"Hope" shall not be lost touch knock at listening to

Healthday KongLingMin reporters

This year our newspaper published on June 16, the front page of this with all looking for a book of penny, describes Beijing union hospital emergency department first director, has 89-year-old ShaoXiaoHong professor has a life of regret, and that is he used a life time has been looking for, still haven't find

To a book. Read this article, "after affiliated tongji university hospital clinical director of the east psychiatric XinXuNanPing.chem eng sci, start their studied in Germany three students, and finally found the German called" don't need the auxiliary means emergency diagnosis "the book.

"If possible, we would like to translate the book." .chem eng sci said. "this is not only to help old man's house at a wish, but because too many doctors reliance on the instrument and drugs. I think that, even today, 'hope' still won't touch knock at listening to the cause

Modern medicine for the progress of outdated. "

S physical check weakening very natural

July 28, 7 PM, in Beijing is still not fully "wake up" to Beijing union medical college hospital orthopaedic young doctor, for doctors and medical students have begun to once a week and a half hour of the morning, please read undergraduate course attending physician above the doctor take turns to introduce this professional including "touch knock at listening to" look

In knowledge and the essential skills. Director of orthopaedic WengXiSheng said: "young doctor always want to jump for major surgery, can we develop the potter is not the operation, but the ability to see a doctor, will see a doctor and know why do you want to go to the doctor the doctor."

"' hope 'touch knock at listening to look that can be detected a flower to? By X-ray machine as not a clear? At the same time, the traditional' hope 'is still listen to touch knock at the same old, same or should keep pace with The Times?" Look for "touch knock at listening" effect, many doctors have different views.

Beijing union medical college hospital emergency department shall be resident doctors jin believes that the current, the patient to the diagnosis of time and medical efficiency is very high expectations of auxiliary examination, not only can quickly than the doctor's hands are more detailed and accurate description, and still can leave a objective report, HeLe and

Not for? Therefore, physical examination should be simplified.

Beijing union medical college hospital, deputy director of the emergency department WangZhong think, the development of medical technology is not to omit "hope," the doctor to touch knock at the hand or as much as possible to touch carefully, next reoccupy modern methods to verify the clues to be found. "' knock at the level of" touch to listen to

Is ZhangXiaoQian must meet the requirements of The Times, this problem is open to question. "

"Physical examinations should discard some out-of-date content." Beijing union medical college hospital medical doctor wu dong think, such as lung auscultation of XiaoMingYin, the past even as sheep to what sound again under classification. With advanced auxiliary examination means, maybe just listening to the doctor after a is

XiaoMingYin is enough.

Some disease new signs and symptoms are constantly was found, wu dong said, the past meningitis is mainly on judgment for stiff neck, because the subjectivity is stronger, now has been changed to let patients shook his head. The past is to look at the main body peritonitis have rebounded on pain, instead

Let the patient cough, cough, stomach pain is if equal to bounce are painful.

Beijing union medical college hospital li rheumatism lead surgeon David llewelyn said, whether sensitivity or specificity, auxiliary examination is higher than the physical examination, so "physical examination is a weakening of the phenomenon of helpless, but it was also a natural evolution and the medical development trends. To this kind of phenomenon

And maybe we need not too entanglements ".

S physical examination is "survey the scene"

Reporter with Beijing union hospital nerve of medical director CuiLiYing during a home, in the face of a suspected "with" the patients gradually, she is not see first mri examination results, but from his pocket a small hammer, knocked to knock patients have losing consciousness right leg.

"Don't look down upon this small hammer, then developed country, are used this tool. Auxiliary examination is not everything. There's mastercard, neurologist first is telling the positioning, then is qualitative, and accurate positioning, must depend upon the most basic of the physical examination." CuiLiYing said.

The hammer CuiLiYing also help for a 70-year-old old man found the right cause. For more than a year, the old man always feel legs boring, in other places the hospital mri brain, because the film with a few small point and diagnosis of cerebral infarction. However, hospitalization for several months,

Not only did not get better, but more and more heavy.

The old man into the consultation room, CuiLiYing first took out the little hammer, found the old man leg strength is very good, muscle strength to grade 5. To do a few nervous system of examination revealed that the tendinous reflex is low, without pathology to ask for, take a needle pierced, and the feeling of around obstacles. CuiLiYing concluded that, the old man

Not cerebral infarction, but deep feeling ataxia. Again, the old man said, found out from them the exact time history because the stomach is bad, have a vegetarian for many years. Don't eat meat will lack of folic acid, vitamin a check of patients with blood, the index of folic acid B12 is very low, need immediate folic acid B12, a month is only 100

DuoYuan will work like a charm.

"Deep feeling ataxia spinal cord damage, the light is not be detected by image." CuiLiYing said, in fact, a lot of the disease through images to the diagnosis, even pathological also can't judge. For it, not a progressive disease with only CT,

The results of the PET can diagnose. If doctors can't through the physical examination to make the right position, even if the head, neck, chest, waist do nuclear magnetic resonance (NMR), patients spend millions of dollars to go out, and in the end it may also be in diagnosis is not clear.

