medicine in china medicine in china in china, the practice of medicine is a mixture of government, charitable, and private institutions, while many people rely on traditional medicine. until reforms in the late twentieth and early twenty-first century, physicians were quasi-government employees and with little freedom in the choice of the hospital to work with. in addition, decades of planned economic policy discouraged physicians from opening their own clinics, and the practice of medicine was generally under the control of local units, such as factories, government, offices, or communes. the reforms created a largely private practice, and physicians now are encouraged to open private clinics and for-profit hospitals. chinese medical association the chinese medical association is the largest and oldest non-governmental medical organization in china. it was established by a group of medical professionals in 1915 with an aim to uniting medical professionals, upholding medical ethics and advocating social integrity. it currently counts over 430,000 members and 82 specialty societies. it publishes over 70 medical journals wa (including the chinese medical journal), as well as a medical bulletin and a medical education magazine. the cma plays a leading and active role in the nation's medical education, training and professional exchanges. chinese academy of medical sciences main article: peking union medical college from 1957, peking union medical college is merged into the chinese academy of medical sciences as one single institution directly under the ministry of health, now the national health commission. physicians physician compensation at government-controlled hospitals, physicians are salaried employees. salaries are based on working experience and professional level. some hospitals also pay a bonus to physicians according to the hospital's operating performance and the physician's contributions. physicians' salaries vary greatly. for those working at busy and well-known hospitals, their base salaries can be a few times as much as those of physicians working at low-ranking hospitals. chinese hospitals are classified into three general levels, with level 3 at the top and level 1 at the bottom. each level has sub-levels of a, b, and c. some elite hospitals are even rated 3a+. for many physicians, in particular those at big hospitals, specialty hospitals, or hospitals with large reputations, physician incomes can be larger than regular hospitals. physicians, and in particular, surgeons, can augment their hospital salaries by conducting surgeries at hospitals other than the ones in which they are employed. many physicians also receive commissions from prescribing prescription drugs and get "red envelopes" from patients (patients give money or gifts to their physicians for receiving treatment) or from sales representatives of drug companies. new regulations issued by the health ministry, however, remove physicians from the practice of medicine if they are found to have taken "red envelopes" from patients, and a hotline has been set up to monitor physicians. social status in china, physicians are well respected, but as a group they are not at the top of the social structure of the country because their incomes fall in the middle class. according to a ph.d. candidate at a u.s. public health school, who was a physician at a well-known 3a hospital in beijing, like other junior physicians, she seldom received “red envelopes” from patients, and only senior physicians or physicians with fame would have such opportunities. the student said those senior physicians had become members of the high-income class. like the student, many physicians, went abroad to study because they were not satisfied with their status. according to a 2002 statistics from beijing physicians association, between 2000 and 2001, in beijing about 2300 physicians resigned, and most of them went to work as sales representatives of drug companies. some still practice medicine but work with privately owned hospitals rather than public hospitals. competitive pressure for hospitals influenced by a centrally-planned economy, many hospitals were managed as government agencies rather than medical service organizations. hospitals did not have competition pressures. the management team usually did not recognize the importance of developing and retaining high skilled physicians. administrative personnel were more powerful than physicians at a hospital. however, with the reform of the medical sector, chinese hospitals are facing increasing competition from privately owned and foreign-investment-backed hospitals. physicians are expected to enjoy higher legal income and better social status. physician training