Instead of narrowing, the gap between talent supply and demand has widened, forming a major pain point in the development of the rehabilitation medical industry, and also hitting the enthusiasm of new blood who want to devote themselves to the rehabilitation field.
Source: Diagnostics
Author: Lingxing
Cover source: pixabay
On June 22, Rehabilitation University, the first university named after rehabilitation in mainland China, was officially unveiled.
According to public information, Rehabilitation University is a public ordinary undergraduate school, which is led by the Shandong Provincial Government and supervised by the Provincial Department of Education. Positioned as a new type of research university, it focuses on carrying out basic and cutting-edge scientific and technological research and cultivating top-notch innovative talents. The number of full-time students is tentatively set at 10,000. At present, the University of Rehabilitation has five colleges (departments), including the School of Rehabilitation Science and Engineering, the School of Life Science and Health, the School of Social Development, the School of Clinical Medicine, and the Department of Public Instruction.
Under China's huge population base, the total number of disabled people is estimated to reach 85 million, the number of disabled and semi-disabled elderly people is close to 44 million, and the proportion of the elderly population aged 60 and above has climbed to 21.1% of the country's total population.
Behind these data, there is a huge demand for rehabilitation services.
The establishment of the Rehabilitation University is not only the first new research university in China, but also an important measure to cope with the aging population and cultivate rehabilitation medicine talents, which is a positive signal for China's rehabilitation medical industry and indicates that the national level attaches great importance to rehabilitation medicine.
But is the future of rehabilitation really so bright?
Looking at China's rehabilitation medicine from the perspective of rehabilitation university
China's rehabilitation medical industry is riding the fast train of social development and ushering in a new stage of explosive growth. Its market size has a compound annual growth rate of 27.1%, and it is expected to reach a market size of 220.7 billion yuan in 2025. At this stage, about one-third of the people in the mainland are likely to receive and benefit from rehabilitation during their illness or injury.
Behind this leap is the convergence of multiple forces:
The aging society is intensifying, and the health needs of the elderly have become a major driver of the rehabilitation medical market. With the acceleration of the aging of the population and the increase in the number of patients with chronic diseases, the demand for rehabilitation medicine industry is becoming increasingly strong, and the demand for rehabilitation physicians and rehabilitation therapists is also showing a rapid growth trend.
According to the Lancet study, China has become the country with the largest global need for rehabilitation in terms of number of people (460 million), followed by India (411 million), followed by the United States (149 million), Indonesia (76 million) and Brazil (70 million).
Among them, the population of chronic disease patients in China shows a growth trend of different levels. It is estimated that by 2030, the prevalence of chronic diseases in mainland China will be as high as 65.7%, of which 80% of patients with chronic diseases need rehabilitation treatment, especially the surge in demand for medical care and rehabilitation services to improve the quality of life, KPMG predicts that during the period from 2020 to 2025, the market size of the mainland rehabilitation medical industry will grow at a compound annual growth rate of 20.9%, and by 2025, the market size will exceed 200 billion yuan.
Source: KPMG "Rehabilitation Medical Trends Lead the New Blue Ocean"
Policy-level support is also indispensable. The attention at the national level is not only reflected in the capital investment, but also provides a good development environment for the rehabilitation medical service industry through the strong promotion of a series of policies and the reform of medical insurance policies, and ensures the healthy growth environment of the industry. For example, the "14th Five-Year Plan for Healthy Aging" clearly proposes to be guided by the health needs of the elderly, optimize supply-side reforms, and promote the high-quality development of health services for the elderly. and the Healthy China 2030 Plan Outline, which points out that prevention and rehabilitation should be combined to achieve "health management of chronic diseases for the whole population and the whole life cycle". In addition, the Outline also expresses concern for mental health and the health of persons with disabilities, pointing out that rehabilitation services should be provided for patients with mental illness and persons with disabilities through the strategies of "promoting community rehabilitation services for mental disorders" and "precision rehabilitation", respectively.
