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55-568: SRMC, along with its affiliated health services facilities and clinics , is one of the largest employers in Santa Rosa County, Florida, employing nearly 700 staff and volunteers, over 200 physicians. A group of Santa Rosa County citizens formed a County Hospital Board in 1951 which filed a Certificate of Organization for what would eventually become the Santa Rosa Medical Center. The initial hospital, known as Santa Rosa Hospital,

110-493: A polyclinic , it can house outpatient departments of some medical specialties, such as gynecology , dermatology , ophthalmology , otolaryngology , neurology , pulmonology , cardiology , and endocrinology . In some university cities , polyclinics contain outpatient departments for the entire teaching hospital in one building. Large outpatient clinics are a common type of healthcare facility in many countries, including France, Germany (long tradition), Switzerland, and most of

165-465: A specialist clinic. Some clinics retain the name "clinic" even while growing into institutions as large as major hospitals or becoming associated with a hospital or medical school . The word clinic derives from Ancient Greek κλίνειν klinein meaning to slope, lean or recline. Hence κλίνη klinē is a couch or bed and κλινικός klinikos is a physician who visits his patients in their beds. In Latin, this became clīnicus . An early use of

220-791: 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

275-614: 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. To become

330-462: A different job. The top three reasons that lead many physicians in Beijing to quit include: doctors are not well paid; hospitals are poorly managed; and there are not enough personal development opportunities. For a government-controlled hospital, the hospital is still operated and managed by a management team under the leadership of the president of the hospital, who is usually nominated and appointed by

385-437: A first step in improving child morbidity and mortality in difficult-to-reach rural areas." Food supplementation in the context of routine mobile clinic visits also shows to have improved the nutritional status of children, and it needs further exploration as a way to reduce childhood malnutrition in resource-scarce areas. A cross-sectional study focussed on comparing acute and chronic undernutrition rates prior to and after

440-767: A food-supplementation program as an adjunct to routine health care for children of migrant workers residing in rural communities in the Dominican Republic. Rates of chronic undernutrition decreased from 33% to 18% after the initiation of the food-supplementation program and shows that the community members attending the mobile clinics are not just passively receiving the information but are incorporating it and helping keep their children nourished. There are many different types of clinics providing outpatient services. Such clinics may be public (government-funded) or private medical practices. Medicine in China In China ,

495-444: A government controlled hospital. But with the reforming of the medical service sector, both physicians and hospitals have more freedom in choosing each other. Young physicians usually have an employment contract with the hospital they work with, and a person can quit at will. The hospital can also lay off the individual if it is not satisfied with the employees performance or morality. It is not uncommon for physicians to quit and take

550-619: A hospital, but support workers are a problem. Some hospitals hire skill-less "underground" labors and after giving them some simple training use them as hospital support workers. These workers, mostly originating from rural areas, are poorly paid by those hospitals. To secure the quality of hospital services, Beijing recently has passed a regulation on training and hiring qualified hospital support workers. In Tianjin, China's third largest city, about 1,000 unemployed people have been trained by local authority and passed hospital support work test. These people returned to work as certified support staff of

605-571: A hotline has been set up to monitor physicians. 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

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660-451: A local general practice run by a single general practitioner provides primary health care and is usually run as a for-profit business by the owner, whereas a government-run specialist clinic may provide subsidized or specialized health care. Some clinics serve as a place for people with injuries or illnesses to be seen by a triage nurse or other health worker . In these clinics, the injury or illness may not be serious enough to require

715-707: A medical doctor, a person needs to study for 5 years at a medical school. For foreign or international students, the person needs to study for 6 years at the medical school, namely because the Chinese version is accelerated. Also, international students have to prepare for and take the Hanyu Shuiping Kaoshi for admission, and during med school, the Medical Chinese Exam. After graduation, the newly minted physician needs to complete 2–3 years of residency training, including training for subspecialty. Upon graduation,

770-476: A number of big hospitals. One needs to study at a nursing school for around three years before being eligible to work as a nurse. Most nursing schools enroll middle school graduates (Grade 9) and senior high school graduates (Grade 12), and they run four-year and three-year programs respectively. A bachelor's degree in nursing has been available since late 1980s and early 1990s in China. Many medical schools including

825-427: A restriction, and some of them have tried all means to lure away prescription drugs buyer from hospitals. For instance, they offer to pay drug buyers half a dollar for each prescription the buyers brought to the drug stores. Normally a prescription is effective on the day it is issued, but it can be effective within three days of prescription under certain conditions. Physicians used to be hired as full-time employees at

