Skip to main content
Top
Published in: Human Resources for Health 1/2018

Open Access 01-12-2018 | Research

The trend and features of physician workforce supply in China: after national medical licensing system reform

Authors: Chengxiang Tang, Daisheng Tang

Published in: Human Resources for Health | Issue 1/2018

Login to get access

Abstract

Background

The annual number of newly licensed physicians is an important indicator of medical workforce supply, which can accurately reflect an inflow into the health care market over a period. In order to both regulate medical professions and improve the quality of health care services, China established its medical licensing system from the point of the implementation of ‘Law on Practising Doctors’ in 1999. The objective of this study is to depict the trend and structure of newly licensed physicians thereafter.

Methods

This study analyses a unique census data set that provides the headcount of newly licensed physicians from 2005 to 2015 in China. We also review a short history of medical licensing system reform in China since the 1990s.

Results

The annual number of first-time licensed physicians in China increased from 159 489 in 2005 to 221 639 in 2015. Up to 2015, over half of newly licensed physicians had not received a medical education equivalent to a bachelor degree or higher. Around 51% of China’s newly licensed physicians were female in 2005, while the same ratio for females in 2015 was 56%.

Conclusion

This article first provides an exploratory analysis of physician inflow into health care market in China using physician licensing data. The medical licensing system in China allows entering physicians with a broad range of educational levels. Moreover, the feminisation of the physician supply in China has become increasingly apparent and its impacts on health care provision still require more rigorous examination.
Footnotes
1
Licensing doctors includes four categories: clinical physicians, dentists, public health physicians and Traditional Chinese Medicine (TCM) doctors. This study did not include TCM physicians as they were categorized under CAM (Complementary and Alternative Medicine). Please refer to http://​www.​gov.​cn/​banshi/​2005-08/​02/​content_​19310.​htm
 
