Why do some doctors say that they have to go to the outside pharmacy to get some medicine after it is prescribed?

Of course, there are many possibilities, which may be that doctors are taking kickbacks, or that hospitals really don't have this medicine, because of relevant policies, or because of the need to control medical insurance costs. ?

First of all, I don't know if you have heard of a new name: zero price increase, which means that the current medical reform requires hospitals to implement zero price increase for drugs, that is, the purchase price of drugs is the sales price, and the amount of drugs purchased by hospitals is how much they sell to patients, so drugs are not profitable for hospitals. However, from the perspective of hospital management, in the process of transportation, storage, storage, sub-packaging and use of drugs, the more drugs sold in hospitals, the higher the cost and the more money lost. Therefore, restricting doctors from prescribing drugs on their own has become a helpless choice for hospital management. In this way, some drugs have been transferred to pharmacies in society. After doctors prescribe drugs, patients can go to pharmacies in the society to buy them, and accordingly, the proportion of drugs sold in hospitals has also decreased. At the same time, after the zero price increase of drugs, hospitals were forced to reduce the variety of drugs, and many drug hospitals did not have them at all, which also caused some drugs to be purchased outside the hospital.

Secondly, the centralized drug procurement system in public hospitals has been implemented for more than ten years. This paper does not evaluate the advantages and disadvantages of this system, but it is an objective fact, because the implementation of low-price bidding has led some pharmaceutical manufacturers to control costs at the expense of reducing drug quality in order to win the bid. The question is, is low price necessarily a good medicine? Must it be an effective drug? In fact, in this way, the drugs that won the bid may not be absolutely guaranteed to be urgently needed and effective in clinic, and the drugs that have been proved to be effective and reasonable in clinic may not be able to win the bid. So some doctors will ask patients to buy the drugs they need outside the hospital.

Third, it is the need of medical insurance cost control.

I don't know if you have heard of another new term: the proportion of drugs, that is, the proportion of the purchase cost of drugs to the total cost of patients during the process of seeing a doctor.

At present, the hospital's quota is that the proportion of drugs does not exceed 30%. For example, if a doctor wants to prescribe 30 yuan for a patient, he must also prescribe 70 yuan for examination and treatment to avoid exceeding the standard, otherwise some drugs will be purchased outside the hospital. In this way, his medical expenses will not be included in the medical insurance, and he will not be punished for exceeding the standard (if the proportion of drugs exceeds the standard, the doctor will deduct it from his salary). In order to control the proportion of drugs, many hospitals have to stop taking drugs and remove some auxiliary drugs from hospitals. Although it is an auxiliary drug, due to the patient's condition, some drugs need to be used, which also makes doctors ask patients to buy drugs outside the hospital. On the surface? Drug ratio? There are great restrictions on the control of overuse of doctors' prescriptions, especially the use of high-priced drugs. But the proportion of drugs is limited to hospitalized patients. Once there is no medicine available, patients can only go to outpatient clinics, other hospitals or pharmacies to buy medicine.

Fourth, some drugs are not included in the scope of medical insurance reimbursement.