Interview Guest: Xiao Fei Jia Yuhua Zhang Xuewu
Moderator: We are particularly pleased to invite three guests to the studio to the Sohu health chat with friends about guests are in the book we are talking about give us a platform to communicate with us with netizens, the greatest concern for our society today and the most sensitive topics doctors and patients the contradiction between the two groups, common ground, understand, and do not understand the aspects of dialogue, I very happy, users do my best to answer your questions, answer questions from moderator, is here Thank you for understanding and support for doctors.
Zhang Xuewu: the netizens, the host, Hello everybody! I am a day a certain degree of trust, so I think the improvement of doctor-patient relationship can play a good role in promoting.
Jia Yuhua: netizens, Hello everybody! also very grateful for this platform with Sohu Health Channel and you talk to friends, We still used to call me Dr. Jia, I am very happy to book the entire publishing process and book author, and we have such a communication, but also allow more people to understand the platform by Sohu real life doctors.
patients to see how doctors do not trust
Moderator: just three guests introduce myself, I heard everyone had talked about a case, among doctors and patients hope to enhance mutual understanding, I want to know whether You worked in the medical industry or you are still engaged in this industry, you usually work or live or have heard of them feel that patients do not trust you?
Zhang Xuewu: definitely yes Of course, I think this distrust is not necessarily a bad thing, sometimes better to urge us to improve ourselves, we, as the doctor, I think the vast majority of doctors is still very strong initiative and responsibility, regardless of the patient What is the reason might be that we have some misunderstandings. as I mentioned earlier, every day we encounter cases of Ye Hao, Ye Hao handled the issue, we hope to do so one hundred percent patient satisfaction and hope for each critically ill reverse and cure disease, but now the scientific and technological means does not mean that all cases are able to achieve one hundred percent of the state less than ideal, so we really want to brave the risk of a certain percentage of this job, it also acknowledged the community is indeed a doctor a high-risk industry. Once hit by a major effort is still not able to resolve the problem, for example, that diagnosis is not clear or there are some side effects of treatment time, although we think that is 1% or 2% risk However, one hundred percent sure the patient is concerned, this really is some distrust.
Xiao Fei: I have done a doctor, I have been a patient, medical researchers now become a doctor as a partner, I see a lot. Actually, I think this distrust is the result of several aspects, first of all, our patients in the disease when the mood is very, very urgent, speaking from his family at this time is to do our utmost to find the most Good doctors do the best treatment for patients at this time because of the body resulting in abnormal psychology is not normal, then the threshold will change, bowel of very strong, and when he felt the doctor did not take him seriously, or There is a sense of his own mistakes, but also caused the reaction to his radical, or overreact to the families, this is normal.
second aspect, our doctors because of work overload, intensity of their work beyond their load, they can not have a lot of time with patients in a very delicate psychological comfort, such as we encountered a patient two days ago, a young girl found a breast lump, ask the doctor would be very serious? doctor answered 50% likelihood of malignancy, the possibility of 50% of benign and malignant is the cancer, she saw, next to the patient to do a radical mastectomy for breast cancer, removal of the pectoralis major, armpit lymph nodes, with a tube continues to attract the young girl looking down after the frightened, crying, can not accept, has collapsed. this time, her doctors explained that many of the treatment of breast cancer, radical surgery is an option , but not necessarily the diagnosis after the patient comfort by talking to the mood turned into another way. but it takes time and careful comfort. We are now doctors, when faced with a lot of scenes that a large number of patients Yongru his outpatient, he can not have a lot of time to do the work in this area, this is a doctor on the one hand the situation.
one more, I think the doctor-patient relationship is the media misled the public over-promote the Yi Xie extreme example. such as excessive fees, Harbin incident happened last year, many of the details we do not pursue the matter, but this is an extreme example. there caused some of our friends from the press for sensationalism, take tea and pretending to use urine modern machines detect abnormal or normal, you can imagine, we are now playing this biochemical analyzer into the boiled water or tea to show definitely is not normal,bailey UGG boots, this way is a crime in the United States, which are lured by fraudulent means another crime, or manufacture of criminal fact false. that such a move has misled our public, which creates a lot of the anger of the public to vent to our body and our doctors on medical institutions.
