Perceptions of permitting physician dual practice with restrictions: empirical evidence of public hospital managers from East, Middle and West of China

Background: This study aims to explore public hospital managers’ perceptions of permitting Physician dual practice (PDP) with restrictions in China. Methods: : A cross-sectional study among 1,513 public hospital managers in 31 provinces of mainland China was carried out from January to October, 2019. Presidents in charge of medical affairs, and directors of medical affairs departments in Chinese public hospitals were recruited for this study. Exploratory factor analysis (EFA) was conducted to determine the factorial validity of perceptions of permitting physician dual practice with restrictions (institution-oriented restriction, IR; physician-oriented restriction, PR). Generalized linear models (GLM) were used to explore and analyze perceptions of permitting PDP with restrictions of public hospital managers with demographic and working-related characteristics. Results: : Public hospital managers’ decision of prohibiting PDP, allowing PDP, and implementing PDP with restrictions was 5.7%, 8.9%, 85.4%, respectively. Mean scores of IR and PR were 16.49 ± 3.03 and 10.84 ± 2.55 respectively. General hospital managers (coefficient of -0.52; P <.01) showed less preference to IR; managers from public hospitals in the West (coefficient of 0.77; P <.01) and Middle of China (coefficient of 0.50; P <.05) favoured IR; managers with academic background of clinical medicine (coefficient of -0.37; P <.05) held lower PR intention. On the contrary, female managers (coefficient of 0.54; P <.01) and managers from public hospitals in non-provincial capital cities (coefficient of 0.35; P <.05) preferred PR. Conclusions: : From the perspectives of the public hospital managers in China, permitting PDP with restrictions would be feasible compared to completely prohibiting or allowing PDP, which could be further enforced in terms of IR and PR. Moreover, public hospital managers hold a slightly more positive view about IR than PR.