Clinical skills are the test of a good doctor

Fan Li, member of the National Committee of the Chinese People’s Political Consultative Conference, Vice President of the PLA General Hospital Clinical skills are the test of a good doctor What is a good doctor? A good doctor is a doctor who is able to treat patients well and has excellent medical skills, and a good doctor is one who is forged by continuous clinical experience. However, in the process of growth of doctors, due to the unreasonable training of talents and the promotion system of doctors’ access, the direction of pursuit of some doctors has deviated – excessive pursuit of papers and scientific research, and even the emergence of fake articles and papers. Tian Wenping, Department of Orthopedics, First Affiliated Hospital of Baotou Medical College Medicine is an empirical discipline. Many medical people and good doctors are not academicians or have received large scientific achievement awards, but they are very experienced and moral, and are able to create miracles. Most people who are devoted to clinical work do not publish many papers, but their value is often not reflected under the existing system. Therefore, in the promotion process, the value of doctors should be re-examined to reflect. The selection of good doctors, first of all, let the patients to assess, followed by the hospital staff to assess. Doctors rely on clinical skills to win patients, so the training of doctors must focus on clinical practice. I do not oppose doctors to engage in scientific research and papers, but the research should come from the clinic and return to the clinic. Wang Tianyou, director of thoracic and cardiovascular surgery at Beijing Friendship Hospital, Liu Jin, a deputy to the National People’s Congress, suggested that the power of the president to deal with disputes be removed In recent years, medical disputes caused by the frequent occurrence of medical incidents, and some hospitals are in line with the principle of “resting on their laurels”, the choice of “private settlement”. Some hospitals have opted for “private settlements” with the principle of “settling the matter” and compensation. There is even the phenomenon of “big trouble to get big money, small trouble to get small money, no trouble not to get money”, so much so that the promotion of the emerging industry “professional medical trouble”. Although the hospital director holds the hospital’s financial power, but the face of such a situation, sometimes very helpless. It is recommended that the hospital’s right to handle medical disputes, especially those involving compensation, be abolished, and that all similar cases be handled in accordance with the legal process, in order to alleviate the phenomenon of medical disturbances and better prevent the loss of state property. The advantage of the proposal is that even if individual patients or professional medical trouble to the hospital, the hospital does not have the power to deal with the dispute alone, the troublemakers will not get their expected “benefits” and can only give up, or seek a formal legal solution. If not, it will only fuel the arrogance of the troublemakers. Through the establishment of a physician’s license to limit the practice of unqualified doctors and prevent the “illegal practice of medicine” undoubtedly deserves praise, which, “the practice of medicine” and the conflict between medical graduates, is also a medical reform can not avoid and must be resolved, but then reform there is a premise can not be changed, that is, to obtain a license to practice medicine must be theoretical, practical The first thing that can be changed is the premise of the reform. Deng Liqiang, director of the legal department of the Chinese Medical Association, said that informed consent should be included in the Law on Medical Practitioners. Before the surgery, the doctor will ask the patient or his family to sign the informed consent form. Overall, it is intended to regulate the behavior of both parties. Informed consent has been written into the Tort Liability Law, which emphasizes the division of liability after the fact, but does not regulate the signing of informed consent before or the act itself. Therefore, informed consent should be written into the Practitioner Law, and in some hospitals informed consent has been generalized, with urine tests being signed and dental fillings being signed, with no standards or rules. At the same time, informed consent sometimes does not have to be signed. A minute to resuscitate a patient, if the patient’s family must sign and the actual conditions cannot be met, it is still necessary to save the patient as the first priority. Therefore, doctors must be empowered in the Practitioner Law to resuscitate patients and not be held back by informed consent. Yang Lixia, vice president of the Second Affiliated Hospital of Zhengzhou University, member of the National Committee of the Chinese People’s Political Consultative Conference (CPPCC) Health communication CCTV should have a special channel Among the many channels of CCTV, there is only no health channel. It is a good thing to set up a channel for people’s health and disseminate knowledge about health care and disease prevention for the benefit