​

Who "stole" the subsidy from the village doctor?

Xu Yucai

Recently There are too many "shocking" events, one after another. Serious hospital infection incidents occurred in two hospitals. Jiangsu doctors were threatened by "Guoan" personnel, Beijing hospitals were beaten by a group of masked people, Heilongjiang anesthesiologists were forced to commit suicide by medical trouble, and Guangxi village doctors went to the streets because of public health subsidies. One by one, it seems that the upcoming two sessions will start year after year with the theme of hospital safety, violence hurting doctors, and strengthening the grassroots. Here, Mr. Xu mainly talks about the medical service in Gongcheng Village, Guangxi, and puts forward some suggestions.

one Why Gongcheng Village Doctors Go to the Street?

two month fourteen day ， It was originally a romantic festival. However, for Guangxi province Gongcheng County Village doctor , but no leisure to romance. They have to go for their own livelihood go into the street Head, walk to the county health and family planning bureau to ask for the basic public health service subsidies that have been withheld for a long time. It is said that this kind of collective going on the street is also a last resort. For the sake of public health subsidies, they have repeatedly asked for no results, so they came up with this bad policy.

Then, why should I have my own hard money? Why should I

​

When "Red envelope" meets the hospital

Xu Yucai

The "red envelope" should be a happy thing for everyone to love. Send and receive red envelopes Yes country People's traditional customs for a long time ， It comes from a kind of normal interpersonal relationship in which the Chinese people still exchange courtesies, reflecting the friendly complex of harmonious coexistence. The meaning of giving red envelopes is more common. First, it is a kind of care for younger generations. New Year's money and birthday wishes all contain the meaning of peace and auspiciousness; The second is the etiquette of wedding celebration, as well as the expression of the first meeting of relatives and friends, gathering and giving wishes to each other; The other is the reward that comes from the heart. It should be said that the red envelope culture not only reflects the Chinese people's emphasis on reciprocity, but also the people who receive benefits and do not forget to give, and also have the mentality of not being ungrateful. From here aspect Look, “ Red envelopes ” It doesn't seem to be anything evil.

However, at present, Chinese hospitals seem to be full of more "Strange gas", even the popular red envelope has changed its taste and become less pure. Otherwise, why should the state ban it?

September 2012 ， The former Ministry of Health and the State Administration of Traditional Chinese Medicine jointly issued《 Guiding Opinions on Strengthening the Prevention and Control of Integrity Risks in Public Medical Institutions 》, where enclosure

​

County level hospital reform: all parties are "a bit bored"

2016-11-01 19:59:39 China Newsweek

Wang Shan

Starting from the elimination of "supporting medicine with medicine", the pilot reform program of county hospitals has been launched for several years, and the Notice has been issued year by year. However, while hospitals complain bitterly, medical expenses have increased year by year. On the one hand, there is a continuous contest between policies and countermeasures, and on the other hand, there is a common complaint from both doctors and patients. The reform of county-level hospitals constitutes a microcosm of China's medical reform.

The State Council recently released the Notice on Doing Well in the Comprehensive Reform of County level Public Hospitals in 2016. The notice proposed to consolidate the reform achievements of canceling drug markups, explore the establishment of modern public hospital management system, promote the de administration of county-level public hospitals, and gradually cancel the administrative level of hospitals; At the same time, the total staffing of county-level public hospitals should be reasonably verified, the staffing management method should be innovated, and the staffing filing system should be gradually implemented.

This is the fourth document on promoting the reform of county-level public hospitals issued by the State Council since 2012. The medical community did not respond much to this. Xu Yucai, deputy director of the Shanyang County Health Bureau in Shaanxi Province, said, "The whole reform feels like issuing documents. There are new documents on it. Now we will issue some corresponding documents according to the new documents, but there is no substantive content."

Behind the silence of the medical industry, there is not no confusion and helplessness. The medical reform at county level hospitals and other levels is a game of interests behind the dilemma that has been difficult to promote for many years

​

Excellent doctors should become "four teachers"  

  What are the criteria for a good doctor? There is no authoritative statement. There are seven standards for registered physicians of the National Medical Association of the UK: 1. Good clinical nursing skills; 2. Maintain excellent clinical medical practice; 3. Have the ability of teaching training and evaluation; 4. Able to properly handle the doctor-patient relationship; 5. Able to properly handle the relationship between colleagues, with good collaboration ability; 6. Honest and trustworthy, honest and kind-hearted; 7. Have a healthy body.

I think that an excellent doctor should strive to become a "four division":

One is "doctor", which is the most basic and well-known. At least one should have the moral quality and professional knowledge that a doctor should have, and at least have the corresponding "medical certificate" and other legal requirements.

The second is "lawyer", which is the basic requirement of the current social situation, laws and regulations, and doctor-patient relationship. Illegal things must not be done. If you do not understand the law, you will inevitably break the law unconsciously. The cost of breaking the law is absolutely unbearable for individuals.

Third, "teachers" should know how to train and educate people. In fact, it is a failure to work alone for decades without one or several proud "students" or reliable successors. Because, no matter now or in the future, medicine is always "experience medicine", and one should not pass on his unique things in his work orally to others.

Fourth, "priest", doctor

​

Scientific planning Carefully implement   Actively promote the price negotiation of drugs directly linked to the Internet

Shanyang County Health and Family Planning Bureau

Direct online drug bargaining purchase is an important part of the national policy of drug classified purchase, as well as the development and improvement of the national policy of centralized drug purchase since the new medical reform. Its main purpose is to make up for the lack of a single channel of centralized procurement and alleviate the shortage of clinical supply of low-cost drugs. Now we will report some practices and experiences of Shanyang County in promoting this work.

