The country is short of at least 100000 pediatricians take what ease the shortage of "pediatrician"

Our reporter Li Gongmei Wei Zhezhe

04, 2016 1 long source: People's Daily - the People's Daily

The print key error correction mall share recommendations What size the original title: relieve "pediatricians shortage" (the line of sight of the people's livelihood)

Xu jun (xinhua)

Since the end of last year, some of the large hospital pediatric TingZhen attention. As the "comprehensive two children" policy, the contradiction between supply and demand of pediatric health care more highlights. The two sessions this year, "pediatricians shortage" problem is representative, committee member. With digital display, pediatric assistant practicing doctors for 118000, need at least 100000, gap of big surprise. Why a pediatrician shortage of "professional"? How to let the profession to regain appeal? The reporter interviewed.

- Ed

Doctors work overload, children still difficult

A few days ago, Mr. Zhang's Beijing child high fever has not to go back. "Children less than one one full year of life, want to go to older children's hospital, but found no. Don't hang on." In desperation, Mr Zhang had to go to ordinary general hospital in pediatric clinic. Comprehensive hospital too many children, husband and wife two people can only child in her arms, Mr Zhang in the corridor of the hospital waiting anxiously.

How difficult is it to pediatric doctor. In Beijing, for example, only two children's hospital of Beijing city, Beijing local children, not only will receive reception of children from all over the country, even the two children's hospital accepts the amount. Throughout 2015, children's hospital affiliated to the capital ErYanSuo, this people to 2.17 million, average daily accepts the amount about 6000 person-time, winter peak reach QiBaQian passengers every day. Beijing children's hospital visitors throughout the year 3.17 million. Two hospitals every physician outpatient daily accepts people achieve 30-40, 50% more than the busy big hospital doctors Beijing workload.

"Overload" are common problems existing in the pediatric hospital operation. It has to do with the design of the pediatric hospital. Our country big city children's hospital accepts ability is in accordance with the half of the adult hospital design plan - this event generally set in 1000-2000, generally only five centuries beds. Co., LTD., see people increasing, resulting in pediatric hospital rapid expansion, er visits door is far more than the original design.

National health and family planning commission, according to the data provided by the pediatric assistant practicing doctors in China for 118000, every thousands of 0 ~ 14 years old children pediatric assistant practicing doctors number is 0.53, and the United States, Canada, Japan, the three per thousand children pediatrician number is 0.85-0.85. Pediatric assistant practicing doctors in China held daily outpatient number of people is about 17 m, is 2.4 times of ordinary medical institutions assistant practicing doctors.

Big city pediatrician work favour, second and third tier cities, too busy. "On average every 5000 children in henan province is a doctor, pediatrician shortage is most severe." The CPPCC national committee, former dean of the Chinese people's liberation army 150th hospital chun-fang gao proposal is to solve the problem of shortage of pediatricians this year.

Chun-fang gao introduces, at present the national children's hospital, only 68 to 0.52% of the total number of hospital, the pediatric 258224 beds, accounts for only 6.4% of the total beds. By the end of 2014, China's gap of about 90000 beds in pediatrics, pediatric assistant practicing doctors gap of at least 100000 people, bachelor degree or above accounted for only 33%, far below the comprehensive clinical department assistant practicing doctors in bachelor degree or above the level of 49.1%. "Pediatricians overall vacancy, as well as the internal hierarchy of talents is not reasonable, lead to a pediatrician overworked, but remain difficult for children." Chun-fang gao said.

"We, director of pediatric hospital has more than 60 years old this year, more than 30 years have never take a vacation, also dare not leave the Chinese New Year. He has reached the age of retirement, still fighting in the clinical front line." Chun-fang gao of the Chinese people's liberation army 150 hospital of pediatrics, a total of three doctors and need to make a diagnosis and give treatment to 10000 children each year, which reached more than 4000 children in hospital.

On the two sessions this year, li bin, director of the national health and family planning committee, said in an interview with the media in our country has 230 million children under the age of 14, this more than the total population of the world's fifth big country Brazil, health care demand is huge, pediatric services resources or not enough.

Medical graduates from pediatrics, no power open pediatric hospital

"Pediatric professional doctor shortage, there are two causes - source less and walk more." Suzhou university President si-dong xiong analysis: "talent source has two kinds, one kind is professional trainings, another kind is a supplement to the relevant professional dispensing. The source of the medical personnel is relatively single, pediatric talent more special, academic interests, social recognition, survival pressure, the influence of the development of space, there will be less people choose to become a pediatrician."

A pediatrician told reporters, when the graduation of time, with the 180 students, she is the only one choice when the pediatrician. "Don't go to the reunion, own development situation worse than students too much, in addition to the stimulation nothing more, besides, also don't have the time."