further social and economic reasons. In the past management of our health care system classification completely broken, and the West in the management of our school, past the village barefoot doctor, they are higher primary school, will be classified, will be vaccinated, then the level is the commune health centers will be appendicitis. county hospital will do the gallbladder surgery, City Hospital can do more complex operations, such as liver resection. Now our system has changed, central hospitals and tertiary level hospitals have become first line of defense, these large busy hospital to die, our community hospital is wants to come, such a waste of resources and the layout is unreasonable, resulting in a large influx of overseas patients to our center city, from the system to create a medical treatment is difficult.
I have Union Hospital, three o'clock passed, then an assistant U.S. ambassador over there seriously ill, to see him. three o'clock in the Union Hospital parking lot, I saw a person lying there waiting to line up, these people cold dressed in cotton coat, shivering. They must have heavy complaints and medical treatment. our broken health care system, grading, resulting in a lot of seriously ill patients regardless of minor ailments, sometimes just a question to a large hospital to find doctors will , drag relationship, gifts, looking for the dealers back number, then the hotel fees, transportation fees, registration fees, ticket dealers added to the cost of all medical expenses, there are also factors in this regard.
Moderator: should be a society aspects.
Xiao Fei: Yes, it is an integrated element. our patients, their families do not understand the doctors best efforts to change the status of medical treatment is difficult, and do not understand the doctors have been working in a state of overload life, the contradictions of all medical treatment is difficult to point a doctor, which is more one-sided. So I think we see in the doctor-patient relationship to see a lot of contradictions, but in fact we have a lot of these contradictions can be hard to change and resolve, For example, a dialogue like this, in fact, our doctors are very willing, in this platform to answer people's questions. Yinggai efforts of our people through dialogue, avoid intensifying the conflict, but through communication, then we understand each other and jointly promote Doctor-patient rapport.
Jia Yuhua: Doctors are indeed some patients to doubt the whole essay process we found some of the articles, said that some patients enter the hospital from the moment the door began to want to find a doctor to stubble, He would like to acknowledge a doctor would be irresponsible, or how, so in the environment in such a psychological impact, he was time the hospital had been hit in the head with a question mark, this state, as just Dr. Xiao row for a long time about the team, from the center of the field came to the city hospital, the time may be only 2 minutes to communicate directly with the doctors, a lot of communication and understanding there is no way to do so completely and causing more and more questions The doctor suspected the patient to be more and more that I have encountered some cases.
doctor's day is spent how
Moderator: Dr. Xiao's remarks, we just know, it should be said In this interview, see our Internet users may also be able to understand that the patient is now intensifying the conflict is really a social problem, we put aside other social issues aside, we mainly talk about the ;, tells us the interview in the online users to see the doctor of the day came in the end is how the.
we know today that we are talking about the book, in fact, probably including eight parts, which are unusual patient, the choice of no regrets, life returns, angels tears, the doctor of the day sentiment, the doctor's frustration, Xingyuxinyuan, it should be said that we selected a number of categories, including the very real life, including emotional curve, including normal work and life experience, let's talk about the working hours of a doctor, because I think this book is indeed also seen a lot of time on the distribution of their work, in particular, I am rather impressed that there is a emergency The doctor said Branch must register his day time is 25 hours, that is, that hour really do not know where to come out. including, as the new millennium, many doctors in the holidays, when the child birthday can not accompany his family had a full account of the holiday, I would like to ask about working hours for doctors to know how much?