of the people. The health channel is not only beneficial to the people, but also has a positive effect on medical professionals. First, proper dissemination of medical legal knowledge will enable both medical professionals and the public to understand the full picture of the doctor’s profession, and doctor-patient communication will be smoother. Second, the tension between doctors and patients is largely the result of individual media hype, which in turn damages the image of the entire group of doctors. In fact, the vast majority of doctors are serious and responsible, and we need mainstream media with a wide audience to promote good doctors and re-establish a positive image of the doctor community. Wen Jianmin, director of the Department of Orthopedics, Wangjing Hospital, Chinese Academy of Traditional Chinese Medicine, member of the National Committee of the Chinese People’s Political Consultative Conference (CPPCC) Medical appraisal cannot be “binary” Most of the disputes between doctors and patients are caused by medical incidents. However, there is a duality in this third party – medical malpractice appraisal and judicial appraisal. China should establish a mechanism for the monolithic identification of medical damage. This is because, for one thing, forensic identification has a different focus than clinical medical identification. Clinical medical appraisal focuses on the identification of the medical process, while forensic appraisal focuses on the conclusion to infer causality. Clinical medical identification is often a group, while forensic identification in most cases is the forensic physician’s own behavior, identification accuracy, objectivity is difficult to ensure. Second, the patient’s condition and etiology understanding, clinical research, disease transformation, forensic medicine can not be compared with clinical experts, and the domestic forensic medical foundation is not high, and the technical strength is not balanced. In contrast, medical malpractice identification is more professional and authoritative. Sun Jianfang, deputy director of the Institute of Dermatology, Chinese Academy of Medical Sciences, member of the National Committee of the Chinese People’s Political Consultative Conference, private hospitals are not “spring doors”. But in reality, due to the absence of strong policies, private hospitals are like a spring door, blocked at the policy level. Such as public hospitals do not pay taxes, and although the state has reduced the amount of taxation of private hospitals, but still does not seem generous enough. Furthermore the hiring mechanism is not equal. Regional health planning places too much emphasis on controlling the number of medical services supplied from the total amount, which often makes it difficult to avoid the problem of monopoly of stock capital and is not conducive to social capital participation in competition. Policy barriers that hinder the development of private hospitals must be removed and current policies must be adjusted to better realize socialized medical practice. Sun Preservation Director of the Department of Pathology, Cancer Hospital, Tianjin Medical University Member of the National Committee of the Chinese People’s Political Consultative Conference (CPPCC) Cheap drugs must establish a reserve system Relevant departments should introduce relevant policies to solve the shortage of cheap drugs. The country should adopt legislation and introduce relevant policies and measures to coordinate multiple departments to ensure the continuous production of enterprises, starting from many aspects such as drug demand, drug pricing and variety characteristics. Introduce protection policies, respect the laws of the market, and give corresponding preferential policies to the relevant departments for drugs that have no clinical substitution but are really in demand and less profitable. Establish a reserve drug system and early warning mechanism. For special drugs to monitor in a timely manner, once found to reduce production to intervene in a timely manner. The first hospital of Jilin University, Professor of Internal Medicine, member of the National Committee of the Chinese People’s Political Consultative Conference (CPPCC), emphasizes the clinical skills assessment of medicine “medical students” and “doctors” is only one word, but the response is the important responsibility of medical education. Medicine is a high-risk profession, and medical education is a long course of study with high investment. Clinical practice teaching is an important part of training medical students’ clinical practice ability and professionalism. Therefore, we should pay attention to the construction of medical clinical practice skills center, make the clinical practice skills assessment of medical students as one of the quality assessment items for medical students, and medical students entering clinical practice must obtain a certificate of eligibility. The national textbook of “clinical practice skills” should be prepared and set up as an independent medical course. The national examination for medical practitioners should be conducted in a clinical skills center recognized by the Ministry of Education to ensure the fairness and professionalism of the examination. Zhao