See the doctor and hold the relation how much sense of safety can be brought

See the doctor and hold the relation, how much sense of safety can be brought
See the doctor and hold the relation, how much sense of safety can be brought
Professor of Jilin University Bethune medical college Qu Ying and patient often feel helpless and strange while seeking medical advice in the large hospital, at this moment, asking an acquaintance for help becomes a lot of patients' respect. Scene Cui print, take a photograph of reality have such a general phenomenon - -Patient seek medical advice, first choose doctor and hospital that know or familiar with generally. If does not know or familiar directly, patients will utilize various social resources before seeking medical advice, pass " relation people " Choose doctor and hospital that he knows or familiar with. This phenomenon is called by some scholars " Concern and seek medical advice " . Then, " concern and seek medical advice " Why generally exist, patient and the doctor, to " concern seeking medical advice " Attitude how,"relation seek medical advice" What influence does the orientation have to the interdynamic between doctors and patients? Centre on these questions, Bethune medical college of Jilin University crooks 200 clinicians and 500 patients of sample investigation of Great Britain and professor, and done interview to some doctors and patients and carried on deep analysis and discussion to this phenomenon. I have worked in one large-scale the first, second and third hospital for nearly 20 years, often someone goes to the hospital to see the doctor through me. I have done statistics of some time, from the July 1 to March 5 of 2009, 2007, 491 people in all will go to the hospital which I belong to to seek medical advice through me, nearly there are 25 people averagely per month. This phenomenon impels me right " Concern and seek medical advice " The phenomenon has carried on the investigation. Through statistics and analysis to the census data, I find a patient presents the obvious " relation orientation " in the course of seeking medical advice ,The doctor would hope and like to receive the relation patient too. " concern and seek medical advice " Have already become the general phenomenon of the social medical service field of China. Patient: Let the acquaintance see the doctor, walk much fewer in detours In the questionnaire, the patient first chooses to pass " relation " Seek medical advice, it is obvious to concern the orientation. The investigation reveals, 9.3% of the people seek medical advice and look for the relation each time, 45.6% look for the relation sometimes, 15.7% want to look for the relation but find, the persons who never look for the relation only account for 29.4%. That is to say, more than 70% of the patients hope to seek medical advice through the acquaintance. This data have got the clinician's affirmation too. Doctor Liu of the department of neurosurgery says: "I patient examined to meet have percent sixty or seventy send for through various relation nearly. " Then, where do patients look for the reason why the acquaintance sees the doctor? According to the investigation, 57.2% of the patients choose " the doctor diagnoses the illness more conscientiously, more patient " ,52.8% choose to " let the better expert see the doctor " ,42.8% choose to " save time " ,What the relation that 40.7% are chosen " recommends can be believed, steady and more sure in the heart even more " ,38.3% are chosen " doctor's enthusiasm, attitude are better " ,36.6% are chosen " no the flower wronged the money " . It is obvious, in many aspects that there are the reason for looking for the relations that the patient diagnoses the illness, among them the main reason is wanting to let better expert see the doctor, and they think the doctor that look for through the relation diagnoses the illness more conscientiously, more patient. In the hospital, patient Ms. Zhao has explained why she sees the doctor to look for the acquaintance with the personal experience, " want, look for pieces of the intersection of technology and competent doctor mainly " . This time, Ms. Zhao's mother needs the operation to excise thyroid tumor, she asks someone to find the most famous thyroid gland subject expert's operator inside the province, the operation is very successful. She says: "In case meet the doctor not good of last technology, will take very great risk. The major issue of closing it in life, can not despise. " Song, teacher of middle school in hospital says: "Let the acquaintance see the doctor, steady and sure in the heart. " Patient Ms. Liu says: "Have people that know, can be spent less and wronged money by me. " Mr. Xu has deep feeling especially: "Acquaintance's necks needn't line up to see the doctor, lead the consulting room directly, doctor's attitude toward relation patient will be a little more cured naturally, and ~s links of registering, paying dues, checking, getting it filled, making a diagnosis and giving treatment etc. are all all right ' block by nothing ', it is convenient to also save time, it is the best choice of seeing the doctor. " Let acquaintances see the doctor to realize these good results on earth? The census data reveal, 36.9% of the patients think " the result is obviously better than not to look for the relation " ,43.5% think " look for and look for it almost " ,15.5% think that " it is better not to look for the relation result " . Patient Mr. Xu says it is sure to look for acquaintances that he sees the doctor: "It is a kind of pain in the neck to have disease, can let doctor's attitude be a little better to concern to look for, walk much fewer in detours, still can know the truth of disease. " Doctor: No one let you explain you fine doctor patient seek medical advice and doctor connect, it examines to be one two-way interdynamic course at all. In the face of the patient is obvious " Concern and seek medical advice " The orientation, how is doctor's attitude? Investigation show, 86.6% doctor accept " relation seek medical advice " ,It is unacceptable to only account for 