Zhang Xuewu: You said one day the doctor, take me, I, as a clinical doctor In the People's Hospital, Beijing, People's Hospital should be very famous hospital, we asked the top three hospitals, and the Affiliated Hospital of Peking University. The responsibility of the hospital doctor in the end is what? People's Hospital Medical teaching and research are the Trinity, to see a doctor , to teach and pursue research, as I am no bit of the. go to work at 8 o'clock to go to work, open the door so that dozens of patients, this is not the same as with the foreign, foreign countries such as Switzerland, I went to a few appointments for patients, is the bottom of my heart, today I Look 5 patients, these 5 patients how to how to deal with, relatively few heart, time is also more abundant. As a doctor can not do this now, you is linked to expert patient No. 15, behind the 15 patients also will be followed, patients will come to tell you that I came from Hunan, I come from Shanxi, hanging here this morning is not on the number, you could not give him a plus tick read, and the general experts in terms of our people out-patient hospital at 12 o'clock rarely read, and 1 point, 2 points are common things.
we are generally so still have to read the out-patient wards, hospital medicine, health education and nurses waiting for you to give them guidance about how to deal with patients, you have to give him some of the patients developed the program. Why is not the time off work a little, a few minutes the patient to hospital is not controlled, and sometimes emergency The patient may just have to work to night, especially the more low-level existence of the problem the more the doctor, the total deal to shift relief to the doctor for duty, such as 6 o'clock in the succession can not 6:00 that I give you the patient left, this is impossible, you have to tell him a piece of observation, explain these things.
I have with Shaw also speak, I said I love nothing to do with doctors, and we lived together for ten years She now sometimes does still not fully able to understand why do I as a doctor all day from dawn to dusk of the endless, really there is no holiday, holidays, Saturdays, Sundays, are likely to run into health care things or other things, not nine to five, having a long holiday, which is impossible.
and often there are some sections, can not say that all the departments, many departments feel half asleep, the night side of a Phone call back have to go, not just a matter of emergency.
Moderator: What we just heard, like that of emergency surgery late at night or when to have an emergency surgery, but now the same way as medicine The.
Zhang Xuewu: Internal Medicine there are some departments that do issue, health care is one. talk about teaching, as our top three teaching hospitals, teaching also penetrate into the inside every day, although the teaching undertaken by many medical care can not let go of things, trying to squeeze time to do the. see that I talk about a class, two classes in two hours, to see how much the bottom, you want to become a famous doctor, to get students satisfaction, pay for more health care than it is time to to do. researchers also have dry ah.
Moderator: I think there is a good question.
Zhang Xuewu: Why is that a medical student tired, when you entered the hospital to face the door that day the number of examinations, the first year is to be positive, in terms of Take People's Hospital, Affiliated Hospital of Peking University, the first year to be positive, to three years to a stage of examination, from the Hospitalization said chief resident, a stage of examination, as the examiner I know this stuff. a doctor to test for a stage five examinations, clinical, case, etc., the hospital doctors, the doctors feel like a gate of hell examination, which is three years. five years to get into attending physician, another test, or face such a test. then give Deputy Chief Physician, Associate Professor, also chief physician assessment, but also comments, Professor urge for you step by step It's that's going up. you get a professor to Daiyanjiusheng, but also graduate with a completed application with a Ph.D., you engage in research funding come from, have to apply for funds, apply for a National Natural Science Foundation Ye Hao, a variety of the numerous fund Ye Hao, not to talk about able to get this money, hundreds of thousands Ye Hao, hundreds of thousands of Ye Hao, have to have a team, after a certain period of time, checking the literature, their brain do some analysis to find a breakthrough.
Moderator: Let the parties to accept the application that this is indeed feasible, but is necessary.
Zhang Xuewu: In fact, these pressures are great, it also does not mention Among the work that I come across any particular things do not go well, the patient's family to the often have some questions, these problems do not involve it, to just your normal thing to do on those of the.
my article inside this book do something else also mentioned, for example, worked for two years as a doctor you host, I do not know if you have the experience, your family and friends and family think you're very easy to work in the hospital, they often say, I Here patients receive hospital you gave me it, can not take today to go in, his sentence is very difficult to do sometimes. as in the People's Hospital, patients should know that a row of conventional department probably a week, ten days live without in, a lot of people you want to be hospitalized patient, you sometimes very difficult, so dealing with interpersonal relationships, dealing with all aspects of the thing, I think doctors have the ability to have the ability to be very comprehensive.
Moderator: I After you are finished the lap that I think you are very tired. That is in addition to doctors to see patients for example, ordinary people that the only duty is to physicians with a patient, in fact, other than in addition to seeing patients, such as you just mentioned need to consider teaching and research need to be considered, but now we know that, as the whole country in the implementation of health care, some time ago is what to write the appropriate name.
