The gratuity could disappear once and for all

  • 2017-05-02 00:00:00
  • Research

96% of the physicians want to work in a gratuity-free health care, but 60% of them think that only the wage increases won’t make gratuity disappeared. Other solutions will also be needed revealed the research of the Union of Residents and Specialist (ReSzaSz) and Szinapszis Ltd. Its main goal was to explore the objective data related to gratuity, and the opinion of the physician-society.


Rejected gratuity-system – physicians do not want to work in a health care with gratuity.


As the research revealed, the vast majority of physicians – 96% – would like to work in a health care without any gratuity. 



We can clearly see that, according to the physicians, fear and service-buying stand behind the gratuity.


In 2013, every third physicians thought that gratuity is really the expression of gratitude. However, it has completely changed in the last few years, a third of them reckon that patients think about gratuity as a way to buy quality services. 29% of them also experienced that patients want to take advantage with the money. Overall, the physicians feel that the rate of patients who give a gratuity and also the amount of gratuity reduced in the past 3 years. 



The general opinion about gratuity is still negative.


94% of physicians reject the gratuity system – most of them (61%) however, need to accept the money in the current situation. Only 5% consider it morally acceptable and 1% thinks that this phenomenon is natural. In the last 3 years from 19% to 33% increased the ratio of those physicians who reject the gratuity fully. 



The wage increases are well sensible, but still don’t guarantee a safe future


The physicians’ monthly net income has significantly increased in the past 3 years, from the average 194.000 HUF to 260.000 HUF. The growth is general, it affects every group. Although the situation has improved since 2013, 74% of them think that their current wage is not enough for their future plans.


The wage increase alone is not enough, we need other solutions 


60% of the physicians think the only the wage increase won’t defeat the gratuity system. Among the residents – the doctors of the future – this opinion is even more common (76%).


If we would like to get rid of gratuity the wage increases are indeed essential, but half of the physicians think that another change should be also implemented: the opportunity to buy “extra” hospital services legally.


60% of the physicians agree that the law should allow the patients to choose their own doctors in exchange of financial compensation. In this case, there wasn’t any change since the previous research.



80% of them agree that piece-rate payment would be a good idea. 9 out of 10 physicians support the plan that those specialists should get extra money who contributes to the education and training of residents. Two-thirds of the doctors fully agree that the public and private health care should operate in a more regulated model.





During the online research in January 2017, 907 physicians filled the 20 minutes survey. The questions were prepared by the team of ReSzaSz. The sample represents every special field of the Hungarian physician-society. The database was provided by Szinapszis Ltd.

The response was voluntary. We could achieve the planned sample size faster than we usually can; this shows that the majority of the physician-society is highly interested in this topic.