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急诊儿科告急:限诊!→暂停!→……无计可施?

2015-12-15 蔡晓峰 MedSci原创

医院的急诊都是每周7天、每天24小时开放的,然而近日有一家医院的儿科急诊却先是分时段开放,进而到了暂停急诊的地步。万幸的是,到目前为止,在媒体上还没有看到“医德沦丧”之类的不冷静字眼,更多的是“无奈”、“无计可施”。显然,中国的儿科医生荒已经到了众人皆知的地步,所以才有这样难得的理解。据广州日报报道,这家医院是广州萝岗地区唯一一家三甲医院。在暂停急诊之前,该院曾经发出过一个急诊儿科分时段出诊的告示

医院的急诊都是每周7天、每天24小时开放的,然而近日有一家医院的儿科急诊却先是分时段开放,进而到了暂停急诊的地步。万幸的是,到目前为止,在媒体上还没有看到“医德沦丧”之类的不冷静字眼,更多的是“无奈”、“无计可施”。显然,中国的儿科医生荒已经到了众人皆知的地步,所以才有这样难得的理解。

据广州日报报道,这家医院是广州萝岗地区唯一一家三甲医院。在暂停急诊之前,该院曾经发出过一个急诊儿科分时段出诊的告示,当时该院告知媒体:因为人员紧张,才采取这个办法,是否长期维持尚不得而知。



然而很快,就出现了这个暂停急诊儿科的通知。值得注意的是,措辞也由原来的“温馨提示”变成了“紧急通知”,似乎喻示着事态变得更加严重。



有媒体在新闻标题中称医院“无计可施”。不过我们的有关部门早就预料到了这种情况,所以早在半年前就提出了急救和儿科两个专业降分录用的办法。然而问题又来了,患者找这些原本应该是不合格的医生看病,能放心吗?于是患者仍然会去在医疗质量上比较有保证的老牌三甲医院,那么国家力推的分级诊疗又将置于何地?并且三甲医院的儿科仍然会拥挤不堪,甚至可能更加严重,因为患者对其他低级别医院可能会更加不放心。

还有办法,那就是大力扶持在发达国家不入流的另类医学(alternative medicine)。这种另类医学虽然性价比不高,但短期内总花费还是比正规医疗来得低,只要少花钱总是好的嘛。于是我们看到一个个张悟本的崛起,个别实在闹得不像话了才稍微象征性地处理一下;于是我们看到各路“健康”媒体、各种“健康养生”微信公众号上充斥着危害人民健康的流言。表面上看,老百姓看了这些健康流言,遇到小毛小病可以用一些偏方自己处理。但长此以往,一方面民众科学素养得不到提高,会加重医患矛盾;另一方面,另类医学药物可能导致急性中毒或慢性脏器损伤,或是因为拖延病情导致小病拖成大病,这样反而危害人民健康,加重全社会的疾病负担和医疗费用支出。

也有人提出,可以让公立医院的医生走出体制,或者采用“广义的多点执业”——开展网上诊疗。但目前的网上诊疗,大多是一些移动医疗公司一头热,真正有能力的医生在本职工作上都累得要死,怎么可能长期进行这样“广义的多点执业”(Lancet Global Health:移动医疗路在何方?中国三级医院资深医生已经在超负荷工作)。公立医院医生走出体制,固然这些医生自己可以减轻工作量,获得体面的阳光收入,部分高收入人群也可以在舒适的私立医院环境下获得高水平医生的诊疗服务;但是,低收入人群怎么办?似乎这些人没有想过。此外,目前觊觎医疗行业的社会资本,以莆田系为代表,大多逐利而来,中国医生即使跳出体制,恐怕也是才离权利的虎穴,又入资本的狼窝,并不能真正实现治病救人的医学本来目的。

实际上,儿科医生荒只是医生荒的一个加强版而已。要想从根源上解决医生荒,降分录取绝不可行,而是应该通过提高待遇,增加人文关怀。各种人士天天喊医生要给患者人文关怀,但医生本身就得不到人文关怀,反而把医生当做机器、奴隶、出气筒、替罪羊,你说这不是缘木求鱼吗?