Zhang Xuewu: About one out of health care issues involved, such as Beijing's health care and foreign health care is a difference, Beijing and Shanghai is not the same, the same drugs can be reimbursed in Beijing in the field can not be reimbursed, the same drugs can be reimbursed hospital, outpatient clinic can not be reimbursed, or reimbursement, hospital reimbursement is not, what can be reported when the disease, such as albumin, blood protein levels must be less than 25 grams of time can offer, to 26 grams is useless. like this side there is an article written much trouble, so this is such a problem.
Xinkai companies have been Shaw's second essay, I would have wanted to write What dream? my biggest dream is to do a purely medical doctors to think of the patient's condition, I face the patient, I do not consider what economic problems, the problem, that problem, if people all walks of life Tracy can be innocent of their own problems to consider, I think certainly on the harmony of this society. As a doctor you can consider taking into account all aspects of it all you got? This is what I think might be able to achieve this dream.
doctors there are a lot of pressure
Moderator: So the doctor that is boxed all aspects of occupational restrictions, in fact, the doctor also increased the burden on a lot of work some of the above.
Xiao Fei: Yes, I know the doctors, when they prescribe, to give the patient accounts, that may limit your health insurance a hundred dollars a prescription, how I like to give you the best combination of the drugs used to open out. such as rheumatism, rheumatoid arthritis, need combination therapy, any kind of drugs are not completely satisfied with the role play, how to do? need a good combination, according to individualized treatment of the patient's condition, but sometimes grouped together more than one health insurance restrictions, it is difficult, this time the patient is not willing to pay more, so doctors wanted to help him afterwards, delays, delays energy. So Director Zhang said in the article, the role of doctors is more, so we say Indeed, relatively heavy burden on doctors, foreign doctors have the burden, for example, insurance companies have to face him, but also they complain about most, their insurance companies drug card, the card they give the patient's treatment, standardized, to come and check , but they are because the income is relatively high, they can hire such a dedicated manager to give him work in this area, and our doctors do not have such power.
Moderator: What should a hands.
Xiao Fei: Yes, just tell the doctor professional. We say to become a good doctor, she is a medical scientist, but to do this would be a doctor, to be lectures, will write articles, and that doctors very tired. we see our doctors more than 70 years old, is still running for their own research, more than 60 years old, is still behind the distribution of their own to find ways to graduate, our 50-year-old doctor still care 80-year-old doctors, their professional life is very long. my teacher Professor Wu Mengchao, a day to spend about six hours in the ward fifteen, he received the highest scientific award, and he loved his own career. In fact, the original intention of our doctors is absolutely first want to cure the sick, the same time, they will heat their career, so they put a lot of energy and time spent in, regardless of cost.
Shanghai Ruijin Hospital yesterday, and I The Professor Chen Nan together, he is vice chairman of Society of Nephrology, talk to our doctor-patient relationship, and his teacher Professor Dong 86-year veteran of his life, conversation until ten o'clock, she wants to Sign back, because the United States of ASN (American Society of Nephrology) General Assembly, the deadline for submission is 0:00, she had two hours to look over his more than a dozen articles, cast out from the Internet, she must be before 12 intense work, this is their time. He took his team hurried back to his office, we went to trial the articles for the kidney in the U.S. Congress to show the data of Chinese medical research, not to be missed this time, So they give quite a big pressure on their own, these times are not calculated.
Moderator: We know that China has a lot of places like Beijing and Shanghai are relatively large cities, most people are likely to each days of eating only one meal at home is dinner, I would like to ask Professor Zhang in Beijing because of your own, you can have several Dayton about a week at home to eat dinner?
Zhang Xuewu: it may be a two meals weekends sometimes hard to tell, other families may also exist such features, some of the general hospital will research, teaching and research some of the will, or some other something else, is always on the weekend to do, may weekend and some time to travel, to the field consultation, to open a time will be academic or related with the drug will be observed, such as I have also received a phone call, said the drug next Saturday depth review, which are generally on the weekend, we are willing to put the weekend, as usual is really no time.