880-654: A small percentage of their monthly incomes. By 1901, China was the most popular destination for medical missionaries. The 150 foreign physicians operated 128 hospitals and 245 dispensaries, treating 1.7 million patients. In 1894, male medical missionaries comprised 14 percent of all missionaries; women doctors were four percent. Modern medical education in China started in the early 20th century at hospitals run by international missionaries. Today Universities, colleges and institutes, which make up China's higher educational system, offer four- or five-year undergraduate programs as well as special two- or three-year programs. To control

935-399: A state-run-enterprise owned AAA hospital (the highest standard), and the acquisition was the first of this kind in China. The investment company plans to buy 10 hospitals in the next three to five years. In Fuzhou , the capital city of Fujian province, four government-owned hospitals have been sold to private investors. Nurses are normally well trained before being eligible for working with

990-456: A visit to an emergency room (ER), but the person can be transferred to one if needed. Treatment at these clinics is often less expensive than it would be at a casualty department. Also, unlike an ER these clinics are often not open on a 24/7/365 basis. They sometimes have access to diagnostic equipment such as X-ray machines, especially if the clinic is part of a larger facility. Doctors at such clinics can often refer patients to specialists if

1045-573: Is a health facility that is primarily focused on the care of outpatients . Clinics can be privately operated or publicly managed and funded. They typically cover the primary care needs of populations in local communities, in contrast to larger hospitals which offer more specialized treatments and admit inpatients for overnight stays. Most commonly, the English word clinic refers to a general practice , run by one or more general practitioners offering small therapeutic treatments, but it can also mean

1100-407: Is provided to those regions' vast rural areas by mobile health clinics or roadside dispensaries , some of which integrate traditional medicine . In India these traditional clinics provide ayurvedic medicine and unani herbal medical practice. In each of these countries, traditional medicine tends to be a hereditary practice. The function of clinics differs from country to country. For instance,

1155-817: 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. 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 . At government-controlled hospitals, physicians are salaried employees. Salaries are based on working experience and professional level. Some hospitals also pay

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1210-453: The healthcare department of a province , a city or a county . But for a private hospital or a publicly traded hospital, the ownership is the same as that of a private company or a public company. There are two types of hospitals in China – for-profit and non-profit . Profit-oriented hospitals may distribute their profit. Non-profit hospitals are government-owned, and will turn earnings into additional infrastructure or hand them back to

1265-545: The Basic Medical Insurance System. Only about 120 million to 180 million workers have some form of healthcare coverage that will pay for Western pharmaceuticals, according to industry analysts. Farmers, who make up the vast majority of Chinese, have no real coverage at all. The Chinese government used to cover up to 100% of medical fees for employees working with government agencies, state-owned enterprises, or educational organizations, but peasants didn't enjoy

1320-619: The Santa Rosa County Commissioners began drafting proposals for a new hospital on a new site. The proposed 4-floor facility included over 100,000 square feet (9,300 m) of diagnostic and treatment space. Funding was acquired and construction began at the hospital's current Berryhill Road location in Milton, Florida. The new $ 4.5 million, 153-bed county-owned facility opened in December 1972 with approximately 300 employees. In 1985,

1375-465: The School of Medicine of Beijing University offer five-year programs in nursing. Most hospitals are located at downtown areas due to people's reliance on public transportation in China. More than 80% of Chinese medical resources are concentrated in urban areas, and the rest in rural areas. The government, employers, and individuals pay for healthcare. In December 1998, a national medical insurance scheme

1430-803: The State-owned enterprise (SOE) and collective insurance. This system has reimbursed 100 percent of employees' medical costs, and 50 percent of family members' costs. The system has been funded, in name at least, by the enterprises. Hoping to reduce enterprise subsidies of all types, the State Council launched pilot reforms in 1994 of the two health insurance systems under its control. Begun in two midsize cities, Jiujiang, Jiangxi Province , and Zhenjiang , Jiangsu Province, and expanded to over 60 cities in 1997, this experiment has become national policy, applicable to domestic and foreign-invested firms. The two State health insurance systems would later be consolidated to be

1485-490: The basic medical insurance drug list, the State Scheme Drug List for Basic Medical Insurance, which is based on clinical need, safety and efficacy, reasonable pricing, ease of use, and the desire to maintain a balance between Western and TCM products. The basic medical insurance and at-work injury insurance of 2004 cover 832 traditional Chinese medicines, up from 415 of 2000; the number of chemical medicines covered by

1540-470: The basic medical scheme, which aims to control expenses on drugs, specifies drugs that are covered by the scheme and eligible for reimbursement. As the government-driven drug price regulation mechanism and the centralized tendering drug procurement program are only applicable to the drugs covered by the scheme, the scheme undoubtedly plays a crucial role in the development of the drug industry. The basic insurance plan does not reimburse expenses for drugs not on