13.4%. Dept. of orthopedics says to the doctor: "At ordinary times, really some friends and family or colleague lets me take patient to each department to see the doctor, I think this gives no cause for much criticism. " The cold doctor of gynaecology and obstetrics will be even more " Concern and seek medical advice " Have linked up with the doctor's engineering level: "If you are a good doctor, there are many people to let you see the doctor. If no one looks for you, prove you are not a good doctor at all. " Also some doctors hold different views. Doctor Ma of the department of general surgery thinks " Concern and seek medical advice " It is a kind of abnormal phenomenon, but it is difficult to improve in short term. Professor Zhao of pediatrics says: "It looks for people that Is diagnoses the illness to be very many, this indicate patient to hospital, know a little about medical market, do not believe in the doctor very much either. " Professor Sun of pediatrics mentions too, this indicates the doctor does not treat to all patients equally without discrimination, make all-out efforts, have caused the intension of the relationship between doctors and patients to a certain extent. In fact, the patient, to " concerns seeking medical advice " Negative effect too yes know: 60.7% of the patients think this phenomenon " cause medical treatment to be unfair " ; 56.5% think " cause the vicious circle and it is more difficult to result in seeing the doctor " ; 25.9% think " unable to look for that the medical dispute takes place, lose more than gain " . Under the state of medical resources relatively in short, the medical care that the society offered, especially high-level medical care can't meet 's patients' demands. Then, most patients will choose to seek medical advice through the relation, and this will inevitablely lead to the fact the treatment is unequal, medical treatment is unfair. And the question of upsetting people even more is, see the doctor through the relation, it is unable to trace to its source once the medical dispute takes place. Patient Mr. Zhang has told his experience. Want, make the intersection of hernia and operation, he ask someone, find one large first relatively more famous doctor and operator of hospital. Take place, infect while being postoperative, have to do the second operation, has met with the second crime. According to the introduction of doctor polling, to the relation patient, doctors may give up and make a diagnosis and give treatment the routine inspection that disease needs for fear of hurting one's feelings, will try every possible means to look for cheap too in respect of using medicine but result as to difference a bit medicines are substituted. Save money in order to save time, some normal visit procedures are simplified, some must The ones that want are checked and is omitted, cause unstandard medical treatment, it is so apt to go wrong instead. However, 73.8% of the doctors say that hope to meet and examine by various patients whose relation introduced over, the ones that do not hope only account for 26.2%. As for the reason, 60.4% of the doctors say that can " increase the clinical experience and improve the engineering level " in this way ; 41.5% choose to " make more friends " ; 40.4% choose to " increase the economic income " ; 38.3% choose to " expand social popularity and promote the social status " . Looked after more, have a few " fond dreams " more or less through the relation Where does doctor's treatment of the relation patient behave? The investigation result reveals, compared with general patient, doctors are mainly shown as " looks after the treatment of the relation patient in the ward is arranged " ( 33.7%) ," see the doctor, check and the operation is preferential " ( 28.4%) ," to condition, cause of disease, treat detailed scheme explanation " ( 26.6%) ," try not to prescribe expensive medicine, does not do the surplus inspection " ( 21.3%) ," exempt from the registration fee " ( 18.9%) ," make a diagnosis and give treatment more cautiously, take charge of even more " ( 16.0%) ," connect and examine time longer, diagnose more conscientiously " ( 14.8%) ," increase, make the rounds of the wards number of times" ( 13.6%) ," reduce or remit and check partly and is in hospital the expenses " ( 5.3%) . It is obvious, the doctor reflects patient's adequate consideration of the relation in serving and linking up more, do not involve the profound content of the healing solution. Doctor Tan of respiratory medicine says: "It is the care passed to look after on languages. The intersection of we and doctor have no right, remove expense from, can only recommend, see the doctor from the condition as soon as possible, shorten the course of treatment to help as much as possible. " Professor Sun of pediatrics thinks: "Matter, look after specially basically, that is, explain clearly a bit, to be thin words. " Doctor Zhao of the department of nerve internal medicine says clearly: "In fact to any patient, the doctors all hope to cure the disease, do not have problem looked after specially. " The gynecological cold doctor says: "As to relation patient, doctors may explain more, but say in terms of medical treatment, whether the explanation is careful with having too great relation to see the doctor carefully. " But investigation show, 53.4% patient think " relation seek medical advice " Doctor under the situation " To condition, cause of disease, treat detailed scheme explanation " ,40.9% think doctor " treat cautious, responsible for " ,39.2% are chosen " seeing the doctor, checking and operation have priority " ,38.9% choose to " connect and examine time longer, diagnose more conscientiously " ,37.9% choose to " try not to prescribe expensive medicine, does not do the surplus inspection " ,31.3% choose to " look after in the ward is arranged " ,The number of times that 14.4% are chosen " to increase and make the rounds of the wards " . It is obvious, the patient thinks that diagnosing the illness looks for the result concerned to embody in a plurality of respects, we can say that involves the