Literature
1.
go back to reference Chopra M, Munro S, Lavis JN, Vist G, Bennett S. Effects of policy options for human resources for health: an analysis of systematic reviews. Lancet. 2008;371:668–74.CrossRef Chopra M, Munro S, Lavis JN, Vist G, Bennett S. Effects of policy options for human resources for health: an analysis of systematic reviews. Lancet. 2008;371:668–74.CrossRef
2.
go back to reference Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376:1923–58.CrossRef Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376:1923–58.CrossRef
3.
go back to reference Anand S, Fan VY, Zhang J, Zhang L, Ke Y, Dong Z, et al. China’s human resources for health: quantity, quality, and distribution. Lancet. 2008;372:1774–81.CrossRef Anand S, Fan VY, Zhang J, Zhang L, Ke Y, Dong Z, et al. China’s human resources for health: quantity, quality, and distribution. Lancet. 2008;372:1774–81.CrossRef
4.
go back to reference Kleiner MM. Battling over jobs: occupational licensing in health care. Am Econ Rev. 2016;106:165–70.CrossRef Kleiner MM. Battling over jobs: occupational licensing in health care. Am Econ Rev. 2016;106:165–70.CrossRef
5.
go back to reference Stordeur S, Léonard C. Challenges in physician supply planning: the case of Belgium. Hum Resour Health. 2010;8:28.CrossRef Stordeur S, Léonard C. Challenges in physician supply planning: the case of Belgium. Hum Resour Health. 2010;8:28.CrossRef
6.
go back to reference Young A, Chaudhry HJ, Rhyne J, Dugan M. A census of actively licensed physicians in the United States, 2010. Journal of Medical Regulation. 2013;99:11–24. Young A, Chaudhry HJ, Rhyne J, Dugan M. A census of actively licensed physicians in the United States, 2010. Journal of Medical Regulation. 2013;99:11–24.
7.
go back to reference Hooker RS, Muchow AN. The 2013 census of licensed physician assistants. JAAPA. 2014;27:35–9.CrossRef Hooker RS, Muchow AN. The 2013 census of licensed physician assistants. JAAPA. 2014;27:35–9.CrossRef
8.
go back to reference Chi W, Kleiner M, Qian X. Do occupational regulations increase earnings? The influence of professional certification and licensing on wage determination in China. Industrial relations 2017. Chi W, Kleiner M, Qian X. Do occupational regulations increase earnings? The influence of professional certification and licensing on wage determination in China. Industrial relations 2017.
9.
go back to reference Chi W, Freeman R, Li H. Adjusting to Really Big Changes: The Labor Market in China, 1989–2009. New York: Springer, 2012:93-113.CrossRef Chi W, Freeman R, Li H. Adjusting to Really Big Changes: The Labor Market in China, 1989–2009. New York: Springer, 2012:93-113.CrossRef
10.
go back to reference Appleton S, Song L, Xia Q. Has China crossed the river? The evolution of wage structure in urban China during reform and retrenchment. J Comp Econ. 2005;33:644–63.CrossRef Appleton S, Song L, Xia Q. Has China crossed the river? The evolution of wage structure in urban China during reform and retrenchment. J Comp Econ. 2005;33:644–63.CrossRef
11.
go back to reference Knight J, Song L. Increasing urban wage inequality in China. Economics of Transition. 2003;11:597–619.CrossRef Knight J, Song L. Increasing urban wage inequality in China. Economics of Transition. 2003;11:597–619.CrossRef
14.
go back to reference Boulet J, Zanten M. Ensuring high-quality patient care: the role of accreditation, licensure, specialty certification and revalidation in medicine. Med Educ. 2014;48:75–86.CrossRef Boulet J, Zanten M. Ensuring high-quality patient care: the role of accreditation, licensure, specialty certification and revalidation in medicine. Med Educ. 2014;48:75–86.CrossRef
15.
go back to reference Leland HE. Quacks, lemons, and licensing: a theory of minimum quality standards. J Polit Econ. 1979;87:1328–46.CrossRef Leland HE. Quacks, lemons, and licensing: a theory of minimum quality standards. J Polit Econ. 1979;87:1328–46.CrossRef
16.
go back to reference Swanson DB, Roberts TE. Trends in national licensing examinations in medicine. Med Educ. 2016;50:101–14.CrossRef Swanson DB, Roberts TE. Trends in national licensing examinations in medicine. Med Educ. 2016;50:101–14.CrossRef
17.
go back to reference Gao T, Shiwaku K, Fukushima T, Isobe A, Yamane Y. Medical education in China for the 21st century. Med Educ. 1999;33:768–73.CrossRef Gao T, Shiwaku K, Fukushima T, Isobe A, Yamane Y. Medical education in China for the 21st century. Med Educ. 1999;33:768–73.CrossRef
18.
go back to reference Hou J, Michaud C, Li Z, Dong Z, Sun B, Zhang J, et al. Transformation of the education of health professionals in China: progress and challenges. Lancet. 2014;384:819–27.CrossRef Hou J, Michaud C, Li Z, Dong Z, Sun B, Zhang J, et al. Transformation of the education of health professionals in China: progress and challenges. Lancet. 2014;384:819–27.CrossRef
19.
go back to reference Zhu J, Li W, Chen L. Doctors in China: improving quality through modernisation of residency education. The Lancet 2016;10054:1922.CrossRef Zhu J, Li W, Chen L. Doctors in China: improving quality through modernisation of residency education. The Lancet 2016;10054:1922.CrossRef
20.
go back to reference Lien SS, Kosik RO, Fan AP, Huang L, Zhao X, Chang X, et al. 10-year trends in the production and attrition of Chinese medical graduates: an analysis of nationwide data. Lancet. 2016;388:S11.CrossRef Lien SS, Kosik RO, Fan AP, Huang L, Zhao X, Chang X, et al. 10-year trends in the production and attrition of Chinese medical graduates: an analysis of nationwide data. Lancet. 2016;388:S11.CrossRef
23.
go back to reference Arrow KJ. Uncertainty and the welfare economics of medical care. The American economic review 1963; 53:941-73. Arrow KJ. Uncertainty and the welfare economics of medical care. The American economic review 1963; 53:941-73.
25.
go back to reference Sylvia S, Shi Y, Xue H, Tian X, Wang H, Liu Q, et al. Survey using incognito standardized patients shows poor quality care in China’s rural clinics. Health Policy Plann. 2015;30:322–33.CrossRef Sylvia S, Shi Y, Xue H, Tian X, Wang H, Liu Q, et al. Survey using incognito standardized patients shows poor quality care in China’s rural clinics. Health Policy Plann. 2015;30:322–33.CrossRef
26.
go back to reference Flexner A. Medical education in the United States and Canada: a report to the Carnegie Foundation for the Advancement of Teaching. New York, 1910. Flexner A. Medical education in the United States and Canada: a report to the Carnegie Foundation for the Advancement of Teaching. New York, 1910.
27.
go back to reference Crossley TF, Hurley J, Jeon S. Physician labour supply in Canada: a cohort analysis. Health Econ. 2009;18:437–56.CrossRef Crossley TF, Hurley J, Jeon S. Physician labour supply in Canada: a cohort analysis. Health Econ. 2009;18:437–56.CrossRef
28.
go back to reference McKinstry B, Colthart I, Elliott K, Hunter C. The feminization of the medical work force, implications for Scottish primary care: a survey of Scottish general practitioners. BMC Health Serv Res. 2006;6:56.CrossRef McKinstry B, Colthart I, Elliott K, Hunter C. The feminization of the medical work force, implications for Scottish primary care: a survey of Scottish general practitioners. BMC Health Serv Res. 2006;6:56.CrossRef
29.
go back to reference Koike S, Matsumoto S, Kodama T, Ide H, Yasunaga H, Imamura T. Estimation of physician supply by specialty and the distribution impact of increasing female physicians in Japan. BMC Health Serv Res. 2009;9:180.CrossRef Koike S, Matsumoto S, Kodama T, Ide H, Yasunaga H, Imamura T. Estimation of physician supply by specialty and the distribution impact of increasing female physicians in Japan. BMC Health Serv Res. 2009;9:180.CrossRef
30.
go back to reference Hedden L, Barer ML, Cardiff K, McGrail KM, Law MR, Bourgeault IL. The implications of the feminization of the primary care physician workforce on service supply: a systematic review. Hum Resour Health. 2014;12:32.CrossRef Hedden L, Barer ML, Cardiff K, McGrail KM, Law MR, Bourgeault IL. The implications of the feminization of the primary care physician workforce on service supply: a systematic review. Hum Resour Health. 2014;12:32.CrossRef
31.
go back to reference Russo G, Gonçalves L, Craveiro I, Dussault G. Feminization of the medical workforce in low-income settings; findings from surveys in three African capital cities. Hum Resour Health. 2015;13:64.CrossRef Russo G, Gonçalves L, Craveiro I, Dussault G. Feminization of the medical workforce in low-income settings; findings from surveys in three African capital cities. Hum Resour Health. 2015;13:64.CrossRef
Metadata
Title
The trend and features of physician workforce supply in China: after national medical licensing system reform
Authors
Chengxiang Tang
Daisheng Tang
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2018
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-018-0278-8

Other articles of this Issue 1/2018

Human Resources for Health 1/2018 Go to the issue