院长年薪制在全国多省份整体加速推进，但医生年薪制的推广仍面临质疑。 "对于医生薪酬体制改革，现在的问题不是医生诊疗积极性不高，也不是医生不愿意提供服务，而是医 生过于追求更多服务与更高费用，这在宏观层面导致医疗效率过低。" 国家卫健委近日也重申,"逐步提高基础薪酬等相对固定的稳定收入占比并建立动态调整机制""研究推进 动态缩小机构之间薪酬差距"。 强化固定收入为主的混合薪酬制，弱化经济激励导向 9月底，国家卫健委在一份对全国人大代表的建议答复中提到，为深化以公益性为导向的公立医院改 革，"鼓励公立医院结合本单位实际，采取多种方式自主确定更加有效的分配模式，在基本工资和国家 统一规定的津贴补贴基础上，优化基础性绩效工资和奖励性绩效工资比例，逐步提高基础薪酬等相对固 定的稳定收入占比并建立动态调整机制"。 长期以来，我国公立医院实施"岗位绩效工资制"，医务人员薪资由岗位工资、薪级工资、绩效工资、津 贴补贴四部分组成。其中，岗位工资和薪级工资为基本工资，绩效工资一般可细分为基础性绩效工资和 奖励性绩效工资两部分。 根据前述研究文章，一项2021年开展的行业调研显示，2020年，全国公立医院固定薪酬所占比例约为 41 ...

Core Insights - The article discusses the declining interest in studying clinical medicine in China, highlighting the low salaries and high pressures faced by doctors, which has led to a hesitance among students and parents regarding the medical profession [1][2][3] Group 1: Doctor's Salary and Work Conditions - The average annual salary for doctors in China varies significantly, with junior, intermediate, senior, and chief doctors earning average salaries of 143,000, 174,000, 218,000, and 265,000 yuan respectively [3] - In first-tier cities, senior doctors earn nearly double compared to their counterparts in county-level hospitals, with average clinical income for senior doctors in top-tier hospitals reaching 246,000 yuan [3][4] - The income disparity among different medical specialties is notable, with some specialties like orthopedics and plastic surgery offering significantly higher salaries compared to others like gastroenterology [5][6] Group 2: Medical Reform and Salary Structure - The "Sanming Medical Reform" initiative aims to stabilize doctors' incomes by increasing the proportion of fixed salaries, which has reportedly exceeded 50% of total compensation in some hospitals [1][10] - The implementation of a salary system for hospital directors is being promoted, with plans to extend this to doctors, aiming to improve overall compensation structures [10][13] - The average salary for hospital directors varies widely, with many earning less than 150,000 yuan annually, indicating a need for reform to ensure fair compensation [11][13] Group 3: Challenges Faced by Medical Professionals - Doctors face increasing pressures to publish research and achieve academic milestones to advance their careers, leading to a highly competitive environment [8][9] - The medical profession is experiencing a crisis of morale, with many young doctors feeling disillusioned due to low pay and high workloads, prompting some to leave the profession [5][7] - The ongoing crackdown on corruption in the medical field has created additional stress for senior doctors, who are often caught between ethical dilemmas and financial pressures [7][9]