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中国工程院院士廖万清:完善分级诊疗制度 基层医生责任在肩

2017-06-01 李硕 新华网

在当下中国,老百姓就医存在看病难、看病贵等一系列问题,分级诊疗成为医改的重中之重,中国工程院院士廖万清指出,“要不断完善的分级诊疗制度,现在亟需解决基层医生的再学习和再教育问题。”

在当下中国,老百姓就医存在看病难、看病贵等一系列问题,分级诊疗成为医改的重中之重,中国工程院院士廖万清日前在“中国分级诊疗交流会”上接受新华网专访时指出,“要不断完善的分级诊疗制度,现在亟需解决基层医生的再学习和再教育问题。”



基层看病难问题必须解决

记者:您觉得推行分级诊疗制度意义最重要的意义是什么?

廖万清:随着老百姓生活水平的提高,病人的就医要求也在发展和提高。过去,大家普遍比较贫穷,很多人得了病也不会去医院看。现在,人们富裕了,得了病不仅仅希望到医院诊疗,更愿意找好的医生来治疗。在一线城市里,医疗资源和医疗人才都很集中,从而吸引了大量病人千里迢迢前来看病。

记者:这就造成了大医院人满为患,基层医院无人问津,进而导致其缺乏长足发展动力的恶性循环,从某种程度上说,也造成了基层群众的看病难问题,对此您怎么看?

廖万清:是的。这是医疗资源不均衡导致的,我国的国情是地缘辽阔、人口基数庞大,所有的病人都涌到大城市来看病,这是不可行的,也是不现实的,因此基层看病难得问题必须得到解决,这就需要完善的分级诊疗制度。

记者:有时候,由于医疗资源的集中,也造成了很多医患矛盾,您觉得和谐的医患关系应该是怎么的?

廖万清:我觉得,不管哪一级的医生,都要细心、认真地为病人解决问题,在看病过程当中也要不断学习,提高自己的业务水平;作为病人来讲,也要相信医生,一个和谐的诊疗环境非常重要。

为医生搭建学习平台至关重要

记者:您觉得一个完善的分级诊疗制度是什么样的?该如何做到呢?

廖万清:完善的分级诊疗制度应该是在县一级的医院能够完全处理常见病,对于设备和人才要求高的疾病可以去地区医院处理,再难一些的病,去更高一级的医院处理,这样才能真正实现病人分流。除此之外,还需要不断加强基层医生再学习和再教育,为他们搭建一个医生教育平台,通过邀请顶级专家入驻并分享经验的方式,使基层医生的治疗水平不断提高,从而实现病人就近就医。

记者:现在一线城市三甲医院资源和基层医院差距到底多大?

廖万清:关于医疗事业的差距,每一个地区、每一个省市都不完全一样。单纯从医疗资源的分布来看,不同地区的农村、乡镇、城市等,差别程度不同,东部和西部城市医疗事业也有医疗差距,不能一概论之。简单来说,大城市比三级城市好,三级城市比乡村好。不过从宏观上来说,随着我国经济不断发展,老百姓收入不断提高,各种医疗资源配套也在不断完善,总体医疗事业是在不断发展进步的。

整合医学是大势所趋

记者:你从医多年有没有遇到一些印象特别深刻的问诊经历?这次经历对您今后的从医生涯有何启迪?

廖万清:肯定有的。我曾遇到一个病人,他检查出肺部有阴影,几次检查都呈阴性。后来进行大会诊,很多医生有不同意见,各种说法都有,有的说是肿瘤,有的说是复发,但是都是证据不足。那怎么办?有的医生说要穿刺,要各种检查,众说纷纭。

记者:那最终怎么解决的?

廖万清:我当初也参加了这个会诊,这个病人我看了他的片子,从总的情况来看,真菌感染可能性最大。后来通过病人的痰中分泌物检查发现果然是真菌感染,用最新的的抗真菌要和综合治疗的方法,最终病人彻底痊愈了。这个例子就说明了会诊的重要性。

记者:您怎么看待当今的整合医学?