1595-492: The basic plan. For example, for employees of foreign enterprises in Beijing hired through Foreign Enterprises Service Corp. (FESCO), foreign enterprises pay FESCO, and FESCO then buys insurance policies for these employees. The government also allows commercial health insurers to operate in China. In 2004, 119.41 million people had basic medical insurance. Revenues of basic medical insurance funds reached $ 91 billion, and payments were $ 74 billion. The qualified drug catalogue under

1650-526: The benefits of this scheme, which is considered a shortcoming of the social medical insurance scheme. The National Basic Medical Insurance Scheme ensures basic medical access by the public under the social security system. Individuals pay an annual insurance premium for their basic medical treatment entitlements. This scheme has replaced the previous government-funded labor insurance medical system. Foreign-invested enterprises are required to provide health insurance benefits, but are not required to participate in

1705-424: The coast became "artificial" communities, and due to lack of traditional home healing practices here, alternative methods such as mobile clinics had to be implemented in these communities for the protection and prevention of diseases. A study done in rural Namibia revealed the health changes of orphans, vulnerable children and non-vulnerable children (OVC) visiting a mobile clinic where health facilities are far from

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1760-501: The countries of Central and Eastern Europe (often using a mixed Soviet-German model), as well as in former Soviet republics such as Russia and Ukraine; and in many countries across Asia and Africa. In Europe, especially in the Central and Eastern Europe, bigger outpatient health centers, commonly in cities and towns, are called policlinics (derived from the word polis, not from poly-). Recent Russian governments have attempted to replace

1815-414: The country which will benefit about 33 lakh (3.3 million) ex-servicemen residing in remote and far-flung areas. Policlinics are also the backbone of Cuba's primary care system and have been credited with a role in improving that nation's health indicators. Providing health services through mobile clinics provides accessible healthcare services to these remote areas that have yet to make their way in

1870-900: The county leased the management of the hospital to the for-profit corporation, Hospital Corporation of America, Inc. and the name was changed to the Santa Rosa Medical Center. Since then, the several firms have leased and managed the facility. The facility has been managed by CHS, since the company purchased Health Management Associates, Inc. in 2013. According to the hospital's website, the facility holds several accreditations and its employed physicians group, Santa Rosa Medical Group, offers multiple specialty care service lines, including: cardiology, urology, family medicine, obstetrics & gynecology, neurology, pulmonology, orthopedics, general surgery, allergy and ENT services. 30°38′03″N 87°04′01″W  /  30.6342°N 87.06708°W  / 30.6342; -87.06708 Clinic A clinic (or outpatient clinic or ambulatory care clinic )

1925-544: The fifth largest market following Japan . AstraZeneca now ranks as the No. 1 foreign brand in terms of prescription sales in the Chinese market. Physicians control the distribution of prescription drugs. Some hospitals and clinics stipulate patients must buy prescription drugs from the hospitals or directly from the physicians who make the prescriptions. Such a restriction aims to prevent the loss of sales on prescription drugs to retailers, but retailing drug stores are unhappy with such

1980-762: The graduate must work as a resident physician for few years to be eligible to take a National Medical Licensing Examination (NMLE) for physician certification. This examination is conducted by the National Medical Examination Center (NMEC). Without approval of registration by the Ministry of Health one can not practice medicine in China as a physician or assistant physician. American type of residency training has not been implemented nationwide in Chinese hospitals though almost all hospitals require their physicians to be trained as resident for few years before promotion to attending. American type of residency program

2035-505: 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. Influenced by

2090-475: The insurance systems increase from 725 to 1031 from year 2000 to 2004, some of which are patent-protected drugs of Western companies. Sino-Generali Life Insurance, a joint venture between China and Italy companies, offers a commercial medical insurance that reimburses 80% of prescription drugs, with an annual maximum reimbursement of $ 1000 per policy. Before the reform of healthcare system, roughly 140 million workers and 60 million family members were covered under

2145-517: The medical field: for example, legal clinics are run by lawyers .) Some clinics are operated in-house by employers, government organizations, or hospitals, and some clinical services are outsourced to private corporations which specialize in providing health services. In China , for example, owners of such clinics do not have formal medical education. There were 659,596 village clinics in China in 2011. Health care in India , China , Russia and Africa

2200-400: The need arises. Large outpatient clinics vary in size, but can be as large as hospitals. Typical large outpatient clinics house general medical practitioners (GPs) such as doctors and nurses to provide ambulatory care and some acute care services but lack the major surgical and pre- and post-operative care facilities commonly associated with hospitals. Besides GPs, if a clinic is