Zhuchi Ren: At least do not delay the time with a patient.
Zhang Xuewu: Yes, Bing Ren doctor time or to guarantee, Otherwise, even more intense doctor-patient relationship, of course,cheap UGG boots, sometimes can not exclude the usual number of consultation evening. In general, the whole family is actually not a lot of time to eat.
how the income of Chinese doctors?
Moderator: On the issue of working hours of doctors for the time being we have a paragraph, the next question I think that Shaw also talked about just a matter of fact, medical treatment abroad may be relatively high, and stir until like the Internet have been one, said the Chinese doctors treated the doctor with the United States make a comparison, there were some people said, this doctor may from abroad for education is not the same with China, because he may have to go through four years of undergraduate , go through the medical profession is a few years to do inside the hospital intern, and finally came up step by step, is a lot of years, I would like to ask, first, please tell us about Dr. Xiao is simple, because you also abroad to be However, you probably feel that foreign doctors what kind of treatment? income is not comparable?
Xiao Fei: I give you some data, should be in March this year, Journal of American College of Rheumatology has done a good article, the United States rheumatologists need of a forecast team has been predicted that by 2020, a few figures here give side, let me say that backwards, from the attending physician, specialists Let's talk about. registered in the United States 4900 Rheumatology specialist, this 4900 doctors to their average wage is 120,000 to 200,000, should be 11 million dollars to 50 million dollars range, their daily average of 10 outpatients should be a few patients, each patient appointment time is about two weeks, 1.3 billion people of our country, they are 300 million people, our rheumatologists may be more than one thousand point, which is the number of meetings each year, there are 200 doctors on duty in various places . Our country has just put the whole of China, in addition to outside of Taiwan, the establishment of rheumatology of the Professional Committee, Zhejiang finally built, and sent to Tibet. us a little more than one thousand to take care of rheumatologists rheumatology population of 1.3 billion people a total of 130 kinds of arthritis, the United States has cried enough doctors, and we actually state rheumatologists care for our patients overload. Our specialist registration Meiyou the United States may be less stringent, but as far as I We know that the wage income of the legitimate public how many people should not be more than 8 thousand dollars, is on the list of your wages, including overtime. Some experts who can give lectures, additional income, this is a special population.
It Online data suggest that a medical school in Guangzhou old doctor, who see 92 patients from morning to night, this should be four or five times more than the United States, but our wages should be the U.S. one-tenth of the annual income of less than So this caused a great imbalance doctor is such a situation. look at the residents, the U.S. residency relatively low wages, usually 30,000 to 45,000 annual salary, I work in the United States, I had surgery certain amount of income, in addition to wages for each surgery, they are training, they can not get the cost of surgery, only a month of food stamps, the meal ticket to get me and they are free to eat in the hospital cafeteria We always go out the liver. but they have a hope, they passed a 5-year surgical resident, two years of specialist training, they can join a large hospital or open their own hospitals, all of a sudden wage can go to 20 million, 30 million dollars, this period is very hard, bite through this period, and then into the doctor. residencies during which they are in debt, and their medical fees in general,UGG bailey button, if the words of Harvard University on a year of tuition should be forty or fifty thousand dollars, such as the University of California, like UCLA, should be 8 per year from 1000 to 10,000 dollars in tuition, they generally are loans, but banks are willing to lend them money because they must have income after graduation, as they graduated as a doctor, and immediately bought car loans, banks willing to lend to them, because they know they'll be able to make money, attention to their career development.
fact, the U.S. hospital when doctors and medical students is very similar to us, from the education system is concerned, I feel like the German system of our country, if correct, could after graduating from high school than medical school, but we have the follow-up national education, such as we are now medical doctors are required to graduate, three master's degree Dr. years. The United States is entering into the college art and science of only two sub-professional, student materials can be mechanical, so you four years after graduation you can choose in the end, as a law, or school, medical, or other industry study , you can choose. American education system I think he can not be applied mechanically to our education system, because our education system is a continuation of, the hospital close to school textbooks, teaching materials, because we are similar with the United States. and our teachers, including the present Director Zhang, MD, director of many of our Western culture all came back, level of education should be equivalent. In this case, if we put in front of the public simply is not judge us on the four-year university National College level, when inappropriate, because the surface of a small medical school undergraduate study and can not high salaries,UGG boots, is wrong, Chinese doctors and medical school at the high school after they make back.
