Medical and health personnel in China always carry forward the humanitarian spirit of saving lives and healing the wounded, uphold lofty professional ethics, and protect the lives and health of 654.38+300 million people in China. It is the main force to practice the new medical reform in China.
Beijing Chaoyang Hospital has been striving to adhere to the concept of "patient-centered" for many years, starting from the things that patients are most concerned about and urgently need, and is committed to improving medical quality, ensuring medical safety, creating a comfortable and civilized medical environment, reducing the burden on patients, facilitating people to seek medical treatment, and making solid efforts to build a harmonious doctor-patient relationship.
A few days ago, the reporter interviewed Dr. Wang Chen, president of the Respiratory Physician Branch of the Chinese Medical Association, president of Beijing Chaoyang Hospital and respiratory expert, and asked him to express his views on how medical institutions can build a harmonious doctor-patient relationship and how to play an active role in alleviating the people's "difficult and expensive medical treatment".
Reporter: As we all know, it is quite complicated to solve the problem of "difficult and expensive medical treatment" for the masses, including government investment, medical and health system, drug circulation system, social security and so on. These problems cannot be completely solved in a short time, but this does not mean that the medical and health departments are powerless. As one of the hospitals with the largest number of outpatients in Beijing, what efforts has Chaoyang Hospital made in recent years to facilitate patients to seek medical treatment and alleviate the people's "difficulty in seeing a doctor"?
Wang Chen: "It is difficult and expensive to see a doctor" is indeed a prominent problem in the current medical and health services, but the specific situation should be analyzed in detail. On the one hand, "expensive medical treatment" mainly means that urban self-funded patients who do not participate in medical insurance and farmers who do not participate in rural cooperative medical care spend a lot of money, and "difficult medical treatment" mainly means that it is difficult to get medical services from well-known experts in large hospitals. On the other hand, due to the rapid development of medical and health undertakings in China in recent 20 years, people who participate in medical insurance or can be reimbursed can enjoy world-class medical services at the price equivalent to Europe and America110, and it is not expensive to see a doctor. Moreover, it is quite common for well-known experts to wait for a few months to see a doctor abroad. Therefore, "it is difficult and expensive to see a doctor" involves many reasons such as system and mechanism. Don't blame all the contradictions on the hospital, but point the finger at the doctor.
As a large-scale general hospital, Beijing Chaoyang Hospital, based on the conscience of "doctors are all good people", takes various measures as far as possible to facilitate patients to seek medical treatment and alleviate the people's "difficulty in seeing a doctor".
First of all, we make full use of the academic advantages of the hospital to provide quality medical services for patients. Many disciplines in Beijing Chaoyang Hospital have academic advantages and have been identified as key disciplines of Beijing medicine or key supporting disciplines of Beijing medicine. In particular, the Beijing Institute of Respiratory Diseases, established by our hospital, is the key unit for the diagnosis, treatment and research of respiratory diseases in China and the base for the prevention and treatment of respiratory diseases in Beijing. Over the years, our hospital has made full use of the advantages of disciplines and strived to provide high-quality medical services for patients. In addition to opening an expert clinic on Saturday and Sunday, we rented a house next to the hospital to open a second clinic, which increased the number of visits by experts per week and extended the time of visits. At the same time, we implemented telephone appointment registration, which eased the problem of patients asking famous experts to see a doctor.
Secondly, break the traditional disciplinary boundaries and administrative divisions, and open a "life green channel" for patients, including emergency green channels and cardiovascular green channels. These green channels are open 24 hours a day, which can provide patients with the fastest, most convenient and most effective rescue conditions and facilities, so that patients can be fully evaluated, diagnosed and treated in the shortest time, which greatly improves the success rate of patient rescue.