"Relying solely on physical examination or auxiliary examination, can make the final diagnosis." WangZhong said, such as the patient's liver surface has a bag piece, it is sex of liquid or solid, is liver or liver abscess? KaoShou light is not out of touch. Once only open to probe

And now many means it can give a definite answer. But, let the patient for CT, the premise is the doctor first to touch out the bag piece, and on the basis of the degree and the hard and soft touch up the patient's signs, make a preliminary judgment and assumptions, and according to this hypothesis to choose

Check the project. That is, no front "hope" is not to touch knock at the back of the CT examination.

"Patients are all say, MianYiKe doctor will 'face reading'." David llewelyn told reporters, because a lot of immune diseases such have the characteristics of the surface. If a young female patients face cross bridge of the nose, double ophthalmic department, not involving the nasal lip of the ditch wing erythema, probably erythema Wolf

Sores; If the patient's hand present symmetrical joint spindle swelling middle thick head (two fine), is likely to be rheumatoid arthritis...... So, for MianYiKe speaking, physical examination will often play a decisive role, many physical check index was even written into some new diseases

Diagnostic criteria inside. And theoretically, 60% to 70% of the disease can be through the interrogation and physical diagnosis for a more specific direction.

Beijing union medical college hospital infection, associate professor FanHongWei said: "diagnosis is like alex. Isn't because of DNA technology, need not ask MuJiRen, don't go to survey the scene? Asked the history is to look for witnesses, physical examination survey the scene is."

S "touch at knock listen to" is a kind of "ritual"

"Hope to touch knock at the foundation of diagnosis is always right." FanHongWei think, the core of the physical examination is a doctor work and think method, it teaches how doctors and patients, how to communicate from abnormal performed in, again how to ask and check combine to find the disease line

Cable. This method is never out of date.

WuDongZe think, physical diagnosis is the essence of "the doctor want and patients together" the idea, and this concept can never change.

It is difficult to find in a number of Beijing union medical college hospital MianYiKe, 35, of the king of outpatient service has been moved, scalpers Fried to 500 yuan, however, when patients experience hardship finally walked into the clinic, in the face of a natural "baby face is". In each patient average is only a short 10 minutes

The diagnosis and treatment of time, how to win their trust? David llewelyn's way is very simple, rely on serious physical examination.

"Touch to knock at a ceremony is, is also a kind of psychological need patients." David llewelyn said, in practice the doctor when he found that the majority of patients are particularly willing to let the doctor performed, because they think the doctor should be this way. Has left several patients in hospitals

Is, if the doctor to talk to, touch for him, he will feel the doctor do a doctor, should be very experienced. Touch is a doctor and patient's first "intimate contact", serious on to the patient care is a doctor and care about performance, it will make patients more trust to medical treatment

Live, and the trust will directly related to the curative effect.

"Hope to establish good touch knock in the doctor-patient relationship is important." .chem eng sci, into a hospital, that is not only expected to hae technical treatment, including effective communication and the psychological satisfaction. Many doctor thought is a knife and medicine cured disease, they don't know

Word doctor an ace in the hole is just what the doctor, the doctor should regard themselves as knife, as medicine, make oneself become a can affect the patient, promote the placebo effect.

Reporter record

How to let the "hope to stay in the clinical touch knock at"

"If there is enough time, if not so many patients in the queue, most of the doctors must be willing to seriously on." Must the jin said. The problem is, China quality medical resources, so many patients are not to go to large hospital to limit, to run an average per patient body

The time on will be very limited, leaving the doctor do physical examination time is even less.

To solve this problem, CuiLiYing think, can only rely on the big hospital doctor, layered from blind pursue outpatient service number freed, ensure the quality of diagnosis and treatment. If a doctor can let patients get the correct diagnosis and treatment scheme can reduce the number of patients to see a doctor, help the patient save money,

And to mitigate the pressure of the big hospital.

"Forced doctors rely more and more the reason of auxiliary examination and a, is the current bad doctor-patient relationship." The central hospital of pingdingshan city henan province orthopaedic surgeons ZhaoXue village told reporters, especially in the face of car accidents and fight the trauma patients, diagnosis must be made clear, certain

Try to be "TieAn". If not in black and white sheets or video material as evidence, in the future, the doctor has something to say.

WangZhong said, in reality, the doctor do have their own helpless, but can't use this as an excuse, I hope to "touch" knock basic skills such as lost, ready to do a "doctor" list.

A county hospital doctor tells a reporter, the doctor is not don't pay attention to some basic body, but not really. Because a lot of grassroots organization of doctors had taken only the after the technical secondary school, also have no chance to get training.

Why "knock at the present situation of listening to" touch would lead the industry wide anxieties, WangZhong think, that is because, from the top to the basic skills, the doctor in weakening. To solve this problem, on the one hand, want to rely on reform system, increase the government primary hospitals to support; The other

On one hand we should rely on education, through the general practitioner and resident standardization training and resident standardization training and strengthen the most basic skills, the most special skill.