main content that a patient pays close attention to, hopes to receive most most in the course of making a diagnosis and giving treatment. We find in the investigation, 43.1% of the doctors think the relation have no effect on healing solution, and 76.1% of the patients think the relation influence healing solution. Can be seen from it, doctors and patients both sides, to " concern seeking medical advice " View existence offset. On one hand, " it is too many and careful to check " , " inspection omitting some and should be paid " With " reduce and use medicine " All unstandard and therapeutic manifestation, with " treat the norm " Run counter to; On the other hand, in real medical care, " it is too many and careful to check " , " inspection omitting some and should be paid " With " reduce and use medicine " It was the kind consideration of the worldly wisdom, but not technological question that mainly reflected. In another investigation, 55.9% patient hope the intersection of relation and doctor he look for in the course of making a diagnosis and giving treatment can offer " make a diagnosis treatment of " ,And 24.7% doctor choose, offer " make a diagnosis treatment of " to the intersection of relation and patient only . The patient thinks that can be more or less looked after more from relation doctor " The fond dream " . Let an acquaintance make " umbrella " ,Defend killing anti-cheating and asking resting assured " concern and seek medical advice " Behind the phenomenon, there is cause in many aspects. Except that China and social Israel " Favor " Based on traditional influence is medical for service mode and medical care current situation worth reviewing too in ours outside, and a question is especially noteworthy: Doctors and patients believe in and lack. At the beginning of the fifties of the 20th century, our country set up socialized medicine and labour protection system in the cities and towns. What this kind of system offered can only be that low standard, wide medical treatment that covers ensure serving. Ensure the state-run hospital under the system to be the owner of national medical resources in this kind of medical treatment, person who becomes domination of national medical resources of the doctor in the state-run hospital. The patient, in order to obtain it than standard higher better than others medical care, certainly will hold the relation, entering by the back door. Our country is the relatively scarce country of a medical resource, medical care has tense supply and demand. First, medical resources are insufficient overall, it is only 2% of the whole world to account for global people 22% Chinese medical resource. According to World Bank's statistics, it is 1.5 people that doctor of every thousand people of our country in 2003 counts, it was 2.3 that every thousand people counted berth, equal to average level of the medium-sized country of the world, but is far lower than 2.6 people of the high-income countries and standard of 6.4. Second, medical resource maldistribution. Existing medical resource 80% centre in the big city, 80% among them concentrate on the large hospital again, urban communities and medical resources of rural medical organization are deficient, technical force is weak. Third, the medical worker is in short supply. The statistical data reveal, the all-inclusive cost of hygiene of our country increased by 77.65 times from 1978 to 2005, expenses of personal hygiene increased by 199.75 times, and hospital, clinic, doctor, the intersection of nurse and increase of number 1~2 times the same period. Meanwhile, it caused the information asymmetry during doctors and patients that the high speciality of medical knowledge is technical, in addition the medical field is in the know to the patient agrees to the ignoring of right, believe in and lack during doctors and patients. Patient seek medical advice, often will employ relation obtain credible medical information, as many as possible to agree right, patient and the intersection of psychology and sense of believing in of relative while being in the know. The patient treats the system to distrust in practising medicine now, think the doctor's medical ethics medical skill is unable to trust, see the doctor in the trap too much, especially go through " to spend money the countless, disease does not get better " After meeting, let pieces of acquaintance not made by " the umbrella " Defend killing anti-cheating, become the choosing first of the patient naturally. Mr. Li, relative of infant, say frankly, look for, concern, it sees the doctor to be for prevent doctor from turn on great prescription. He says: "Child's cold had a fever last time, it would be better if let a doctor of understanding prescribe some medicines, just ten or twenty yuan. There can be once, doctor knowing has been here, the doctor who paid a home visit at that time had written a prescription once. Really there is too much difference to know the doctor and not know the doctor. " The retired worker uncle Yang says: "There are few really responsible doctors of the hospital now, if get serious disease, especially need to do the operation, let who see the doctor relation? " Ask someone to look for the relation to see the doctor and already become the customary thing, this reflects in fact a patient loses confidence to the hospital, to the doctor. Please participate in Reader's friend: What think about you " Look for the relation to see the doctor " This phenomenon? Whether you have had too " Let the acquaintance see the doctor " Or " does the tape acquaintance see the doctor? Wooden in barium for ��� knock �� gold-plating be lasted Xin to last lesson Yu of apricot 1 postscript to last of team ���� hammer Qian color ��� Zhangs protruding Ju �ľ scrupulously to be lasted � for the times idles impossibles dirties after lasting ��? The contribution please send to rwgl@jkb.com.cn (mark out " cultural and educational sight " Accept) . You can log in to the newspaper network of the health too ' www.jkb.com.cn) Participate in discussing. --Editor


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