王辰院士:医生是天然的研究者

2015-07-22 佚名 医学界

在近日举办的中华中医药学会养生康复分会第十三次学术研讨会上,中日友好医院院长王辰院士分享了自己对医生从事临床工作和研究的看法,指出了很多中国当前医疗工作者认识上的误区。 论经验 医生和护士大部分的知识和经验是从书本和老师那里学到的,这是间接经验,而对于直接知识和经验,王辰院长在一次查房中问一位医生:“什么是临床直接经验?”医生回答的很干脆:“就是临床摸爬滚打、日复一日积累出来的

在近日举办的中华中医药学会养生康复分会第十三次学术研讨会上,中日友好医院院长王辰院士分享了自己对医生从事临床工作和研究的看法,指出了很多中国当前医疗工作者认识上的误区。

论经验

医生和护士大部分的知识和经验是从书本和老师那里学到的,这是间接经验,而对于直接知识和经验,王辰院长在一次查房中问一位医生:“什么是临床直接经验?”医生回答的很干脆:“就是临床摸爬滚打、日复一日积累出来的。”

王辰院长并不否认这种经验对于一个医生的重要性,但他认为,这虽然是宝贵的,但作为医生必须要知道它同是也是粗浅和模糊的,尤其是没有经过科学方法验证的。“你奉为神圣经验的临床经验很可能是对的,也可能是错的,而且这种经验没有经过严格验证,所以必须客观看到它的局限性。”

当王辰院长问医生除了自己摸爬滚打积累的直接经验外,还有没有别的直接经验时,那位医生无言了。王院长说:“更高层次的直接经验来自于我们的研究,尤其是针对临床问题的临床研究,这是在发现过去医疗事件中的不足,然后提出和凝练问题,用创新思维和方法解决问题,找出答案,从而改善诊疗事件。这是基于科学的方法得出的,所以是可以重复和验证的,这也是一个医生知识积累的高层部分。”

所以王辰院长把医生分为三类:第一类是临床行医者(医匠),受过一定的经验传授,也读过医科,但主要临床经验是自己积累起来的,他可以看病,也有一定解决问题的能力,但在科学素养上有所不足。第二类是科学行医者(医师),经过严格的医学院校训练,有很好的现代医学背景,按照现代医学指南推进和从事临床工作,大部分医院医生都是这样的。第三类医生是医学科学家(医帅),这些人既是临床医生也是科学家,医学新知识的积累,都是由这些人的研究工作和学术活动产生的。

王辰院长说:“对于医生来讲,自由从事研究工作的医生,才能站到医学的巅峰,才能引领医学的发展,成为医学的促动者。”



谈研究

王辰院士认为,医生天然是一个研究者,临床和研究是天然一体、高度统一的,没有研究无以造就好医生。“每个病例都要用研究的态度去做,每个病例身上都蕴含着科学奥秘,隐含着医学上的重大突破。”

现在医疗界有种说法:医生不应搞科研和教学,会影响临床工作。王辰院长说:“这是很糊涂的话,如果没有科研和教学才会影响临床,没有科研何来创新?没有教学何来人才?研究工作的目标是为了改善临床实践,我们追求的临床目标是一天比一天好,只有通过研究工作才能达到。”

还有观点认为医生晋升不应该要论文,王辰院长认为这也是糊涂观念。他认为医生是知识分子,知识分子天然的承担着知识创造的责任,也是对人类的责任,而医生又是知识分子里面的精英知识分子阶层。“现在培养良医的机制还没建立起来,培养庸医的机制忽然广泛建立了,这是最可怕的事情,如果说医生不用做研究了,也不用写论文了,大家觉得释然和放松了,都觉得符合自己的根本利益,但我们的临床工作只有用科学研究的态度做,才能做好,就算是普通的乡村医生也应该做研究,更不要说大医院医生。”

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    2015-11-12 stfoxst
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    2015-10-31 三三五五

    哈哈

    0

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    2015-07-23 yydlt

    不是所有医生都要搞科研!

    0

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    2015-07-23 yydlt

    也没有那个必要!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1651457, encodeId=0f1e165145e1d, content=<a href='/topic/show?id=3eb5683638a' target=_blank style='color:#2F92EE;'>#王辰院士#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68363, encryptionId=3eb5683638a, topicName=王辰院士)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05be24209031, createdName=cy0332, createdTime=Sat Feb 27 06:39:00 CST 2016, time=2016-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2032730, encodeId=c49d2032e3058, content=<a href='/topic/show?id=ff85e343730' target=_blank style='color:#2F92EE;'>#研究者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73437, encryptionId=ff85e343730, topicName=研究者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1a19115, createdName=stfoxst, createdTime=Thu Nov 12 10:39:00 CST 2015, time=2015-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42041, encodeId=9d864204181, content=哈哈, beContent=null, objectType=article, channel=null, level=null, likeNumber=109, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=df9e1651052, createdName=三三五五, createdTime=Sat Oct 31 09:18:00 CST 2015, time=2015-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33353, encodeId=a8a033353b4, content=不是所有医生都要搞科研!, beContent=null, objectType=article, channel=null, level=null, likeNumber=170, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCEEr4dM45RatXXGAkFCicnNYiasFiaRicicO1YWsIeTFOhgapauqib8Z8TChNB3ttVC5RqNHptDvAxA72Q/0, createdBy=a82a1611288, createdName=yydlt, createdTime=Thu Jul 23 02:57:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33354, encodeId=26d633354c9, content=也没有那个必要!, beContent=null, objectType=article, channel=null, level=null, likeNumber=133, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCEEr4dM45RatXXGAkFCicnNYiasFiaRicicO1YWsIeTFOhgapauqib8Z8TChNB3ttVC5RqNHptDvAxA72Q/0, createdBy=a82a1611288, createdName=yydlt, createdTime=Thu Jul 23 02:57:00 CST 2015, time=2015-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=33279, encodeId=dd8a332e9b9, content=无语!, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=acd01628312, createdName=1dd82894m82(暂无匿称), createdTime=Wed Jul 22 12:13:00 CST 2015, time=2015-07-22, status=1, ipAttribution=)]
    2015-07-22 1dd82894m82(暂无匿称)

    无语!

    0

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