To solve the "difficult" for?

10:23:15 April 12, 2016

Source: journal of science and technology

On the eve of Spring Festival this year, the gate hospital registration hall "girl angrily rejected, dealers" incident. The right to live video capture.

During the two sessions, said li bin, director of the health development planning commission, "I want to thank the girl, with a roar, promote the solution of the problem".

S the news

, our reporter Li wo

Ill go to good hospital to hang a well-known visit will not be easy. The hospital visit source co., LTD., queue overnight registered has become the norm; Patients "grab" speed matches the WeChat grab a red envelope, this gave the "cow" party. Earlier this year, the gate traditional Chinese girl in the nu scold, dealers "event, the difficulty of the visit again before the public.

Register in order to solve the "difficult" and "difficult", in the end of the "2016 years of education in general medicine and primary care services development international BBS", formally announced the formation of wenzhou medical university institute of general medicine, and its affiliated eye (eye hospital in zhejiang province) and optical hospital in zhejiang province for the first time "group therapy" service mode, hope that through the hierarchy referral patterns, such as for patients with demand faster after the visit.

A line observation -- -

Medical resources concentration

Eye optical hospital affiliated to wenzhou medical college level in the front rank in the whole country, every day there are patients from all over the country to seek treatment. The hospital dean professor esmebaby thinks, "medical care", "registered to" is not accurate. Even in a lot of 3 armour hospital, hang a common number is not too difficult.

Data shows, in the city of health resource allocation, there is a great imbalance. Only 7.3% of the total number of medical institutions hospitals are occupying 80% of the total health assets, 60% of medical staff. Medical resources concentration inevitably lead to the medical human resource distribution, high level medical personnel highly concentrated, as a result, the public tend to choose the hospital at or above the county level with good medical conditions, has formed "under the hot, medium temperature, cool" phenomenon. The big hospital to work overtime and who crowded; County hospital patients, bed stress; In towns and townships are few go to a doctor, medical resource utilization is low.

"XiaBuQu, do not leave, use bad"

Because of the low social perception, career development path is not clear, lack of effective incentive mechanism and scientific performance appraisal system, grassroots medical institutions is difficult to absorb and stable talented person. Medical students are not willing to to the grass-roots employment, doctors are not comfortable for a long time to work at the grass-roots level, lead to bad "XiaBuQu, do not leave, use" problems exist for a long time, talent cultivation and talent management don't mix.

According to investigation of wenzhou medical college, most of the current orientation training of general practitioners in the villages and towns and mountainous engaged in medical service, and even many people choose the career; Even after graduation in accordance with the agreement, contract, once the opportunity one thousand tries to go back to the big hospital work, rural grassroots medical institutions qualified medical personnel lack of facts is still grim.

So, grassroots medical institutions in the high level of doctors do not leave, medical level drops, a vicious cycle of patients more reluctant to go to.

- the difficulty analysis --

The steel used in the blade

At present, the hospitals are layered diagnosis system, the expert sees most of the patients condition often is very simple, ordinary resident, attending physician can processing, this also is a waste of expert resources.

"Medical team" refers to a famous medical expert team, including experts doctor, doctor, ordinary doctor, etc. Patients by expert team, first was done by the other members of the expert team, according to the patients will indeed need expert diagnosis and treatment of patients, well-known experts in the booking directly by team members to diagnosis and treatment. Well-known experts in the diagnosis and treatment of patients, according to the illness needs by famous experts I make an appointment to visit, or transferred to other team members to visit, the formation mechanism of two-way referral hierarchy. This greatly improve the efficiency of the expert diagnosis and treatment, not for the demand conditions and provides a convenient way to visit patients.

, head of the hospital team and treatment patterns, eye optical hospital affiliated to wenzhou medical university dean assistant Stewart wu for optic nerve disease, eye disease, is very good. He said: "I'm 60 a week visit, at least a third of all is sick, I don't need this term, has been occupied resources, really need people can't hang up the number. Now the team members is equivalent to a" sieve ", the patient first screening again, just turn in need come to me."

Esmebaby said, expert team diagnosis and treatment of the new medical service mode, will be experience of senior experts and young, the doctor's time at the grass-roots level, let senior experts focus on solving problems, on this basis, to help them make effort, to "high, fine, sharp" technical development; At the same time is beneficial to strengthen the "mentoring" between the doctors, accelerate the development of general practitioner. "In this way, can alleviate the people looking for medical care, difficult and complicated, the difficulty of experts, achieve the best use expert resources, for the masses to provide more secure, efficient and convenient medical service."

At present, the hospital's official website, 51 registered network platform, such as eye optical hospital affiliated to wenzhou medical university launched the first of six key specialty well-known expert team to accept appointment. Next, the hospital plans to form 2-3 team, all the hospitals ace departments into a "medical team" mode.

Raise the level of primary care

"A lot of patients have such experience, took a lot of energy to visit, and stood in line for a long time, the results of experts spent only a few minutes to the end of the interrogation, this let the patients psychological is very uneven; for experts, disease is so common, and there are many people in the back of the queue waiting for diagnosis, unable to take more time for each patient." Therefore, as a representative of the National People's Congress (NPC) esmebaby put forward many times on the national annual, called for the establishment of grass-roots gp series "gb province, county township, standardized training" model of team construction.

Reducing the pressure of big hospital in diagnosis and treatment, let more patients treated adequately is the another way: to raise the level of primary care, let the victim "triage" to the towns and townships.

Health service quality key in a doctor at the local level. But according to the China health statistics yearbook, our country has about 60000 practicing scope for general medicine (assistant), only 3.5% of the total number of (assistant) medical practitioners, far below the 30% - 60% of the average level in the world. Due to lack of funding and staffing shortage, less chance to participate in practice, most primary healthcare poor wages, low income, responsibility.it is difficult.

Therefore, wenzhou medical college in practice with the local government ordering cultivation as the starting point, with excellent gp at the grass-roots level as the goal, to schools, hospitals, community facilities open teaching as a platform, formed a unique undergraduate level of ordering of the general practitioner training mode at the grass-roots level.

- expert advice --

To attach importance to basic general practitioner training use

Lack of outstanding talent has been a primary care system construction. Esmebaby proposal, the exploration and practice from the school, to use induction, and on-the-job training of grassroots gp series "gb province, county township, standardized training" construction mode, perfect the relevant laws and regulations system, solve the general medical talents "XiaBuQu" and "stay", the core issue of establishing standardization and long-term general practitioner training system, promotion of gp's professional knowledge and influence.

In 2010, the school has pioneered in wenzhou was carried out by gp at the grass-roots level government undergraduate level of ordering orientation training. In 2012, the work carried out in zhejiang province, the school of 11 cities in the province more than 40 counties and 373 gp order cultivation, and become the ministry of education, the ministry of health the first outstanding doctor education pilot project plan. 2013, cultivate professional professional development from a single clinical medicine to clinical medicine, oral medicine, traditional Chinese medicine, nursing and other four undergraduate programs, current ordering cultivation student number up to 1952 people.

For expert team and treatment patterns, core esmebaby said this model is to have a famous doctor, must also gives doctors a lot of support. Such as echelon team not only have the "head", also need to have "no", "3", the attending physician, director of the doctor, etc. "If the team all the doctor's appointment, at the same time the patient must be looking for the best doctor to see." Office space to design good also, the patient referral to the famous experts from team members, to a very short distance between the clinic, so patients feel more comfortable, etc.

"Hard to solve a doctor, registered, we want to make the three-dimensional boxing, the top design, not only have to cultivate talented person, team, etc., to form resultant force." Esmebaby said.