Do we lack the doctor?

Do we lack the doctor?
Do we lack the doctor?
" when to register needn't stand in a long queue " ? " good doctor can come in when the community " ? " pediatrician's gap 200,000 " Because medical resource distribute unreasonable changing the place of examination system to be still imperfect training the intersection of system and existing problem,etc. by doctor, cause large the intersection of hospital and expert to be in short supply, pediatrics, some the intersection of doctor and gap of discipline such as being complete large. This issue of topic invite several expert discuss the intersection of doctor and reason and countermeasure of maldistribution from different angle, different aspects. A string of expert's number of view is very difficult to see the doctor I have not seen the doctor at home for many years in Chinese Academy of Sciences Professor peak, mother has suffered from serious illness, I am responsible for looking after, just have an opportunity to personally experience. Though has asked acquaintance for help, it is still unusually difficult to send mother to the large hospital and hold a consultation that day. Our whole family have set out 5 people altogether, one goes to the hospital to register at 3 o'clock in the morning, " large unit " Set out at 7 o'clock, arranged different teams separately, did not see the doctor at last by 10 o'clock a.m., it's mothers 's turn to test at noon. Elder person has sat on the wheelchair on more than half days, the vertebra stresses that it is difficult to endure to make her pain, really there is not a disease that wait for the disease out to come too. Expert enough to result in, see the doctor difficult I feel, it sees the doctor difficult and at all difficult to be really too little demands to the patient in experts. Probably there are 2 million medical practitioners of medical practitioner and assistant at present in our country, share to 1,300 million people to, every thousand population nearly have 1.5 doctors. Such a doctor very little than to seem population have, India every thousand population only 0.6 doctors, and U.S.A. is 2.7. However, it is analyzed that the quality structure of the doctor of our country is exposed to go wrong for a while. The doctor of our country has only accounting for about 1/3 of level of education of undergraduate course of universities, level of education of doctors of medicine is still less than 1%. In India, U.S.A. and other developed countries, the doctors all need to accept the education of doctor of medicine. If according to the intersection of doctor of medicine and standard, the intersection of doctor and population of us than only 1/40 of India then. A large number of medical science give birth to, give up, take up a job as a doctor expert to be so in exceedingly short supply, why do but we fail to increase the expert's supply? In recent years, accept the number of people of the medical education and utilize obvious mismatch of the number of people actually. In 2005, the persons who graduated from the medical college were 575,000, but 460,000 people did not enter the health care field; In 2010, 900,000 people will graduate, 543,000 people are not engaged in health care. That is to say, 60% of the graduates changed one's profession to do other work. As a whole, the doctor's incomes are generally on the low side. The average salary of the worker of health care trade will be only 1.12 times of average salary of national worker in 2008, it is much lower than the average salary of some workers of monopoly industry. For example, the average salary of the telecommunication trade worker is 1.7 times of the national average salary, tobacco industry and the banking industry is 2.1 times, software industry is 2.6 times, securities business is 5.9 times. Become a doctor, need to accept and educate regularly for many years, and then is accepting on-the-job training constantly, working pressure, responsibility risk are very large, but its whole income compares with ones that paid, still in lower level in the society. No wonder in now society " The thousands upon thousands of horses and soldiers " The post of civil servant of the competition and post of the monopoly industry. The post stop up doctor's development opportunity few except that doctor's job lacks attractiveness, it is too difficult important reasons of seeing the doctor to limit all sorts of systems of the doctor post. The public hospital unifies the whole country, other social resources are difficult to enter the medical trade, have limited the growth of the medical post. In the public hospital, the doctor's establishment is limited, doctor and hospital bundle together: The doctor can only be the employees of a hospital. It is to solidify the doctor's job development opportunity that this kind limits the greatest problem brought: The graduate of medical college can work for hospital of the first, second and third, have a chance to become the expert; And work for hospital at the basic level, because can only contact common disease, frequently-occurring disease, lack the good atmosphere continued educating, it is very difficult to improve medical technology. For this reason, when the graduate of medical college is unable to enter the hospital of the first, second and third, they choose to " give up " . The limited post of hospital of the first, second and third has stopped up the chance to train medical expert that the a large number of societies need. View 2 Raise the efficiency of making a diagnosis in grades Member of the CPPCC National Committee, subsidiary hospital heart professor of internal