National standards for accompanying patients will be implemented and service providers will be limited to institutions

After the implementation of national standards

What is the patient’s most immediate feeling?

Du Peng, Dean of the Health China Research Institute at Renmin University of China: The most direct feeling is that the sense of security when seeking medical treatment will be greatly improved. The national standard clarifies what medical attendants can and cannot do after receiving standardized training. There is such a yardstick. There are clear regulations on what the accompanying services provide, emergency plans during the accompanying process, how to strengthen communication with patients, and what red lines cannot be touched. This allows many people, especially the elderly, patients seeking medical treatment in other places, and patients with certain dementias to receive better protection. The ultimate beneficiaries of these regulations are the medical staff, which can greatly improve their sense of security in medical treatment.

Clarify that service providers are limited to “institutions”

What problem is intended to be solved?

Du Peng: I think it plays an important role in two aspects because it is oriented towards institutions rather than individuals. First, the institution has the relevant responsibilities to verify the qualifications of the medical attendants, train them, and purchase relevant insurance for them, so that the trained medical attendants can provide better services. On the other hand, before there were national standards, everyone would encounter three types of problems:

• The first type is that the scalpers gathered in the hospital will increase the price in the name of accompanying patients. In name, they are accompanying patients, but in fact they make money from this.
• The second type is that the medical attendants will misinterpret the diagnosis results, recommend drugs, and recommend treatment procedures because they have no training and are motivated to make money. If patients don’t understand it, they may take big detours and spend a lot more money.
• The third type is that the service items are not clear. It is unclear which services are provided and to what extent they are performed. When disputes arise, they do not know how to resolve them. The person accompanying the patient may simply run away. There is no responsible agency for these problems.

Therefore, the national standard clarifies that service providers are limited to “institutions”, which can better strengthen supervision, provide high-quality services, and better protect patients.

How does an accompanying clinician know what to do or not to do?

Du Peng: The 12-item positive list in the national standard for accompanying patients tells everyone what can be done, while the 7-item negative list is a red line that cannot be touched. Under the regulations, medical attendants can only provide auxiliary services, including accompanying patients to register, pick up medicines, etc., but they cannot make medical judgments. They cannot make judgments or mislead patients on things that the doctor has not mentioned just because they have traveled to the hospital too much. The 12 positive lists and 7 negative lists are clear provisions for the most common problems currently. Of course, new problems may be encountered during the implementation process, which can be continuously improved. But the most important contradictions and problems have been basically covered in the positive and negative lists.

For the grassroots, how to make the national standard truly come into effect?

Du Peng: There are still big differences in grassroots services between first- and second-tier cities and third- and fourth-tier cities, especially in rural areas. I think we still need to differentiate and accurately classify and promote the implementation of national standards. Classification can be divided into three types:

• The elderly in first- and second-tier cities have a great demand for medical treatment, high-quality medical resources are concentrated, and there is also a huge demand for accompanying doctors. Therefore, the first- and second-tier cities strictly implement the national standards for accompanying doctors.
• The elderly are the mainstay of medical treatment. The implementation of national standards for accompanying patients can be combined with subsidies and support measures for elderly care services to make services accessible and affordable. In other words, it is not a completely market-oriented behavior.
• In areas with relatively few medical resources, volunteer services and inclusive services, especially mutual aid services, are more encouraged during the medical treatment process. In the early stages, standards may not necessarily be implemented as strictly as in big cities, but there must still be training and corresponding emergency plans, including clarifying what can and cannot be done. The implementation can be different from that of first- and second-tier cities, and advocacy can be strengthened.

How can the accompanying medical service be truly inclusive?

Du Peng: I think we need to distinguish between basic services and market-oriented services. For example, for the elderly who live nearby, the prices of the services they need most can be relatively inclusive; but some elderly people need to go to farther places, across longer distances, or even need 24-hour services, and market prices can be combined accordingly. In this way, the overall price will not be pushed up because of a certain type of service, and more people can receive inclusive services more accurately.