Dept. of pathology analyses and explains the difficult position to need new thinking

Dept. of pathology analyses and explains the difficult position to need new thinking
Dept. of pathology analyses and explains the difficult position to need new thinking
Staff reporter Zhang CanCan "Guard and estimate, the gap of doctor of dept. of pathology is up to 25,000 persons. " A few days ago, the pathologic quality of Ministry of Public Health accused of appraising at the working conference in 2011 held in Liaocheng of Shandong, the pathologic quality of Ministry of Public Health accuses of appraising the centre General Board, Chen Jie, Professor of BJ Union Hospital dept. of pathology and checking pathology " The resources " Weighed down with anxieties hour. Many top experts of dept. of pathology in our country say, pathology and examining, image " Troika " as modern medical diagnosis ,And as the gold standard of the disease diagnosis, pathological diagnosis plays an essential role to choice of the healing solution, being treated weight more and more large in tumour especially, " the badly paid, have a big risk, Cheng CaiWan " Current situation last a great deal of difficult position that dept. of pathology. The clinical pathologic quality in Shanghai accuses of the centre director, subsidiary tumour hospital Professor Du Xiang of Fudan University's saying, discipline owes account too much, in addition, leave no successor, " terrific when not shouting loudly that dept. of pathology has already got! " " there are too few doctors liking to be engaged in to be with specialized pathology " According to the introduction of Chen Jie, there were 9929 pathologic doctors in the whole country in 2005, estimate less than 15,000 people at present. And the open total berth of all kinds of medical organizations of the whole country will amount to 4,039,000 in 2008. Ministry of Public Health issued in 2009 <>Stipulate, the pathologic doctor arms with 2 people according to person of every one hundred sick beds 1. Even if 100 berths only allocate a pathologic doctor, need about 40,000 pathologic doctors, the gap is up to 25,000 persons, system and certification system that the unified pathologic doctor has been trained that and our country has not set up, cause the pathologic doctor's level to be different. Auspicious to seem in Du, this only conservative to estimate. The general hospital of 15 of the first, second and third of Shanghai, opens several 19755 berths actually, there are 141 pathologic doctors, the technician is 109. 130 are engaged in the hospital served in pathological diagnosis in the whole city, the gap of doctor of dept. of pathology is very great. "Hospital know dept. of pathology doctor in short supply, suffer from, employ, like, engaged in pathology specialized doctor too little too. " Du Xiang tells reporters, Shanghai will train resident's standardization in 2010, according to the demand of every hospital, planned to employ 40 doctors of dept. of pathology, only employed to 25 finally, one year later, because 3 people go abroad or other reasons are left, only leave 22. The resident of this year trains and only employs 22 doctors of dept. of pathology in standardization. "Very grieved, dept. of pathology has become trade that no one wishes to do! " Problem seriously imbalanced in proportion that dept. of pathology still faces doctor's gender. One of subsidiary nearly 30 pathologic doctors on the permanent staff of tumour hospital of Fudan University which Du Xiang belongs to, among them only 4 are men doctors, it is for the most part women to like to be engaged in a specialized one of pathology definitely, there are very few men, " the sound development of this pair of disciplines is unfavorable too. " Du Xiang says, dept. of pathology is one, experience discipline, pays attention to doctor's personal ability and experience, no matter what apparatus does it use, need people come interpretation finally, it endures to be 10 year more upper, the pathologic reports issued are all deficient, and people's cultivation needs very long cycle, pathologic professional personnel very much difficult to relieve in in short supply current situation in short term. Charge, hang upside down, cause dept. of pathology become Chen Jie, department of edge, think, pathology is checked and charged low, can't reflect the technological content of pathological diagnosis, it is an important reason causing pathologic discipline to shrink. With examine and the intersection of image and apparatus weed out the old and bring forth the new constantly, charge, soar and compare constantly, pathological diagnosis depends on the microscope mainly, pathological diagnosis charges and is well below other medical projects to charge. According to the introduction of Du Xiang, do work to examine and charge 75 yuan in Shanghai, take out and informs since the organization to transmit, pass 7 processes. Bring the prostate to puncture to say, the more on different positions puncture, may find the focus present, usually need to wear between 14 and 18 strings, but the present charge stipulates no matter how many strings are worn only charges 75 yuan without exception. Mean the more to dept. of pathology doing, the higher the cost is, the