职业索赔团伙通过利用医疗程序漏洞向基层诊所进行举报索赔，正成为困扰基层医疗机构的突出问题。一些诊所因未按规范开具处方销售药品被举报，最终不仅要退款，还被判赔偿，其中一起案例涉及退款300元并赔偿2000元[1]。更引人关注的是，有投诉人自2023年以来已提起20件相关诉讼，甚至将同一张处方在7家不同药店反复购买后投诉[1]。
针对这一现象，监管和司法部门正在采取行动。吉林省在2025年一起行政裁定中驳回了起诉，明确认定投诉举报具有明显牟利特征[1]。即将于2026年4月实施的《市场监督管理投诉举报处理办法》明确禁止滥用投诉举报牟取不正当利益[1]。
法律人士对此现象表示关切。律师甘伍叶指出，"仅凭未开具处方要求十倍赔偿，通常缺乏直接法律依据"[1]。医疗管理专家徐毓才则警告，"任由恶意投诉泛滥，人与人之间的信任会越来越弱，基层医疗的人性化服务也会越来越少"[1]。
Professional claims-filing networks have begun systematically exploiting regulatory gaps at basic-level medical facilities, filing complaints and seeking compensation based on procedural violations rather than actual medical harm.[1] These organized campaigns have prompted excessive caution among physicians, with some refusing routine patient services to avoid potential disputes.[1]
One documented case involved a clinic that dispensed medication without issuing a prescription, resulting in a complaint that forced the clinic to refund 300 yuan while paying 2,000 yuan in damages.[1] In another instance, a single prescription was repeatedly purchased at seven different pharmacies by the same complainant, who has filed approximately 20 related lawsuits since 2023.[1] Such patterns reveal the coordinated nature of these claims operations targeting medical institutions across provinces including Henan, Jiangsu, and Shaanxi.[1]
Judicial authorities have begun recognizing these schemes and taking corrective action. An administrative decision in Jilin Province in 2025 dismissed a case, determining that the complainant's allegations demonstrated "obvious profit-seeking characteristics."[1] At the regulatory level, the Market Supervision and Management Complaint and Reporting Handling Measures, effective April 2026, explicitly prohibits the abuse of complaint mechanisms to obtain improper benefits.[1]
Legal experts have voiced concerns about the insufficient basis for such claims. Attorney Gan Wuye stated that "demanding tenfold compensation based solely on failure to issue a prescription typically lacks direct legal foundation."[1] Xu Yucai warned that "allowing malicious complaints to proliferate will gradually erode interpersonal trust and diminish the human-centered approach to grassroots medical care."[1]