medicine Ge JunBo of Zhongshan of Fudan University " when to register needn't stand in a long queue " ? " good doctor can come in when the community " ? The difficult problem of seeing the doctor has been perplexing ordinary people all the time. Base on the premise that existing medical treatment is always put into and medical total scale does not change, two methods that it is which solve this difficult problem to dispose and utilize medical resources rationally. China present medical resource distribution have fairness greatly, the polarization phenomenon among rich area and poor area, countryside and city, large hospital and small hospital grows in intensity, there are direct relations with structure of two yuan in urban and rural areas of what China have now in this. Under the economic and social law, nearly all economic and social resources concentrate on the large and strong place. It is the same in the medical distribution of resource, advanced technology and outstanding talent centre in the large hospital of big city, the countryside and shortage of medical services and medicines of urban community's hospital, or difficult to attract qualified curing skill talents, ordinary people have to scale mountains and ford streams and make light of travelling from afar to the city, to the large hospital to seek medical advice. But medical care is different from other trades, only it is very difficult to reach " everybody enjoys the health care " through the adjustment of market economy Ideal for state,last resources medical. Propose: 1. The medical finance of the government is put into turning towards the low developed area, countryside, community at the basic level to slope, can divide the limited cake to the above-mentioned area more within some time. According to population and existing medical disposition, increase the quantity of the medical service organization, set up medical service organization in village and community, dispel one hundred li of current situations of finding a health station of neighbourhood. 2.Offer hardware support to hospital at the basic level, allocate the basic medical monitoring device in the form of replenishing in the government, meet basic medical demands of ordinary people. 3.Strengthen the job training that the hospital at the basic level cured skill personnel, increase the technical support that the large hospital cured skill personnel, from existing to cure the intersection of skill and personnel and train qualified complete doctor and basic unit cure skill personnel in the this year's graduate. 4.It is public beneficial to insist on, offer attractive labour remuneration and welfare guarantee by government, in order to attract qualified complete doctor and outstanding talent. On the other hand, ensure the disintegration of the system with welfare medical treatment, market-based medical treatment ensures the forming of the system, the patient can choose any hospital and go to a doctor freely. But ordinary people's medical professional knowledge one is deficient and pursue the blindness of high-quality medical resources, make them get around the community health Center of a gate, go to large hospitals to line up to rob the brass-wind instrument, some cold and chronic disease write a prescription to go to the large hospital even ,Sought medical advice for time again in vain and economic cost. Large hospital forever berth nervous, and some small hospital lack patient to be on the verge of bankrupt. To this kind of situation, make a diagnosis in grades the system needs improving and implementing badly. Propose: 1. Accelerate establishing the system of hierarchical medical care, science orients the functions of the hospitals at all levels. Qualified complete doctor and fine medical apparatus enable community's hospital, the first class hospital, rural health stations, little hospitals of villages and towns check on the person as the first in ordinary people's health service. 2.Pass the limitation in submitting an expense account in the range, amount, proportion etc. of system of medical insurance, lead ordinary people to go to the hospital at the basic level to carry on the first visit, the hospital at the basic level changes the place of examination to difficult disease and serious disease. 3.Build the information-based platform which grades medical service system, share high-quality medical resources, raise the operational efficiency of grading medical service system. The view 3 can let the doctor not be scarce Yellow swallow raises the large hospital of doctor's working efficiency to require the clinician wants medicine to teach and grind and do, the doctor can't put into whole-heartedly clinically, will aggravate a patient and register the difficult problem. I propose, should give consideration to reform clinical scientific research system and doctor's incentive system, let doctor break away from in complicated research work, put into clinical work, wholeheartedly. The patient feels " It is difficult to see experts " Reason been in the first for doctor working efficiency high. We might as well use experience of western countries for reference, it is thinning the doctor post to be. For example, seeing that the reputable doctor is rare, might as well allocate a assistant for them, let the doctor save and appear for energy and time to make a diagnosis and give treatment several patients more. Increase the quantity first and then consider the view with general quality is, the community doctor of China is not up to standard of from measuring to the quality at present. I think, guarantee it is most important, but needn't be so high to