Thirdly, under the guidance of the concept of "patient-centered", the medical staff in our hospital sacrificed their rest time to create a "year-round waiting clinic" with 365 days of uninterrupted consultation and a "daylight saving time" clinic with one hour extension in the morning and evening in summer to facilitate patients to seek medical treatment. In order to consolidate the therapeutic effect, departments such as heart center and respiratory department vigorously carry out patient health education, establish multi-level networks, and transmit health information to patients. It also trains talents for community hospitals by holding training courses, training doctors on behalf of them and providing on-site guidance, and actively participates in community health work. For example, the Heart Center of our hospital sends 1 chief physician and 1-2 attending physicians to open expert clinics in Jingmian Group community and Guanzhuang Dongli, Xili and Shuiawzi communities 10 communities, and regularly train community medical personnel; Regularly send head nurses to carry out nursing management; Carry out health education and consultation free clinic activities for community residents from time to time. These measures enable people in the community to get high-quality medical services from experts in large hospitals at their doorsteps.
Fourth, efforts should be made to improve the medical environment. The outpatient system of our hospital provides patients with four forms of medical treatment: special needs expert outpatient service, special needs professional outpatient service, general expert outpatient service and general professional outpatient service, which improves the outpatient medical treatment environment. In addition, the hospital has also adjusted the administrative rooms, increased the medical rooms, improved the computer charging system for outpatient and emergency departments, and strived to create a comfortable and civilized medical environment for patients.
It is worth mentioning that in June 5438+February, 2004, the former China Railway Construction General Hospital was officially transferred to Chaoyang Hospital, and it was renamed Beijing Chaoyang Hospital Jingxi Campus, which doubled the "territory" of Chaoyang Hospital. Jingxi Campus is located in Shijingshan District, which is relatively poor in medical resources, covering the western part of Beijing with superior medical resources, narrowing the gap between the central area and the marginal area in medical and health development, building an east-west emergency network for the capital, and greatly improving Beijing's ability to deal with public health emergencies.
In 2005, Chaoyang Hospital discharged 29,000 patients, with outpatient10.5 million, becoming a veritable main force in the medical and health field in the capital.
Reporter: It is more complicated to solve "expensive medical treatment" than "difficult medical treatment". What good measures does Chaoyang Hospital have to reduce the economic burden of patients?
Wang Chen: As a primary hospital directly facing patients, we have been trying to save money for patients.
First of all, choose high-quality and cheap drugs to directly benefit patients. Take levofloxacin injection as an example. These drugs are commonly used in clinic and have a wide range of applications. At the beginning of 2005, the Pharmaceutical Administration Committee of our hospital passed a resolution to stop using four kinds of expensive levofloxacin injections produced by different manufacturers and choose "levofloxacin hydrochloride for injection" with lower price. Compared with 2004, the total cost of levofloxacin injection decreased by more than 5.5 million yuan in 2005, which is equivalent to directly benefiting patients.
Secondly, the first single disease price limit, strictly control the patient's medical expenses. The service measure of "laparoscopic cholecystectomy with a price limit of 7000 yuan for single disease" was introduced in Jingxi Hospital of our hospital, which was well received by Beijing residents. On the basis of strengthening standardized management, improving medical technology and ensuring medical quality, hospitals try to reduce the consumption of medical resources, ensure the normal operation of hospitals, and let patients enjoy low-cost and high-quality services. After careful investigation, we have successively introduced four mature single-disease price-limiting service measures, such as laparoscopic surgery for benign ovarian tumors, laparoscopic surgery for hysteromyoma, tension-free inguinal hernia plasty in general surgery, phacoemulsification combined with intraocular lens implantation in ophthalmology, aiming at "accepting supervision and benefiting the people", so that ordinary people can spend less money and enjoy the best medical services, and Chaoyang Hospital can also "enjoy the best medical services".
In addition, hospital leading cadres set an example, severely investigate and deal with unhealthy trends in the industry, strive to put an end to the phenomenon of "kickbacks" and "red envelopes", and effectively reduce the economic burden of patients.
Reporter: Medical personnel are engaged in high-tech jobs with high occupational risks, which require superb medical technical level and noble ideological and moral realm. How do you motivate medical staff? What good experience do you have in the construction of medical ethics?
