2009 is coming to an end, the health care industry has many major events, from the official implementation of the new medical reform program to the criticism of many years of the reversal of the burden of proof may be broken, from the fight against the A flu to the doctor-patient transposition experience, from the “Nanping medical incident” to the “Peking University Hospital incident “…… these are all touching the health care practitioners’ body and mind.
So, which events have left a deep impression on you? We selected 20 medical events from the major medical events throughout the year, what impact did these events have on the industry? What are the far-reaching implications? We invited 19 experts to comment on each of these events.
On this basis, the China Medical Association, Physicians Daily, in conjunction with Physicians.com and Sohu Health, conducted a voting campaign to select the “Top 10 Medical Events of 2009”. This edition contains the “Top Ten Medical Events of 2009” and comments from 10 experts.
1, the full implementation of the new health care reform, a number of comprehensive reform to start
The State Council proposed ten tasks to promote the reform in 2009.
Medical reform is a complex system project, requiring a long-term, arduous and gradual process. Medical personnel are not only the providers of medical services, but also the participants of medical reform. If the health care reform lacks the active participation of medical personnel will be very difficult to succeed. For every practitioner in the health industry, it is also important to seriously ask yourself: Are you ready to face the health care reform?
Li Dengfu, Secretary of the Party Group, Jilin Provincial Health Department
2, the burden of proof may be “positive placement”
Tort Liability Law (Draft)” the third review draft deleted the “…… presumption of causal relationship between the act of treatment and patient damage” clause.
It is ironic that physicians are the ones who treat patients and save them, but according to the current principle of presumption of fault, whenever a medical dispute arises, physicians have to desperately adduce evidence to prove their innocence.
The Tort Liability Law (draft) stipulates that the one who claims is the one who proves, and the original inversion of the burden of proof from the legislative responsibility will, to a certain extent, relieve the psychological pressure on medical personnel.
Wu Chongqi, vice president and secretary-general of the China Health Law Society
3, China’s physicians to lift the ban on multi-point practice
The new medical reform requires “promoting the vertical and horizontal exchange of talents between different medical institutions, and studying and exploring the multi-point practice of registered physicians”.
This means that the medical profession has been calling for the issue of multi-point practice of physicians has finally been allowed and encouraged by the central policy.
In China, physicians who are qualified to practice medicine are fixed in the hospital to which they belong, and their practice must be approved by the hospital before they can proceed, otherwise, they will not only suffer reproach, but also affect the evaluation and promotion of their titles. In the case of a lack of medical resources, the difficulty of mobility of quality medical personnel has, to a certain extent, exacerbated the “difficulty of access to health care”. Therefore, only by removing restrictions on the location and mobility of physicians can more patients flock to large hospitals without having to travel long distances.
Liu Guoyen, director of China Medical Economics Research Center, Peking University
4, “Nanping medical trouble” incident shocked the country
On June 21, the first hospital in Nanping City, a number of health care workers were injured. That month, there were a number of “blood spattered white” incident, known as “black June”.
When a doctor-patient relationship is established, both parties hope for a good outcome, but it is difficult for a physician to fully combat the natural laws of disease with human ability. Objective and rational treatment of the adverse consequences of medical treatment and even medical negligence is a quality expected of a mature society.
Medical disturbances not only inappropriately magnify the social role of medical malpractice, but also lead to the emergence of irrational rights, exacerbating the tension between doctors and patients, while causing unnecessary psychological pressure and burden on medical staff, which is not good for both doctors and patients. The whole society should pay attention to the incident of medical disturbance and take measures to combat and prevent the recurrence of such things, only then can we build a harmonious doctor-patient relationship and make efforts for the progress of society.
Deng Liqiang, director of the Legal Affairs Department of the Chinese Medical Association
5.”Peking University Hospital Incident” caused controversy
In November, after media reports, the “Peking University Hospital incident” has caused strong repercussions in the society. Peking University Hospital has become a hospital that has taken human lives.
In the face of this matter, both society, the media and the medical and health care sector should have a good mentality. For the community, to understand the special nature of medicine, especially to understand and cooperate with the work of medical clinical practice, otherwise physicians will not be able to grow; the media should try to contribute to the current not very harmonious doctor-patient relationship, in the face of the incident, please be sure to consider first, more communication with the relevant parties, communication, the problem is accurate, which will help to improve the relationship between doctors and patients; for the medical and health care sector, strict rules and regulations, strengthen management, especially for the clinical practice of internship physicians. Especially for the clinical practice of intern physicians, it is important to establish a sense of risk, ensure patient safety, strictly abide by the rules and regulations, and participate in clinical practice under the guidance of supervising physicians. At the same time, we should try to speak out about the special nature of physician growth and seek more understanding and support from society, and definitely not to choke on it.
Former Vice Minister of Health, President of the Chinese Physicians Association Yin Daqui
6, 70% of physicians for the current practice environment worries
The survey shows that only 7.44% of physicians believe that the current practice environment is “good”, while the choice of “poor” and “extremely poor” up to 63.61%.
