何苦把儿科医生短缺归咎于“医闹”

2018-01-11 张红亮 中国网医疗频道

将儿科医生短缺责任归咎于患者和社会的做法,看起来让公立医院的医生满怀悲壮,实际或许是在避重就轻。

1月11日,社交媒体上一篇题为《当你抱着高烧的孩子在急诊流着眼泪苦苦等候的时候,你是否依然觉得医闹和你无关?》的文章被刷屏。文章描述了最近流感肆虐,医院儿科人满为患,一些家长抱着发烧39度的孩子,却看不上病,并且作者直言儿科医生短缺是因为医闹。截止健康界发稿时,这篇文章已经阅读点赞双“10w+”,更是有7000多人为之打赏。

文章中写道:为什么当你抱着发热的孩子赶到急诊,却发现没有医生为你孩子看病?问问你自己“当护士给你孩子输液未能一针见血的时候,你有没有拳脚相加?当医生拒绝你无理要求的时候,你有没有破口大骂?当你对治疗结果不满意的时候,你有没有去围堵医院去打医生砍医生?”

从文中不难看出,作者彻底地“站边医生一边”的言论,的确引来不少医生的点赞。但随之而来的是理性反驳的声音。

中国社科院公共政策研究中心主任朱恒鹏表示:把儿科医生短缺归咎于“医闹”,纯属瞎扯。为何心内、骨科、肿瘤内科医生不短缺?这些科室没有医闹吗?文章作者这种丝毫不反思医疗行业自身问题,将责任全部归咎于患者和社会一方的做法,看起来让公立医院的医生心安理得且满怀悲壮,实际效果则是拉仇恨。让患者和社会进一步不信任医生群体。道理很简单,一个把错误完全归咎于他人而丝毫不自我反省的人和群体是不会获得信任的。这是另一个版本的“塔西佗陷阱”。

儿科医生李清晨在微博上评论这篇“爆文”时表示:“没有人愿意干儿科的第一位原因不是因为收入太低吗?!流感造成这么大的恐慌,你在这个时候还在利用群众的焦虑和医生的委屈做收割,你心里过意的去吗?针对医生的暴力应该谴责,但这不应该成为评论所有医疗事件的万金油,更不应该夸大渲染这种并非普遍的暴力事件。”

儿科医生短缺是全国性问题

事实上,对儿科医生短缺问题的争论,始于近期肆虐的流感导致医疗机构儿科压力倍增。近日“天津海河医院儿科整体病倒,医院儿科被迫停诊”一事引发热议,这起事件让儿科医生短缺问题再次摆到台面上来。健康界获悉,天津市卫计委医政医管处副处长温晓清随后表示,通过给予专项岗位补贴等方式,近两年天津市儿科医生增加了约300名儿童医生,目前天津市的儿科医生数量是1669个,儿科医生缺口大约是600人。

中国医师协会儿科医师分会会长孙锟曾介绍,儿科在综合性医院中处于弱势地位。过去几年中,一些综合性医院甚至把儿科给关了,年轻医生的流失比例也相对较高。上海相关统计数据也发现,这3年流失了269名儿科医生。其中,综合医院流失率为13%,儿童专科医院流失率为4%”。

儿科停招17年造成了巨大人才缺口

我国儿科医师的短缺早已是公认的事实。2017年5月发布的《中国儿科资源现状白皮书(基础数据)》显示,当前中国儿科医生总数约为10万人,却要服务2.6亿0岁至14岁儿童,平均每2000名儿童才能拥有1名儿科医生,儿科医生缺口已经超过20万。

1999年,医科院校的儿科系停止招收本科,代之以临床医学专业,儿科学则成为临床医学专业其中的一门课程,这被认为是儿科医生缺失的主因之一。

天津市某医院一位熟知儿科医疗教育的医政人员还介绍,当时儿科学一般都是在医学院的本科,专科里很少开设儿科专业。现在医学院的本科在儿科方面也基本没有恢复,因为没有教材,专科院校就更不用说了。

国家卫计委和教育部2016年开始合作恢复儿科本科招生,支持中国医科大学、重庆医科大学等8所高校举办儿科学本科专业,但儿科停招的17年间造成了巨大的儿科人才缺口。

医治“儿科停诊”需开综合药方

随着全面“二孩”政策落地,儿童日益增长的医疗服务需求与儿科医护专业人员不足的现状成为突出矛盾。儿科医生短缺的现状,缘于儿科医生职业风险高、薪酬待遇低、医患矛盾多、工作时间长、负荷重等因素。

为缓解需求,相关部门曾下发文件指出,医院儿科不得停诊拒诊,“儿科医务人员不足时,可以对高年资内科医务人员进行专业培训,充实儿科医疗力量。”但是,“儿科不够内科凑”只是应急举措,治标不治本。医治“儿科停诊”需开综合药方,从根本上解决儿科医疗服务供需矛盾。

首先,提高薪酬待遇,增强职业吸引力。在新一轮医改中,应当合理调整儿科医疗服务价格,更加准确体现儿科医生的劳动价值,并从进修深造、职称晋升、奖金分配等方面采取倾斜政策,稳定儿科医生队伍。与此同时,相关部门可逐步放开管制,让优秀的儿科医生流动起来,到不同地方为患儿提供服务。

其次,完善分级诊疗,增加医疗资源供给。目前,我国只有53.2%的综合性医院有儿科,社区卫生服务机构设置儿科的仅占12.6%。

此外,加强科普宣传,缓解儿科就诊压力。不少家长一遇到孩子发烧哭闹,就抱着去医院,在治疗过程中也容易因常识和信息掌握不充分而和医生产生矛盾。对此,有关部门要做好儿科常见病多发病的防治宣传,开通多渠道咨询热线,指导家长从容应对,不盲目扎堆医院,就医期间更好地理解和配合治疗。

2018年1月9日,国家卫生计生委例行发布会上,国家卫计委医政医管局副局长焦雅辉表示,党中央和国务院高度重视儿童医疗服务工作问题,各地对儿科医疗服务体系的建设也高度重视,采取了很多的措施。除了增设儿童医院、综合医院增设儿科外,卫计委会同教育部加大医学院校儿科专业医学生的培养。另外,从住院医生规范化培训方面,加大儿科住院医生规培的力度,利用各级财政资金支持,加大一些医生的转岗培训。

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    2018-01-25 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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    2018-01-19 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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    2018-01-13 1209e435m98(暂无昵称)

    学习了.谢谢分享

    0

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    2018-01-13 liuxiaona

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