relatives should be applicable to all patients，The means to achieve this kind of cautious effect is that each patient has fully and effective legal means to maintain your legal health、Economic interests。my country's existing law is mainly reflected in the infringement liability when serious medical faults occur，and the legal relief pathway during medical infringement is also very limited。Existing medical infringement litigation requires serious medical fault，and the proceedings of litigation is long。Although the new mediation process broaden the dispute resolution channel，but，Acts that severely damage the economic interests of patients such as over -medical but have no obvious or serious medical consequences，There is no valid legal relief method。The very targeted faithful obligation requires the medical party to take care of his patient as if he looks at his family，Therefore, you can cope with improper medical behaviors involved in "tumor treatment"。

　　Diagnosis and treatment separation and "second diagnosis"

Credit product features for medical services，A feasible alternative system is to separate the diagnosis and treatment of the disease (including the sale of drugs)，Medical staff who provide diagnosis only provide diagnosis，and the treatment and medicine are provided by other medical staff。Such a design is provided by a third party because of the treatment，Therefore, the diagnosis has reduced the chance of obtaining improper income from using exaggerated disease diagnosis，Therefore, it can reduce the motivation of the severity of the disease with information asymmetry and exaggerate the disease，Asymmetric information between the information between the medical services can be appropriately relieved。Study shows，Diagnosis bet365 best casino games and treatment separation can greatly reduce the price and excessive medical and service problems of medical services (26%)。For example，Assume that the average treatment cost of pneumonia is 2000 yuan，and the treatment cost of bronchitis is 1,000 yuan，In the case of diagnosis and treatment of services provided by the same medical institution，Diagnosis of diseases as pneumonia obviously more economic income。In the case of the separation of diagnosis and treatment，The income of treatment is attributed to a third party，The diagnostic person diagnosed the upper respiratory tract infection and the intentional error was diagnosed as pneumonia (pneumonia will need more、More expensive treatment) cannot benefit directly，Therefore, there is no longer concealing the disease、motivation for exaggerating the diagnosis of the disease。It has been clear due to the diagnosis，and have a more certain therapeutic specification，Therefore, the therapy can only charge the treatment cost of upper respiratory tract infection，The cost of the treatment of pneumonia cannot be charged。

Another way to reduce information in medical services、The possible measure for excessive medical care is the opinions of other experts in the diagnosis and treatment process (or "second diagnosis")，That is, after the first diagnosis of the disease and giving treatment plan，When the situation allows，Please give the independent medical staff to give the judgment and suggestion of the illness and treatment plan again as a control。More studies show，The opinions of other experts are effective means to reduce medical fraud。Not all diseases need to seek secondary diagnosis，But for some more complicated、Diseases that are prone to improper treatment，Second diagnosis is considered to have obvious value。bet365 Play online games Studies show，The possibility of secondary diagnosis is enough to significantly reduce the incidence of excessive treatment，This effect is particularly obvious when the cost of introducing the second diagnosis of other experts。If it is said in tradition，Other experts may have higher costs，But when the development of artificial intelligence and remote medical technology，Make the second diagnosis cost control，Introduce the opinions of other types of diseases to other experts to reduce the improper behavior in medical services，It may be necessary、Feasible means。For example，Since 2016，For some surgery that is easily susceptible to excessive abuse，For example, spine surgery, etc.，German legislative requires that there are no cost -free expert opinions to these surgical procedures for free。Another example happened in Switzerland，Some insurance companies provide customers with a second opinion of 10 % to 15 % for customers who promise to seek second opinions before receiving certain types of surgery。

other，The reputation mechanism for the introduction of medical personnel is also considered to be able to reduce improper medical behavior to a certain extent。Studies show，The concern of medical staff about reputation may lead to more friendly patients，It can also reduce the excessive medical care and high charging problems of patients to a certain extent。But the reputation mechanism usually requires an competitive environment，That is, in a full competition environment，Reputation mechanism is particularly valid。

In short，For the medical service industry that greatly affects people's livelihood and is more contradictory，Perform targeted response on the basis of accurate grasp of its characteristics is necessary and beneficial。The above -mentioned laws、bet365 live casino games System or provides ideas for solving medical services，But it must also acknowledge that it exists more or less limitation，This also requires us to continue targeted surveys。

　(Author Unit: School of Law of Ocean University of China; School of Medicine Humanities, Peking University)