the requirement for the community's doctor quality that a doctor has enough quantity in the community. It is the task of top priority to guide the patient correctly now, there is no harm in issuing various encouragements they to the policy that the community seek medical advice. Improve community's doctor's salary and conditions (including offering the guarantee house purchased in its service area after renting for it rationally, create conditions for it lives and works in peace and contentment) ,Implement the wage system of the performance, tie its bonus to work load and public satisfaction, keep the important action of the complete doctor here and attract. Improve system of changing the place of examination, determine by the intersection of community and doctor patient should go, think the intersection of higher authorities and doctor. Provided that, the degree of freedom that the ones that need to improve community's doctor change the place of examination, they should establish the cooperation relation of changing the place of examination with more hospitals. A patient proposes cancelling expert's number the expert's only meeting and examining changing the place of examination, the expert only accepts the changing the place of examination appropriately of the subordinate doctor. Meanwhile, expand ordinary clinic, can accord with the paying a home visit amount of doctor who determines the same day of visit amount of the same day. A doctor belong to registering incomes and can be paid a home visit. The large hospital cancels the freedom clinic gradually, the substitute is the clinic of making an appointment. In fact the doctor does not lack, but because is uncomplete to the system of patient and doctor management, " it is difficult to see experts " to cause . It is difficult to solve and see the doctor, should reform from system first. (the former Sino-British institute hospitals of author's department manage a researcher, Glasgow university MBA of Britain) 4 pediatrics of view lacks the training system What the team of pediatricians of most hospitals faced is not to grow vigorously that China cures bright red one of branch's president of SCTE's pediatrics and contains at present, but have difficulty in taking a step. The statistics show, the pediatrician of our country will only account for 1.62% of the total number of doctors in 2008, every a thousand children have 0.2598 pediatricians, compared with 1.4558 pediatrician / a thousand children in U.S.A., our country still lacks over 200,000 pediatricians at least. In recent years, the pediatrician's increase stays cool especially. The university cancels the pediatrics speciality because most of children can't express one's own pathologic characteristic accurately, so pediatrics is commonly called as " The mute department " ,More consummate when needing doctor's engineering level, this needs basic training of reserves to be sturdy. Ministry of Education, in order to widen the speciality one, in the adjustment of " bachelor degree catalogue of university and college " in 1998, the intersection of pediatrics and as change professional to stop enrolling new students since 1999 speciality. This action has cut off the pediatrician's steady source. The pediatrician's source, study the professional graduates of clinical medicine of the universities and colleges in first, medicine at all levels at present; Second, study to the specialized graduate student of pediatrics; Third, other second discipline or tertiary discipline graduate student, persons who choose pediatrics to obtain employment for various reasons. The former arranges to be considerably less than the original pediatrics speciality in the pediatrics teaching at stage of the universities and colleges far, only possess the most elementary pediatrics knowledge. Back the intersection of the two and number only take very light proportion. Train in pediatrics training under the system and situation not complete of system, it is really very difficult to train the qualified pediatrician. Train the system not to perfect the pediatricians of hospital and general hospital at the basic level yet, without ability to treat children's acute infectious disease, there is no professional doctor of fixed children's first aid. A lot of hospital departments implement more economic contract systems, it is unwilling to cause the young doctor or have no chance to go to the hospital of higher level to receive a training and study. In addition pediatrics position relatively low in hospital, train funds to be difficult, doctor accept training and go out learning opportunity to be less, have inadequate experience clinically, emergency ability is relatively bad, rescue ability insufficiently in endangering serious illness. If does not improve the pediatrics speciality and train the system as soon as possible, can only cause pediatrician's team and extremely uneven further deterioration of state of medical resource. It is enough to build the pediatrics hospital, should like in important position for government to invest. The general hospital is extending the outpatient building, inpatient building, building the branch constantly in recent years, lower children's hospital of the whole income has not caused the attention of the governments at all levels yet. It is extremely uneven that the domestic pediatrics speciality is developed at present, the pediatrics of most hospitals and general hospitals at the basic level is in keeping with an effort state, and formed the vicious circle. Propose the country is here " Twelve five " While planning, list the development and construction of pediatrics