1、 Unifying ideas

The main policy for direct online drug procurement is the issuance of two thousand and fifteen 〕 seven Document No. and Shaanxi Health Pharmaceutical Government [ two thousand and fifteen 〕 one hundred and eighty No. seven The No. document clearly states that "women's and children's specialty non patent drugs, emergency (rescue) drugs, basic infusion, drugs with small clinical dosage and commonly used low-cost drugs shall be centrally linked to the network and directly purchased by the hospital". Before implementation, we organized the heads of relevant units to study the spirit of documents and unify their ideas.

2、 Scientific planning

In order to ensure the smooth progress of the work, our county mainly considers two points in the process of planning the direct online drug purchase, one is to give full play to the drugs of medical institutions

​

What can village doctors do for on-site service?

Xu Yucai (Health and Family Planning Bureau of Shanyang County, Shaanxi Province)

Village doctors are always thankless when they treat villagers at home. What diagnosis and treatment can be done by village doctors, and which village doctors should refuse ， It is indeed a matter of entanglement between the village doctors and the supervision department. In this article, the author will talk with you.

In general, there are two basic principles: The second is discretion. Because if they do not follow the law, they are likely to be punished by the law. If they do not take appropriate measures, they are likely to offend many villagers and earn a bad reputation.

So, how can we achieve compliance How about "law"? First of all, we should understand how the "law" is stipulated. To be honest, we have looked up many regulations on the management of village doctors and village clinics, but there is no clear and specific provision on whether village doctors can provide door-to-door services. Law on Medical Practitioners and Regulations on the Administration of Medical Institutions All clear It is stipulated that doctors should be in registered medical institutions According to their scope of practice Practice. stay Registered Unauthorized diagnosis and treatment outside the medical institution Are prohibited by law.   but In real life, in order to protect the life and health rights of patients, doctors are also allowed to extend their medical services to

​

【 review 】 medicine drug No price reform Said So nice

Xu Yucai

Recently, the National Development and Reform Commission announced the full implementation of medical price reform in public hospitals ， To sum up, there are three points. First, the medical price reform of public hospitals at the county level has been fully covered, and urban public hospitals in eight provinces have been fully implemented. Second, after the reform, the overall cost of patients has not increased, the income of doctors has increased, and the income structure of hospitals has become reasonable. Third, the phenomenon of excessive inspection, excessive medical treatment, and excessive drug use is still prominent, which requires coordinated reform. People's Daily When publishing this article, the title is directly changed to “ The medical price reform in public hospitals has resulted in patients not paying more and doctors not earning less ”, seems to have more "sense of achievement".

however As a grass-roots person "Sense of gain" does not have the above that So good. The author believes that the current medical price reform in China is at least There are three prominent Question:

First, price adjustment The idea of "general tune" is bound to be difficult to produce "strength" and play its due role of "stimulation". For example, in 2012, when a province reformed its county-level public hospitals

• How are you, teacher
• Lyrics: Car shop Composer: Yin Tieliang
• Singer: Yu Wenhua
• Sometimes I can't forget grammar when I write something
• Sometimes I can divide and add something
• I walked on the bookshelf along your pointer
• My youth is full of flowers of life
• How are you, teacher? How are you, teacher
• I also want to listen to your Mandarin
• How are you, teacher? How are you, teacher
• I read all the comments you gave me
• Every question mark in life
• Ah, I know how to answer
• Sometimes when I think about something, I always think about you
• Sometimes seeing you is like seeing my mother
• Looking at your blackboard, I entered Broad University
• My career depicts the splendor of life
• How are you, teacher? How are you, teacher
• I really want to touch your white hair
• How are you, teacher? How are you, teacher
• I saw the photo you sent me again
• Every wisp of family in life
• Ah, I know how to express
• How are you, teacher? How are you, teacher
• How are you, teacher? How are you, teacher
• How are you, teacher

High energy warning ahead, the county hospital to grab the job of the big hospital?

Xu Yucai

On May 12, the National Health and Family Planning Commission, Medical Administration and Medical Administration Bureau issued the Basic Standards and Recommended Standards for Medical Service Capability of County Hospitals, which clearly stipulates the setting of departments, the capabilities that should be possessed, and the equipment allocation of county hospitals. Among them, artificial joint replacement surgery, installation of cardiac pacemaker, radical cancer surgery, craniocerebral injury surgery and many other treatments and services that can only be done in provincial and municipal hospitals in the past can also be done in county hospitals in the future. For a while, it caused quite a shock in the medical circle. People were worried about whether such a positioning would rob the jobs of large hospitals?

Grab jobs 's worries are superfluous

Most of them are large hospitals, but the author believes that such concerns are superfluous. The medical service ability that a hospital can have is not available overnight. The introduction of one or two experts to perform several operations may fill some gaps, but is it far from the county hospital's ability to perform such operations?

For example, a doctor went to a large hospital for further education, and it was easy to see a large hospital perform a heart stent operation. Even in front of the "master", he could do one or two cases, but he never dared to go back to the county hospital to do it, because once he was on the operating table, he must know how to do it. Without the backing of the cardiac surgery department of the large hospital, who would tell you what to do if it failed? Medical treatment is related to human life. No matter when, safety is the first priority of medical service.

Therefore, the author believes that there is no need to fry the pot as soon as the Health and Family Planning Commission has issued a standard

How can such a "killer weapon" guide patients to stay in the county for medical treatment?

Xu Yucai

Recently, the media reported that the Anhui County Medical Community guided patients to seek medical treatment in the county, and made it clear that its "killer weapon" was that the new rural cooperative medical care payment was made on a per capita basis.