Ping Director of the Oncology Hospital Management Branch of the China Hospital Association, a member of the National Committee of the Chinese People’s Political Consultative Conference (CPPCC) There is still a lot of homework to be done to improve medical insurance. In the three years since the new medical reform, some structural problems plaguing the development of China’s health have begun to change, and China’s basic medical insurance reform has achieved varying degrees of success in terms of the number of people covered, the scope of services and the out-of-pocket ratio. Moreover, the coverage of major diseases is being gradually broadened, although there are still some major diseases that are not yet covered, and there is still a lot of homework to be done to improve medical insurance. It is worth noting that in the government work report made by Premier Wen Jiabao this year, he again stressed the need to accelerate the improvement of the national medical insurance system, consolidate and expand the coverage of basic medical insurance, and improve the level of basic medical security and management services. The subsidies for urban residents’ medical insurance and new agricultural cooperative were raised to 240 yuan per person per year. Comprehensively promote the protection of uremia and other 8 types of major diseases, including lung cancer and other 12 types of major diseases into the scope of protection and assistance pilot. Wang Hongyang, member of the Chinese Academy of Engineering and member of the National Committee of the Chinese People’s Political Consultative Conference (CPPCC) Academic integrity data system should be networked In recent years, China’s scientific and technological level and innovation capacity has been greatly improved, while academic corruption, plagiarism and fraudulent events occur frequently. It is recommended to reform and improve the current academic evaluation system and system in China, and establish a scientific, independent and complete academic evaluation and tracking system. Establish and improve relevant systems and regulations so that academic corruption can be governed by law. In addition, it is necessary to establish and improve the academic credit system and the nationwide networked academic integrity data system. All relevant academic institutions, such as the Chinese Academy of Sciences, the Academy of Engineering, and major universities, can jointly establish “integrity record monitoring network” to establish and effectively track personal integrity records and unify supervision and management. This record can be used for personnel appointments, awards and scientific research projects, and if necessary, this academic supervisory body can also publish personal information about the lack of academic credit through the appropriate channels, and regularly evaluate the academic credit of individuals jointly with relevant departments. Xiong Sidong, Vice President of Suzhou University, Member of the National Committee of the Chinese People’s Political Consultative Conference Retaining medical talents Attracting good students to study medicine is a prerequisite Retaining medical talents is a prerequisite to attract good students to study medicine. At present, this problem has encountered embarrassment, a large number of medical colleges and universities merged into comprehensive universities, medical science is not the best specialty of the school, good students are often attracted to finance, international trade and other majors, and students transferred to medical majors, and their minds are not solid. This problem should be addressed in a targeted manner. First, the whole medical scale is now expanding. Medical school training blindness is very large, to control the scale of medical student enrollment training. How many new doctors do we need in a year? How many students can each type of medical school train in a year? These two data should match. Otherwise, there will be a shortage of doctors, and vice versa will lead to a surplus. Secondly, we should strengthen the relevance of training and change the way of medical education in order to adapt to the demand of hospitals for doctors. For example, medical schools can be directed to train according to the requirements of hospitals, rather than blindly training students, students blindly touch the market, hospitals blindly recruit students. Netizens say There is no current salary system for doctors, and salaries are still a product of the pot-luck era. Someone should come down to the grassroots to understand what we think. Especially in the promotion of doctors’ titles, the requirement of English and papers for primary care doctors is not too valuable and disconnected from our actual work. It is possible to make the title evaluation of primary doctors the same as that of the education system. –If we want health care reform, how much does the government invest every year? If we want to break the drug interest chain, who will guarantee the income of doctors? Financial security, supervision mechanism, strict punishment measures and other important links should be improved in time. If the medical reform is to be weighed on the scale of interests, then of course, only defeat! –Happy Freedom zxf