Rehabilitation medicine is a medical discipline that helps people recover from illness and improve their quality of life, and is as important as preventive medicine, clinical medicine, and health care medicine. However, in the mainland, rehabilitation medicine started relatively late, and the development is not so fast.
Professor Xi Jianing of Capital Medical University said in an interview last year that the main reason is that rehabilitation medicine has not been treated as an independent category, and management and system construction have not kept up. For example, there is a special center for disease prevention and prevention, a medical administration and hospital authority for medical treatment and treatment, and more traditional Chinese medicine for body maintenance, but rehabilitation medicine lacks such a special "big housekeeper".
During the two sessions of the National People's Congress this year, Academician Li Xiaokun, president of Wenzhou Medical University, a deputy to the 14th National People's Congress, suggested that there are more and more elderly people in the country, and heart disease and stroke are also common. Rehabilitation medicine should be put in a more important position and become a large discipline category. In this way, we can not only train more rehabilitation professionals, but also prepare in advance, so that people across the country can enjoy better rehabilitation services in the future, and lay a good foundation for our healthy life.
The establishment of the University of Rehabilitation and the beginning of enrollment are to meet the needs of the society for rehabilitation services, to send a large number of urgently needed professionals, to fill the gap in the domestic rehabilitation education system, to cultivate high-level rehabilitation professionals, and to promote the development of rehabilitation through interdisciplinary integration and international cooperation.
However, under the huge demand, there are also hidden difficulties.
Three mountains weighing on the head of the rehabilitation industry
01|There is a big gap but it is difficult to find employment
Experts estimate that there are about 50,000 rehabilitation therapists in the mainland, which is more than 10 times different from the international standard of 50 rehabilitation therapists per 100,000 population, so there is a huge gap.
Although the rehabilitation industry is in dire need of more talent, there are still a large number of rehabilitation medicine graduates who struggle to find industry-related jobs.
The total number of college graduates in the class of 2024 is expected to be 11.79 million, an increase of 210,000 from 11.58 million in 2023, a year-on-year increase of 1.81%.
In the face of the current economic development and the pressure of the job market, the employment pressure has increased sharply, according to the data, the employment situation of rehabilitation graduates in 23 and 24 is not optimistic.
Since the 80s of the 20th century, China's rehabilitation medicine has gradually started, and a three-level rehabilitation medical system has been initially established. However, although this system has begun to take shape in terms of framework, rehabilitation medical resources are still unevenly distributed, and there is still a serious shortage of rehabilitation talents.
According to the data released by the Ministry of Education, as of 2021, there are about 849 higher education institutions related to rehabilitation therapy in mainland China, including 303 undergraduate schools and 546 junior colleges.
If it is estimated that 50-100 people graduate every year, about 42,000-85,000 rehabilitation graduates enter clinical work in China every year. Please note, however, that this is only an estimate based on assumptions and mainly refers to graduates at the junior college and undergraduate levels, with secondary school graduates not included in the statistics. This has led to an oversupply of the talent market, a decline in the value of academic qualifications, and increased competition for jobs.
According to data released by the China Employment Research Institute, the number of job seekers in the first quarter of this year increased by 34.64% compared with the end of last year, but the recruitment demand increased by only 5%.
Although Rehabilitation University has three affiliated hospitals (Qingdao Central Hospital of Rehabilitation University, Qingdao Hospital of Rehabilitation University, and Qingdao Rehabilitation Hospital of Rehabilitation University), it is still a question worth waiting and thinking about whether these hospitals can meet the internship needs of a large number of students every year.
02|The test after the extension of the industry adjustment
In the public draft of the National Occupational Classification Dictionary (2022 Edition), rehabilitation therapists and rehabilitation assistive technology consultants are classified as rehabilitation and correction service personnel, and their attribution, classification and work tasks are newly defined:
Rehabilitation therapists and rehabilitation assistive technology consultants belong to the category of rehabilitation and correction service personnel; Psychotherapists fall into the broad category of medical and health technicians; Respiratory therapists are classified as paramedical service personnel.