The dissatisfaction of physicians is related to the current tension between doctors and patients, firstly, the protection system is not sound, and the dissatisfaction of patients who pay for their own medical care; secondly, the medical service system is not sound, 80% of large hospitals are concentrated in large cities, and the problem of “difficult access to medical care” is prominent; thirdly, clinical medicine has certain limitations, and cannot achieve the expected goals of patients. Finally, society and public opinion regard the unscrupulous behavior of individuals as the behavior of the whole team of physicians, which puts the whole team of physicians in a disrespectful situation. In order to change this situation, we can only hope that the new medical reform will deepen, and hopefully change from the system and from the awareness.
Gao Runlin, vice president of the Chinese Physicians Association
7, public hospitals to give departments to generate revenue targets called to a halt
On February 10, the Ministry of Health stressed that it is strictly forbidden for public hospitals at all levels to issue revenue-generating targets to departments, and that it is strictly forbidden to directly link the income of medical staff with the economic income of the departments.
Unlike businessmen who aim to earn the highest profit, the value of physicians lies in treating patients and saving lives. Therefore, in order for physicians to serve patients without distraction, it is absolutely not possible to use economic indicators to assess physicians.
The physician is for the patient, even if the service is those who can not afford to pay or even need to visit the service, but also to use the least money, the best service for the patient to cure, this is the highest standard of physician value.
Physicians are a noble profession, and their nobility lies in saving lives in times of crisis without regard to financial gain. The Ministry of Health’s reaffirmation of this issue is very necessary and timely, and once again reinforces the nobility of the profession and the importance of physicians to the people.
Li Chunsheng, Director of Emergency Department, Beijing Chaoyang Hospital
8, the price of medicine reform to set high consultation fees and low drug costs
On November 23, the National Development and Reform Commission made it clear that China’s pharmaceutical price reform is set in the direction of “high consultation fees and low drug costs”.
The direction of “high consultation fees and low drug costs” is right, but the implementation process is difficult, and it is impossible to be in place in one step. First of all, “high consultation fees and low drug costs” may affect the normal operation of hospitals. The Ministry of Health data for the past ten years show that the share of drug revenue in total hospital revenue is maintained at more than 44%, while the current government investment accounts for only 5%, the abolition of hospital drug sales markup, relying only on the increase in treatment fees far from compensating for the normal operation of the hospital needs.
Secondly, at present, China’s medical and health services and prices are still the product of the planned economic system. Hospital labor costs are very low, less than 20%, only 6% of the outpatient fee. Outpatient fees, nursing, surgery and other medical services prices cannot reflect the proper value of technology and labor. The purpose of “high consultation fees and low drug costs” is to make the income of medical staff visible and to become “sunshine wages”. However, if the income of medical staff is significantly reduced, the whole industry will be impacted, and ultimately affected by the people.
Finally, the primary medical institutions are relatively simple and extensive drugs, a significant increase in the cost of treatment may cause patients to flock to large hospitals.
Zhu Jihong, Director of Emergency Department, Peking University People’s Hospital
9. Influenza A is rampant and the battle to stop it is on
Influenza A is a disease that raged from the beginning of this year to the end of the year.
Since SARS in 2003, shouted for many years “wolf” really came this year, which is “influenza A H1N1”. If SARS is a surprise attack, then in response to influenza A, we are fighting a prepared war. From the early stage of the epidemic, we have been passive and vigilant in controlling the source of infection and cutting off the transmission route, to today’s active vaccination and enhancing the immunity of the population, we have been calm and easy to cope with the whole process, and we have won the first battle in the influenza A interdiction war, completely controlling its transmission momentum.
Yu Xuezhong, Director of Emergency Department, Peking Union Medical College Hospital
10.Patients’ consent is required for intern doctors to participate in treatment
The Interim Regulations on the Management of Clinical Practice in Medical Education, which came into effect on January 1, require that trainee and intern doctors must obtain the consent of patients when participating in consultations and treatment.
Young physicians, including trainees and interns, are the future of clinical medicine in China, and caring for them with enthusiasm and supporting them effectively is a major event of strategic importance and a hundred-year plan. Any suppression, hindrance, strangulation of the new medical force – young doctors training behavior is not conducive to maintaining the health of the people, but also for the sustainable development of clinical medicine in China, are short-sighted.
Clinical internship, including consultation, physical examination and even the necessary technical operations under the guidance of senior physicians is a necessary path for their growth, trainee physicians and interns in the consultation and treatment must be agreed by the patient, in a sense this is a major progress in the development of modern clinical medicine in China, it marks the further improvement of the legal system of clinical medical education, marking It marks the further improvement of the legal system of clinical medical education, the respect of clinicians for patients’ human rights, and the further embodiment of the spirit of humanistic medicine. As patients, on the one hand, they hope that their right to information, privacy and decision making can be fully respected and receive better medical treatment and care, on the other hand, they should consider the continuity of medical development, enthusiastically support the growth of young physicians and help them progress as soon as possible, which is the patient’s obligation.
Young physicians are the new force on the medical front, they enter the hall of clinical medicine at the beginning, enthusiastic and active, serious and good learning, these are valuable advantages, but the shortcoming is the lack of clinical experience. Therefore, in clinical practice, on the one hand, we should be open-minded to learn from the senior doctors, on the other hand, we should fully respect the patients and their families, care about their suffering, and try to solve their problems. In a sense, the patient is also the teacher of the healthy growth of young doctors.