Chun-fang gao believes that pediatric professional particularity and high pressure, high risk and low treatment are the main reasons for the shortage of pediatricians. "Pediatric patients complicated, quick change, once the illness would be life-threatening, and patients age, unable to articulate the doctors need to be with the experience in diagnosis and treatment, referred to as' dumb doctor, doctor physical and mental pressure is very big." Children's body not well, the first choice is often a hospital, directly increase the workload of pediatrics. And the children are only children in our country, the hospital chaperone, more in the pediatric clinic often crowded, the medical staff in the process of receiving, often complained, distrust of move. Misunderstood, be wronged, and even become a pediatrician "norm".

A pediatric cardiology doctors told reporters: "cardiology, technical content is very high, and pediatric cardiology, higher request to the doctor's. The requirements of pediatric cardiologists were more than any other pediatric take two years to practice more, a lot of people so back." Mainly because the individual small children, organ fine, can't afford to trauma, relative to adults, treatment more difficult. Children's use of medicines and chemical reagents, consumables and very little, the operation can only be tinkering, more doctor test technology level, the risk is bigger.

However, with such a relatively difficult work, but not a high level of pay. According to the survey, pediatrician pay less than half of the adult similar department. The reason is very simple, under the medicine for the medical mechanism, hospital by selling medicine for revenue. Children less dose, have good technology, "sell" is not a good price. The reporter checked the, the price of a lot of technical service fees is only about 50% of the adult, the income level of pediatricians naturally low.

Income is low, resulting in pediatric brain drain is serious. Pediatrician self-mockery: employment choice for general hospital, and then choose community hospital, finally consider the pediatric hospital, the pediatric hospital want to change professions.

In 1998, the education ministry will merge into pediatric clinical departments, disappeared from undergraduate majors in pediatrics, compounded the shortages. In recent years, the phenomenon of medical graduates don't become obvious, about 30% - 30% of improper doctor, men left to become a much less when a pediatrician.

In the first hospital of Peking University, dean of yu-cun liu's opinion, lack for pediatric hospital. Last year, he said, the first hospital of Peking University were reached more than 13700 cases of pediatric patients, on average, a patient's discharge costs about six thousand, the average adult discharge fees to nearly twenty thousand, obvious pediatrics is not cost-effective.

Retain talent policy tilt training talents and improve treatment

"Shortage of pediatricians, reflects the deeper problems in the medical system reform: on the one hand, the existing basic medical insurance system in China there are problems on allocation health resource; on the other hand, requires the government to consider the professional characteristics of pediatricians to expand pediatrician contingent, improve the level of pediatric medical, to give policy support." The Beijing municipal health and family planning commission director party to the point.

In February, the education department of pediatric professional education forward, strive for to 2020 every provinces (autonomous regions and municipalities) at least 1 universities undergraduate level professional education of pediatrics, 38 also required a high level of medical colleges and universities to increase the number of pediatric professional graduate admissions. Since July this year, China medical university, chongqing medical university and other 8 universities recruit students who major in pediatrics, to strive to recruit students 2020 pediatric residency more than 30000.

This is a positive signal. But there are still a party to the British think talent training process, the priority is to consider how to further release the vigor of a pediatrician, strengthen the popularization of basic knowledge in pediatrics, let parents learn to ailments in dealing with the prevention of disease, etc. "For example, pediatric patients is respiratory infection caused by the disease, most of the time, there is no need to pediatric hospital medical common sense, increase parents can effectively ease the pressure on hospitals and doctors." In addition, you can explore a pediatrician in community outpatient service, to better meet the needs of children.

Yu-cun liu suggested that the number of foreign graduates in Beijing to tilt, pediatrics clinical skills of graduate student recruit students number to pediatric tilt, make part of the person in three years later will become a pediatrician.

Chun-fang gao suggested that enhance pediatric treatment, the pediatrician in salary, promotion, further study on the policy tilt, at the same time, improve the paediatric service prices.

From the Angle of the school personnel training, si-dong xiong suggestion, according to the requirements, determine the setting of university professional, some conditions of colleges and universities, to restore to the professional Settings. Talent training is more close to the development of pediatrics, setting scientific course system, let the student be willing, are interested in learning professional pediatrics. At the same time, school should strengthen the pediatrician practice base construction and clinical work.

"No training, pediatric is madrassa reflected, but trained pediatric talents, will choose pediatric professional work, or to the performance evaluation system, promotion system, degree of social recognition is there enough attraction." Si-dong xiong said.

Li bin, national health development planning commission jointly with relevant departments, take comprehensive measures to resolve the pediatrics resource shortage problem. "Much starker choices-and graver consequences-in" period, the country to increase the supply of pediatric medical resources to continue as the focal point of system construction, strive to achieve every provinces can have a children's hospital, the resident population of more than 3 million cities set up a children's hospital. At the same time, reasonable compensation for pediatric medical personnel, to ensure that the pediatric medical staff's income is not lower than or other medical personnel with professional qualification is higher than the average level of income.

The People's Daily (17 April 01, 2016 edition)