Image source: Arterial.com
This is undoubtedly a great benefit for rehabilitation practitioners, and it is helpful to enhance their professional identity and professionalism.
Previously, rehabilitation professionals were often seen as technicians in the medical workforce. After the realignment, it expanded to the wider health, sports and leisure sectors. This change means that rehabilitation services are not limited to hospitals, but are also developing in a more diversified direction, such as helping people improve their health through sports and leisure activities.
However, classifying professions such as rehabilitation therapists as health, sports and leisure service personnel may blur the professional boundaries of rehabilitation medicine in the public perception, resulting in the underestimation of the professionalism of rehabilitation therapists and weakening the status of rehabilitation services in the medical system.
Some rehabilitation therapists often laugh at themselves in their studies and work, they have experienced the same heavy study and examination as doctors, but in practice, they are often misunderstood as simple "waiters". However, in fact, one of the key problems encountered in the field of rehabilitation therapy is that the rehabilitation students trained by colleges and universities are often not immediately competent for the complex rehabilitation work needs.
In the current educational environment, it is not difficult to find a common phenomenon: after completing the study of rehabilitation, many students are often limited to mastering basic operational skills, but fail to fully and deeply understand the overall process of rehabilitation and the scientific principles behind it. Although it can ensure that students can master the practical operation in a short time, they are often unable to cope with the complex and changeable rehabilitation scenarios.
There are also some schools in China, such as Ji University, Shanghai University of Traditional Chinese Medicine and Kunming Medical University, which have taken international steps in rehabilitation education. They not only focus on the development of students' skills, but also emphasize a comprehensive grasp of rehabilitation theory, patient psychology and interdisciplinary knowledge. Students in this mode of education are often able to adapt to the work environment more quickly after graduation and become independent professionals.
However, such an educational model is still a minority in the country. After graduation, most rehabilitation therapists still need to go through a long period of standardized training before they can gradually combine the knowledge they have learned with practical work. This training period is not only a test of students' professional knowledge, but also a hone their comprehensive quality and adaptability.
The core of rehabilitation therapy is that the therapist can independently judge the patient's condition and design a personalized rehabilitation plan accordingly. It is not enough to be able to perform pre-set rehabilitation exercises or assist the patient, the therapist also needs to have the ability to flexibly adjust the intensity of the training according to the real-time progress of the patient's recovery. The lack of such core competencies may not only delay the patient's recovery process, but also lead to medical disputes and bring trouble to rehabilitation institutions.
It is a top priority to encourage more universities and medical institutions to cooperate and jointly build a more complete rehabilitation education system
After the classification adjustment, the career path of the rehabilitation industry has been extended to a wider range of fields, including non-traditional medical settings such as sports and leisure, will the curriculum of the rehabilitation university also keep up with the new occupational classification as soon as possible?
With the diversification of rehabilitation services, it has become a major challenge to ensure the professionalism and service quality of all service providers. Especially in non-medical settings, such as sports clubs, fitness centers, etc., the lack of strict supervision may lead to uneven quality of rehabilitation services, affecting rehabilitation effectiveness and industry reputation.
03|Development is hindered and undervalued
An industry practitioner and reporter emphasized that he felt: "The sense of professional identity is low, and the promotion path is not smooth. ”
The field of rehabilitation therapists is facing a series of problems, including an imperfect professional qualification recognition mechanism, significant differences in professional skills and service quality, and a lack of clear career promotion paths.
She explained that due to the lack of a set of fine professional and technical title system for the rehabilitation therapist profession, this not only limits the career growth path of therapists, affects their recognition and loyalty to their profession, but also creates obstacles to the career planning of rehabilitation professionals. Furthermore, with the establishment of rehabilitation higher education institutions such as rehabilitation universities and the vigorous development of rehabilitation disciplines, it is expected that more highly educated talents will be attracted to the field of rehabilitation. However, without the support of a nationally recognized vocational qualification system, it will be difficult to motivate top talents to devote themselves to the rehabilitation profession, which will fundamentally exacerbate the mismatch between the supply of professionals in the field of rehabilitation services and the market demand, and restrict the healthy development of the entire industry.