in the health care while developing. While setting up children's section hospital actively, resume the pediatrics function in the general hospital, develop community's pediatrics construction in a more cost-effective manner. (Zhu YongJi puts in order) Represent the deputy to the National People's Congress of the sound, director's plum of a dawn of pediatrics of Kweichow Province Zun Yi affiliated hospital of medical college: The most tense one is pediatrics resources at present. The pediatrician is rare, the children's hospital is scarce, pediatrician's work load is great, the treatment is low, pay attention to, advise the public hospital reform to begin from paying attention to pediatrics. Deputy to the National People's Congress, market the People's Hospital president Yin ChuanGui of Linyi, Shandong: At present, the pediatrics of above- second -class hospital exists and registers to check, treats standing in a long queue in hospital, crowds and has stopping up, disorder phenomenon in various degree, especially in the season of occuring frequently of children's disease, the waiting time of pediatric clinic patient of the large hospital should be in above 4 hours. Average each doctor should look in one day One or two hundred patients, work overloadingly seriously. Lead to the fact the main reasons discontended with pediatrics question of masses are as follows, first, the pediatrics work has a big risk, high pressure, task are heavy, the treatment is low, understand in the society; Second, medical worker, medical science are grown it is unwilling to do pediatrics; Third, does the government department include defending? �� is surnamed that one far � of �� Bei Yi splashes and waves the star threshold to close Lu �� Jia LuFang �� of �� The uncut jade floats Xun covers and cherishes Wo scrupulously to cough and spout Bright Sheng's tired female phoenix neon condemns ��� Pu �� of Gan Stare at the shaddock mould �� Ni �� Wave �� Ma S �� insect destructive of the roots of seedlings study carefully escape from �� of ���� decayed tooth the intersection of kang and the intersection of �� and the intersection of cellar and the intersection of �� and the intersection of box and 6 � table while being flat oh Arrive Chen L Gou is favored with �'s table Di sedan-chair Pan cough �� of barium thumb ancient wine vessel made of horn U ���Ҫ� peaceful �'s human skull cash and stir the � mushroom of apple Zan �'s table Idle � general Sou � � Pu the intersection of bones of the body and 8 human skull cash, stir the intersection of apple and the intersection of � and the intersection of stem and the intersection of �� and torrs of fish hawk inlay �� cash, fall from the sky or outer space, offer the intersection of Feng and string all cut off from �� Liu all The peaceful ��'s sedan-chair Pan of �� of Qiu octogenarian of extensive region coughs and is posted and reveals �'s table tennis �� Ao R �� worried fervent �ͯ� by � to give repeated exhortations =' ��'s sole's ��'s kang ���ͯ� ] reaches escaping from �� Gou Zhyuan's page �� mu �ͯ�=)J Sting the intersection of �� and joyous salty Gou, tut-tut the intersection of apricot and earnest �, purchase, push away Lu � escape from �� so �� know visit Zhyuan angry �� Qian ] act as = �� is strong in 4 and post and reveal �ͯ�=' �� Jian's curtain � purchases the leg and coughs coin �� Yan Tao ����'s sacral bone ���� takes off ridicule �ͯ� by the core chaff =' wish the intersection of Qiang and arm, emperor of ���, by the intersection of �� and Ba>, angry the intersection of iron chains and shrimp ellipse acute communicable diseases dregs of rice rare? How outstanding intelligently deputy to the National People's Congress, Deputy Director of Gansu Province Standing Committee of the National People's Congress Lausanne are clever: Doctor's scarce situation stresses further in the western region, the consequence is more serious. In remote health stations of Tibetan pastoral area such as Qinghai, Gansu, Sichuan,etc., even the basic public health care problem has not been solved yet, the medical facilities are simple and crude, simple appendix operation can not be all done, infant and pre-school children and pregnant and parturient women mortality are very high. Propose strengthening the support of the public health service funds of ethnic mimority area of the western region, train the local doctor, strengthen doctor's coordinated cooperation and support in the big city, take special measure dispose, flow for each villages and towns the intersection of surgery and train wait for. Deputy to the National People's Congress, chief of Jiangxi Province department of public health Li Li: Talent's shortage is a bottleneck which restricts the service ability of the hygiene, especially the basic unit. It takes ten years to grow trees, but a hundred to rear people. Medical talents' cultivation cycle is long, very difficult. Jiangxi Province regards expanding medical talent resources by every possible means as and promotes the thread of the medical reform to catch, primarily for recruiting a medical practitioner in the health clinics in towns and townships, give 20,000 yuan for each person every year, related 10,000 yuan while saving; Secondly train talents for the commune hospital. Should retain staff, must try every possible means to solve their worry, such as investing in building the room, let them have places that stay. In the city, mainly improve community's medical worker's treatment and engineering level, set up effective on-the-job personnel training mechanism. (staff reporter Liu Ping'an puts in order)


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