In fact, we now have a great system of perplexity. American doctors and lawyers considerable income, for example, I served as an intern lawyer, I entered a law firm, a partner after I do, there is a large wage increases. their way to doctors and lawyers stage of development similar to, but not the same as in our country, I know the income of our current law can be ten times the doctor, public revenues, this caused the elite , the same high level of education will have a different class, the doctor's legitimate income or very low stage of a lawsuit through his lawyer, to do consulting, including litigation with the doctors, get a high income. This is a social is not balanced, through education, through efforts, we have no way to get a good income, is a very confusing place, showing that society is not very great importance to education, which also resulted in a tendency that we now have, we do not willing to do a doctor, is willing to shop and go Lvshi. I saw the post at that time, we Yaozuolvshi, with the doctors to court, so a good win, especially now that there are many doctors to Xuelv Shi.
Moderator: And specifically to fight medical lawsuits.
Xiao Fei: hit medical lawsuits, a phenomenon that is not really a normal phenomenon, I have asked the host about the education system and the revenue, we with the similarities and differences between the United States to put in here.
Moderator: and then ask Zhang, you just said the People's Hospital is a tertiary level hospitals, and we have talked about the book, saying that the value of a 24 hours of overtime, emergency 24-hour classes, overtime is 20 yuan, excluding the income of meals three times a day, it should be said that a few dollars of the proceeds, I would like to ask, for example, a night shift in the People's Hospital, you may occasionally look at the value of night, your night fee How much?
Zhang Xuewu: For me in terms of the level of 30 dollars, because our people were divided into three-class hospitals, doctors from the hospital, the first layer, to the chief resident, I belong to the general duty, hospital doctors is Each ward should have a person, something you'll have to attend the patient, chief resident is the second layer, the management of several wards, for me the value of third-line classes, may be the whole People's Hospital, medical, or surgical, gynecological, all involved to the time when medical problems have come forward, means that the hospital this evening, what medical problems you will be solely responsible, and this time you really involves the level of human life in the end of this how kind.
Moderator: for example, the line you just said, the second line, third line because you are you, this is the same as you?
Zhang Xuewu: the same, is 30 dollars.
Moderator: But is not under the title is not the same as the amount of money, right? like you are the director of health.
Zhang Xuewu: This money is the same as the fee is the same night, but doctors are not the same with the nurses, nurses value of slightly more than a night , because she could not sleep, the doctor did not matter if you can rest, the provisions of our hospital nurses is 60 dollars.
Moderator: Because she had been on duty.
Zhang Xuewu: She has always wanted to stare, open eyes monitor the eyes, she wanted to visit. emergency should be a little more, but I have a few years did not go to the emergency department, how much money I 搞不太清楚, not too much.
Moderator: I remember before is inside in our forums, because that possible Bushi as in Beijing, Shanghai, nor is such a high another hospital, doctors said at the time of the Zhiban night fee is five dollars, because now a lot of hot lesbian Biru Qu their hair, cut a hair at least 50 dollars or 100 dollars, but the value of a doctor or nurse when the patient or the treatment of disease, does his work only worth five dollars to do?
Zhang Xuewu: This is the same as outpatient or emergency department registered the essentially similar, such as our registered only 5 dollars, 7 dollars, of course, some well-known experts in particular linked to special needs patient, it is very individual, speaking for the majority of clinics are still very cheap stage.
Moderator: I see this book in fact part of the time I first moved, I feel a little sad, which talked about ; Africa practice in mind, , one foot in the door is a cross-court, another issue, we are now including some hospital for infectious diseases is more concentrated, but the general hospital as the Director Zhang inside, do not know the arrival of a number is not whether the patient is potent infectious diseases, or the usual course of treatment also should be some way, protection may not be noticed, it is likely infected with some disease, you usually work ...
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