Wang Chen: The profession of doctor is sacred. Love and responsibility are essential qualities for medical staff. During the SARS period, the staff of our Chaoyang Hospital, together with the medical staff of the whole country, won wide acclaim from the people of the whole country for their professionalism and professional ethics. We often say that "doctors' parents care about patients", and doctors' care, responsibility and superb professional services for patients will definitely gain the respect and trust of patients. Trust between doctors and patients is an important guarantee for building a harmonious doctor-patient relationship. In fact, most medical staff are competent and have due professional standards and professional ethics. They work hard and busy on weekdays, and they have to continue their studies. Without hard work and dedication, it is difficult to become a good doctor. However, the misconduct of a few doctors has indeed tarnished the image of "angels in white", which has led to the tension between doctors and patients and the increase of medical disputes. In 2005, our hospital took the opportunity of carrying out the activity of "maintaining the advanced education of workers", and through the exemplary role of party member, we improved our consciousness of serving patients and strived to establish the doctor-patient relationship on the basis of mutual trust, mutual understanding and mutual respect. Of course, their efforts should be rewarded accordingly. Therefore, in order to mobilize the enthusiasm of medical staff, we constantly tap the potential, optimize management, do everything possible to improve the treatment of employees, and constantly improve the "sunshine income" of employees without increasing the burden on patients. At the same time, severely investigate and punish, put an end to "gray income", and prevent "gray income" that "benefits for a while and loses the long term" from tarnishing the lofty image of doctors. We require the leaders of colleges and departments to "take teaching as the policy and set an example", establish a professional and service system that can be inspected and supervised, standardize medical behavior, improve service measures and improve the feedback mechanism of patients' opinions, so that patients can truly feel the achievements of medical ethics construction.
Reporter: As an expert leading cadre who has studied and worked abroad and struggled for a long time to heal the wounded and rescue the dying, what suggestions do you have for the future medical and health system reform in China?
Wang Chen: I personally think that some problems in China's medical and health system are caused by the following reasons:
First of all, the social security system is not perfect. It is extremely important to further deepen the reform of the health system. The "New Rural Cooperative Medical System" being implemented by our country represents the correct direction of health development in China.
Secondly, the price formation mechanism of the medical system is not reasonable. This includes the price of medical care and the price of medicines. In terms of medical price, the current pricing does not fully reflect the difference in technical service charges of different levels of hospitals. Because no matter how different the level of medical technology is between hospitals and experts in hospitals, the price of medical services is the same or similar, which leads patients to go to big hospitals regardless of serious illness or minor illness. Big hospitals are overcrowded, but first-and second-class hospitals are neglected. In fact, in Beijing, it is not difficult to see a doctor in a first-class or second-class hospital, but patients do not go. Why? Because everyone wants to spend the same or similar money to enjoy the best quality and the highest technical service. Therefore, we should establish a price system that can reflect different levels of hospitals, different expert levels and different medical services as soon as possible, and guide different patients to the corresponding levels of hospitals, especially the first-and second-class hospitals. As long as we make full use of the existing medical system in China, we can effectively alleviate the problem of "difficulty in seeing a doctor".
If the "difficulty in seeing a doctor" is mainly due to the unbalanced utilization of medical resources caused by unreasonable medical price pricing, then the "expensive medical treatment" is mainly due to the unreasonable drug price system. For drug prices, there are many gray spaces in the current drug price management system, which breeds corruption such as commercial bribery. If the root cause of corruption is not eradicated, but only the corruption caused by this system is rectified, then such anti-corruption work will not be thorough and lack long-term vitality. Hospitals must give up the right to purchase drugs. For large-scale third-class general hospitals, we put forward the concept of "drug outsourcing", that is, the hospital's drug procurement and drug logistics are entrusted to pharmaceutical companies, and hospitals no longer directly implement drug procurement, but should supervise the quality of drugs purchased by pharmaceutical companies. "Drug outsourcing" is a benefit to the people, which is conducive to the construction of medical ethics, the management and development of hospitals, and the standardization and healthy development of pharmaceutical companies' behavior.