more compensate, this kind charges to stipulate obviously unfavorable to ensuring the medical security. And prostate is a bit more puncture and can be up to 3000 dollars to charge in U.S.A.. In China, pathology charge hang upside down very serious, dept. of pathology doctor income medium-sized on the lower side basically in hospital. The pathologic quality in Shandong is accused of Sun Qing, director of centre, and introduced, the hospital under the province of Shandong will implement the new expenses standard from October of 2009, pathological diagnosis charges to greatly improve. The fast icy section rises to 400 yuan from original 100 yuan, a position of every increase adds 100 yuan. The inner mirror lived and examined 40 yuan / example originally, 200 yuan / example now, increased a position and added 50 yuan. Puncture and examine 260 yuan / example alive, cut the sample of 300 yuan only, radically treat the sample of 480 yuan, consult about 200 yuan in difficulty, autopsy is 2600 yuan, opened the cranium and added 500 yuan. " the adjustment of the price has aroused the working enthusiasm of the doctor of dept. of pathology greatly " . The medical reform that will begin in 2009 proposes changing and raising medicine with medicine constantly, adjust the medical service price rationally, but is limited by the factor such as being complicated of the rigid to the management system of the price, hearing procedure to restrict, it is that " the stairs creak but no one comes down" that most medical treatment of province and city charge to adjust ,Even if been already taking Shanghai that medical treatment has charged and adjusted the paces, it is very little that pathology charges and changes. Leave standardization, standardize, have smallly the intersection of distance and Xiang Du, think without high-level pathological diagnosis, and what is launched by dept. of pathology is clicked and measured on the basis of the disease target organizing, it is unable to realize that the individual treats. Take tumour as examples, individual's correct implementation treating, rely on the molecule target in modern pathological technology measure tumour to organize at first, assess the disease -specific molecule target accurately, employ the whole automation equipment based on procedure of standard procedure, adopt the standardization, standardized pathology to measure the procedure, find out that can be from target to patient really benefiting while treating, it is the key to raising individual's efficiency of making a diagnosis and giving treatment of tumour, it is the task that the modern pathologic doctor faces too. Medical science department Professor Zheng Jie of department of pathology in Peking University says, dept. of pathology obviously progresses after 30 years of development, but there are many problems, need setting up a set of pathologic quality control standards badly. Zheng outstanding to participate in hold a consultation, finding many the intersection of hospital and dept. of pathology have, abuse immune the intersection of group and phenomenon that dye, "a pathology has sliced and run 30 immune groups to dye, in fact only several items are useful, and dye many kinds of antibodies on a piece of section, it is apt to pollute each other. " The man, wild professor of China of Beijing dept. of pathology of general hospital of Military Area Command thinks too, dept. of pathology needs to change the small and workshop-based mode, the application popularizing standardization and dyeing reagent, " the immune group dyes Quality accuse of not working also to need stressing, be accused of not testing unified quality standard slice. " Combine resource set up area pathologic centre Du auspicious to say pathological diagnosis level represent one medical competence of hospital, in pathologic doctor being in short supply training cycle under the long current situation, can consider combining resources, set up the pathologic centre in the area, the government increases input, there are few hands that change pathologic doctors, current situation with bad income, attract more young doctors to join in the pathologic speciality. The reporter knows, Zhejiang Province Ningbo Municipal Health Bureau has already stripped subordinate 6th dept. of pathology of tertiary hospital out wholly, having established the clinical pathological diagnosis centre of Ningbo, the public service authorized as Ningbo Municipal Health Bureau by the local editorial member is accepting propping up the public institution, the city finance provides funds in the central building of newly-built pathological diagnosis of more than 57 million yuan, still arrange the special fund every year, always put it into 50 million yuan for equipment purchase and technical application, arrange for the special fund to be used for personnel training and introduced at the same time. The centre is deposited by the subsidiary tumour hospital of Fudan University. Du Xiang thinks, sets up the pathologic centre in the area and can strengthen the capability of pathological diagnosis, can reduce patients and come and go ceaselessly, it is a direction in which pathologic discipline develops in the future.


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