2255-506: 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

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2310-475: The plan. According to a news report, 44.8% of urban residents and 79.1% of rural residents have no medical insurance. } Many of people are private payers. They either cannot afford to buy medical insurance, or do not understand the value of medical insurance. In contrast to rural residents, urban residents have much better situation. Many employers have bought for their employees group or supplementary medical insurance, and employers deduct from employees' payrolls

2365-548: The policlinic model introduced during Soviet times with a more western model. However, this has failed. In the Czech Republic , many policlinics were privatized or leasehold and decentralized in the post-communist era: some of them are just lessors and coordinators of a healthcare provided by private doctor's offices in the policlinic building. India has also set up huge numbers of polyclinics for former defense personnel. The network envisages 426 polyclinics in 343 districts of

2420-461: The policy. Starting from 2001, a new medical coverage plan took effect, marking the government's withdrawal from shouldering whole medical insurance burden. Under the policy, urban residents must join a government managed basic insurance coverage plan for urban residents and pay a certain amount of monthly fees based on their income levels, and up to 70% of their medical expenses can be reimbursed. So far around 100 million urban residents are covered by

2475-522: The politicized space. For example, mobile clinics have proved helpful in dealing with new settlement patterns in Costa Rica. Before foreign aid organizations or the state government became involved in healthcare, Costa Rica's people managed their own health maintenance and protection. People relied on various socio-cultural adaptations and remedies to prevent illnesses, such as personal hygiene and settlement patterns. When new settlements that sprang up along

2530-427: 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

2585-658: 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. 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

2640-585: The remaining 15% going to drug stores. Stripping out the government's subsidies , all government-subsidized hospitals would have been in the red. This poor operating performance can be partially due to that non-profit hospitals have little incentive to control costs, given the government's subsidies. In 2000, a reform started to occur in the Chinese hospital system. Government owned hospitals are being restructured, some of them being sold to individual investors, and more and more private hospitals are founded. In 2004, Beijing Aikang Medical Investment Company bought

2695-445: The remote villages. Over 6 months, information on immunization status, diagnosis of anemia, skin and intestinal disorders, nutrition, dental disorders was collected and showed that visits to mobile clinics improved the overall health of children that visited regularly. It concluded that specified "planning of these programs in areas with similarly identified barriers may help correct the health disparities among Namibian OVC and could be

2750-613: The respective government authorities. Non-profit hospitals also enjoy preferential tax treatment and several government subsidies. They also get low-cost financing from the government for their capital investment. By the end of 2002, China has 306,000 healthcare and medical organizations, 63,858 of which are hospitals and clinics, 219,907 of which are nursing homes and 22,270 fall into other categories. Among them, only 1% are for profit, although all non-profit hospitals and clinics also rely on profits of selling drugs and treatments. Drug sales from hospitals account for 85% of total drug sales, with

2805-440: The training process in a specialty hospital or in a subspecialty at a general hospital. Some medical experts have called for a standardized training and testing system for specialty physicians in accordance to American system. The classification of specialties at a Chinese hospital is similar to that at a U.S. hospital. According to BCG's prediction in 2002, China's prescription drug market is expected to reach $ 24 billion and become

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2860-449: The word clinic was "one who receives baptism on a sick bed". Clinics are often associated with a general medical practice run by one or several general practitioners . Other types of clinics are run by the type of specialist associated with that type: physical therapy clinics by physiotherapists and psychology clinics by clinical psychologists , and so on for each health profession. (This can even hold true for certain services outside

2915-455: Was chartered as a non-profit hospital , to be operated and managed by the county. Construction began in mid-1951 and on December 2, 1952, the first patients were admitted. The hospital was located on Stewart Street in Milton. It was expanded in 1963 and again in 1966. According to the hospital's website, local growth and population needs were exceeding the capabilities of the 100-bed facility by 1970. The Santa Rosa Hospital Board of Directors and

2970-441: Was launched by the State Council. By end of 2002, most of the county or above level cities had joined the scheme and covered a population of about 100 million. Social Insurance Fund Administration Centre, a department of the Ministry of Labor and Social Security, oversees this insurance system. Currently, this system only focuses on employees of enterprises at or above township level. Those in remote or less developed areas cannot enjoy

3025-469: Was launched in some University affiliated hospitals. These students will complete their MD study and have to pass the national certification test during the residency. There are general hospitals and specialty hospitals. A medical graduate rotates through several departments and then assigned to a specialty department according to his or her strengths and the hospital's needs. Specialty physician usually are attendings who specialized in certain specialty during

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