廖万清:我现在很主张整合医学,为什么呢?因为我们要整合各类自然知识、各种先进技术,来为我们医学服务,从而帮助我们诊断治疗病人。整合医学是大势所趋,也是医学发展到今天的必然结果,也能不断带动分级诊疗的发展,从而切实解决老百姓看病难的问题。

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    2017-11-08 1e145228m78(暂无匿称)

    学习了谢谢作者分享!

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  4. [GetPortalCommentsPageByObjectIdResponse(id=259603, encodeId=613525960305, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Nov 08 06:37:36 CST 2017, time=2017-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1688145, encodeId=268116881452e, content=<a href='/topic/show?id=6a8d4e950d4' target=_blank style='color:#2F92EE;'>#工程院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47950, encryptionId=6a8d4e950d4, topicName=工程院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b96328479830, createdName=ms5439512287675881, createdTime=Sun Sep 17 13:42:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1500842, encodeId=ac89150084212, content=<a href='/topic/show?id=ccc42182eab' target=_blank style='color:#2F92EE;'>#中国工程院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21827, encryptionId=ccc42182eab, topicName=中国工程院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc939466478, createdName=wumeihua91, createdTime=Sat Jun 03 05:42:00 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205561, encodeId=b5c220556171, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Fri Jun 02 09:26:42 CST 2017, time=2017-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205294, encodeId=9ca4205294d5, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Jun 01 17:09:59 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205274, encodeId=19bb2052e428, content=整合医学是大势所趋,也是医学发展到今天的必然结果,也能不断带动分级诊疗的发展,从而切实解决老百姓看病难的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Thu Jun 01 15:37:51 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-06-02 139****5926

    好文章学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=259603, encodeId=613525960305, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Nov 08 06:37:36 CST 2017, time=2017-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1688145, encodeId=268116881452e, content=<a href='/topic/show?id=6a8d4e950d4' target=_blank style='color:#2F92EE;'>#工程院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47950, encryptionId=6a8d4e950d4, topicName=工程院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b96328479830, createdName=ms5439512287675881, createdTime=Sun Sep 17 13:42:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1500842, encodeId=ac89150084212, content=<a href='/topic/show?id=ccc42182eab' target=_blank style='color:#2F92EE;'>#中国工程院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21827, encryptionId=ccc42182eab, topicName=中国工程院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc939466478, createdName=wumeihua91, createdTime=Sat Jun 03 05:42:00 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205561, encodeId=b5c220556171, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Fri Jun 02 09:26:42 CST 2017, time=2017-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205294, encodeId=9ca4205294d5, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Jun 01 17:09:59 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205274, encodeId=19bb2052e428, content=整合医学是大势所趋,也是医学发展到今天的必然结果,也能不断带动分级诊疗的发展,从而切实解决老百姓看病难的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Thu Jun 01 15:37:51 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-06-01 139****5926

    好文章学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=259603, encodeId=613525960305, content=学习了谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Wed Nov 08 06:37:36 CST 2017, time=2017-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1688145, encodeId=268116881452e, content=<a href='/topic/show?id=6a8d4e950d4' target=_blank style='color:#2F92EE;'>#工程院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47950, encryptionId=6a8d4e950d4, topicName=工程院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b96328479830, createdName=ms5439512287675881, createdTime=Sun Sep 17 13:42:00 CST 2017, time=2017-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1500842, encodeId=ac89150084212, content=<a href='/topic/show?id=ccc42182eab' target=_blank style='color:#2F92EE;'>#中国工程院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21827, encryptionId=ccc42182eab, topicName=中国工程院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=cc939466478, createdName=wumeihua91, createdTime=Sat Jun 03 05:42:00 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205561, encodeId=b5c220556171, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Fri Jun 02 09:26:42 CST 2017, time=2017-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205294, encodeId=9ca4205294d5, content=好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Jun 01 17:09:59 CST 2017, time=2017-06-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205274, encodeId=19bb2052e428, content=整合医学是大势所趋,也是医学发展到今天的必然结果,也能不断带动分级诊疗的发展,从而切实解决老百姓看病难的问题。, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Thu Jun 01 15:37:51 CST 2017, time=2017-06-01, status=1, ipAttribution=)]
    2017-06-01 有备才能无患

    整合医学是大势所趋,也是医学发展到今天的必然结果,也能不断带动分级诊疗的发展,从而切实解决老百姓看病难的问题。

    0

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