健保制度下基層診所經營模式 —以『明安聯合診所』為例

Abstract

全民健保施行二十年來逐漸改變台灣的醫療環境，基層診所的經營環境日趨嚴峻。過去診所醫師只要專注看診，現在還得面健保給付不合理與同業競爭壓力。因此，基層診所的經營者如何在全民健保制度下發展一套能複製的經營模式，並能在市場競爭中持續發展就顯得相當重要。 本研究以『明安聯合診所』為研究對象。明安聯合診所設立於2009年，是一間以耳鼻喉、小兒科、家醫科、內科與婦產科為主的聯合診所。目前共有12間診所，主要位在新北市與台北市。在回顧全民健保發展、分析基層醫療產業現況、分析個案診所經營模式與個案診所內部優劣勢、外部機會與威脅後，本研究歸納出「醫病關係的經營、類連鎖加盟展店策略留住優秀醫師、經營自費門診」三個關鍵成功因素讓個案診所能在競爭激烈的基層醫療環境中得以成功複製其經營模式，並在七年間由一間診所擴展至十二間診所規模。 此外，本研究也提出下列結論供基層診所經營者診所營運參考：(一)基層診所經營日趨艱辛，需謹慎規劃發展策略與經營模式、(二)採取以病患為心中的經營模式、(三)診所經營需要全方面人才以面臨挑戰。藉以此研究分享給基層診所經營者未來發展方向之參考。

Taiwan's national health insurance (NHI) system has gradually changed the healthcare system in Taiwan over the past 20 years, which resulted in running clinics in Taiwan difficult for Taiwanese physicians. In addition to clinical practice, physicians have to face the challenge from NHI regulation changes and competition of the primary care. Therefore, it becomes critical to develop a business model which is repeatable and highly competitive. In this paper, we studied the case of Ming-An Clinic. Ming-An Clinic was founded in 2009, and it has multiple specialties including: ENT, Pediatrics, family medicine, general medicine, Obstetrics and Gynecology. Nowadays, Ming-An has set up 12 different clinics in Taipei. After reviewing NIH history and analyzing the present situation of Taiwan’s primary care and Ming-An Clinic’s case, we found 3 key successful factors that lead the clinic to succeed in competitive environment and setting up 12 clinics in 7 years. The successful factors are: maintain good doctor-patient relationship, provide physician retention program, and start self-paid clinic service. In addition, this study provided following 3 suggestions for primary care physicians (1) Running primary care clinics in Taiwan is getting difficult, therefore crafting a good strategy and a business model is necessary. (2) The business model must be patient-centric. (3) Running a primary care clinic needs talents who understand medical management, marketing, finance, talent management…etc.