It is understood that there are obvious regional differences and industry imbalances in the salary of rehabilitation therapists. The national average monthly salary is about 5,000 yuan. Specific to different cities, the monthly income of rehabilitation therapists in first-tier cities (such as Beijing and Shanghai) ranges from 6,000 to 15,000 yuan; Second-tier cities (such as Hangzhou and Nanjing) mostly have monthly incomes between 3,000 and 6,000 yuan; In third- and fourth-tier cities, it is even lower.
On the other hand, according to KPMG's analysis in the report "Rehabilitation Medicine - Trends Leading the New Blue Ocean", the main training channels for rehabilitation therapists are concentrated in colleges and universities, but this training path is quite long. In order to become qualified rehabilitation therapists, undergraduates must not only complete five years of undergraduate study, but also accumulate one year of work experience in the professional field, which undoubtedly prolongs the cycle for talents to enter the industry.
At the same time, the field of rehabilitation medical services has long faced the dilemma of unstable and insufficient financial support, which is particularly prominent in the limitations of the medical insurance payment system. Medicare is the main means of payment for many people to access rehabilitation services. However, the current medical insurance payment system may not have comprehensive coverage of rehabilitation services or limited reimbursement ratio, which means that patients need to bear a higher out-of-pocket part, which directly limits patients' willingness and ability to seek rehabilitation services. For rehabilitation medical institutions, if most potential patients do not come to the clinic because of payment problems, it will directly affect the income stability of the institution.
In economically underdeveloped areas, due to the scarcity of overall medical resources and the fact that medical insurance funds may be tight, medical insurance support is often more limited for services that require long-term investment and high costs, such as rehabilitation. This makes it difficult for rehabilitation disciplines to be effectively developed locally, and it is difficult for patients to obtain necessary rehabilitation services.
Even in areas with better economic conditions, the reform of the medical insurance payment system is more focused on controlling the overall expenditure of medical expenses, and rehabilitation services often require patients to participate for a long time, involving multiple treatments, the use of specialized equipment and human resources, all of which push up the cost of services. The current medical insurance payment model may be more suitable for the treatment of acute diseases, and the support for rehabilitation services that require long-term and continuous investment is insufficient, which makes it difficult for rehabilitation medical institutions to balance revenue and expenditure due to the high cost operation and medical insurance payment amount.
As a result, even if rehabilitation medical institutions are able to provide high-quality services, it may be difficult to achieve financial sustainability due to the limitations of medical insurance reimbursement, that is, it is difficult to maintain a profit model.
The low pricing of rehabilitation programs in medical insurance, as well as the unreasonable fee structure, have directly widened the pay gap between rehabilitation therapists and clinicians, and exacerbated the economic pressure within the industry.
These economic difficulties have not only led to the frequent turnover of rehabilitation professionals in search of higher-paying employment fields, but also led to a large loss of talent in the industry. Although since 2019, some regions have tried to adjust the cost of medical services through the reform of medical consumption linkage in an attempt to alleviate this situation, unfortunately, these measures have not touched the roots, and the true value of rehabilitation practitioners has not been fully recognized.
Instead of narrowing, the gap between talent supply and demand has widened, forming a major pain point in the development of the rehabilitation medical industry, and also hitting the enthusiasm of new blood who want to devote themselves to the rehabilitation field.
Resources:
- Arterial Network "Rehabilitation Specialist Becomes Waiter? 3 thoughts on triggering 5 major changes in the industry"-2022-07-24
- Qilu Evening News "Shortage of Rehabilitation Therapists and Low Sense of Professional Identity? It should be included in the National Occupational Classification (NISCO)
- Look at the medical community "The country's first rehabilitation university was approved! The first undergraduate program enrolls 300 students》
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Source of this article: Diagnosis lock boundary
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