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  2. [GetPortalCommentsPageByObjectIdResponse(id=61680, encodeId=87756168030, content=唉, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Thu Jan 28 02:19:00 CST 2016, time=2016-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48425, encodeId=8a014842547, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 17:02:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46496, encodeId=787a4649620, content=难以改善,工作量大加待遇不高,不容易, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Thu Dec 17 18:07:00 CST 2015, time=2015-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46352, encodeId=cc4046352fe, content=应该控制门诊量,增加质量, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150714/IMG55A4BC357ED6E1444.jpg, createdBy=9f231612624, createdName=liushui8012, createdTime=Wed Dec 16 08:40:00 CST 2015, time=2015-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46348, encodeId=cda846348e8, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Wed Dec 16 08:16:00 CST 2015, time=2015-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46211, encodeId=4dcb4621194, content=麻烦不要把替代医学翻译成不入流的另类医学!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffdc1671292, createdName=蓝喵, createdTime=Tue Dec 15 18:23:00 CST 2015, time=2015-12-15, status=1, ipAttribution=)]
    2015-12-26 hixiaoluo

    好文章,值得看。

    0

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    2015-12-17 三三五五

    难以改善,工作量大加待遇不高,不容易

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=61680, encodeId=87756168030, content=唉, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Thu Jan 28 02:19:00 CST 2016, time=2016-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48425, encodeId=8a014842547, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 17:02:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46496, encodeId=787a4649620, content=难以改善,工作量大加待遇不高,不容易, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Thu Dec 17 18:07:00 CST 2015, time=2015-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46352, encodeId=cc4046352fe, content=应该控制门诊量,增加质量, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150714/IMG55A4BC357ED6E1444.jpg, createdBy=9f231612624, createdName=liushui8012, createdTime=Wed Dec 16 08:40:00 CST 2015, time=2015-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46348, encodeId=cda846348e8, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Wed Dec 16 08:16:00 CST 2015, time=2015-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46211, encodeId=4dcb4621194, content=麻烦不要把替代医学翻译成不入流的另类医学!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffdc1671292, createdName=蓝喵, createdTime=Tue Dec 15 18:23:00 CST 2015, time=2015-12-15, status=1, ipAttribution=)]
    2015-12-16 liushui8012

    应该控制门诊量,增加质量

    0

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    2015-12-16 田田1746

    已阅

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=61680, encodeId=87756168030, content=唉, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Thu Jan 28 02:19:00 CST 2016, time=2016-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=48425, encodeId=8a014842547, content=好文章,值得看。, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bc301610909, createdName=hixiaoluo, createdTime=Sat Dec 26 17:02:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46496, encodeId=787a4649620, content=难以改善,工作量大加待遇不高,不容易, beContent=null, objectType=article, channel=null, level=null, likeNumber=125, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Thu Dec 17 18:07:00 CST 2015, time=2015-12-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46352, encodeId=cc4046352fe, content=应该控制门诊量,增加质量, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20150714/IMG55A4BC357ED6E1444.jpg, createdBy=9f231612624, createdName=liushui8012, createdTime=Wed Dec 16 08:40:00 CST 2015, time=2015-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46348, encodeId=cda846348e8, content=已阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=139, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42b01658905, createdName=田田1746, createdTime=Wed Dec 16 08:16:00 CST 2015, time=2015-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46211, encodeId=4dcb4621194, content=麻烦不要把替代医学翻译成不入流的另类医学!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ffdc1671292, createdName=蓝喵, createdTime=Tue Dec 15 18:23:00 CST 2015, time=2015-12-15, status=1, ipAttribution=)]
    2015-12-15 蓝喵

    麻烦不要把替代医学翻译成不入流的另类医学!!!!

    0

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