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香港医生从容自信执业 靠的是……

2017-08-24 丁好奇 环球医学

香港特区政府一贯对于医疗领域的高投入,使得医院不必依赖向患者收费弥补开支,患者能享受低价优质的服务。医师收入的高低由合约提前确定,与医师完成的工作量无关,与医师创收大小、开药多少更无任何关系。

医改是世界性难题,香港如何医改呢?其核心内容不是加大政府投入,而是改变特区政府对医疗投入的“包办”。而且香港医改无论怎样进行,有一种观念是不会改变的:医生是看病救人的,不是挣钱的。

香港特区政府一贯对于医疗领域的高投入,使得医院不必依赖向患者收费弥补开支,患者能享受低价优质的服务。医师收入的高低由合约提前确定,与医师完成的工作量无关,与医师创收大小、开药多少更无任何关系。

“香港医生的薪酬相对较高。”一位业内人士表示,当医生有了一个阳光体面的薪酬,让他们不需使用“灰色”手段,只要在医院认真工作,也可获得高薪。

刘少怀表示,所有员工均使用聘用制,由医管局统一管理,医务人员也不再有副高、正高职称,而是沿用香港体系,分为住院医生、副顾问、顾问。伴随身份的变更,配套的薪酬改革也随之进行。医管局有关人士介绍,与实行编制管理的医院不同,不再以级别定薪,而是以岗定薪,自主制定每个岗位的薪酬标准。“这种设计以医生的实力和贡献为本位,能激励医生努力提高医术,为病人看好病。”

香港医院管理局专栏标语写道:患者是人,医师护士也是人。强调医院不但要对患者关怀体贴,而且亦应关心医护人员的冷暖。医院将患者放在首位,将与患者直接打交道的医师、护士称为前线人员,总务后勤人员主要为患者及前线人员提供支持服务,行政人员及医院总监则置于最低位。后勤工作基本社会化,通过签订合同,作到及时准确、保质保量提供服务,并定期深入病房对各种医疗设施进行安全保养,常用物品都是直接送到前线人员的手中,公立医院98%的医疗为免费服务,医师更不会为诸如患者欠费、逃费等事情操心,从而使医师的心思和精力完全放在患者身上及医疗诊治活动中。

香港公立医院对患者的就医方式进行了明确规定,除符合严格标准的急诊患者可随时接受诊治外,非病情紧急的患者就诊、检查及手术均采用预约,未经预约的患者要么预约等待、要么到私立医院自费就医。从而使医师能主动合理安排工作量,避免加班加点、超时劳动和疲劳工作。他们认为,医师疲劳执业是医疗安全的最大隐患。

香港医院管理局虽然实行了专业教育与培训制度、临床督导制度、临床审核制度、临床工作的检查与指导制度、事故申报制度、公众意见汇集制度、风险管理制度等一系列有效的医疗风险管理制度和措施,但医疗风险依然存在,投诉纠纷时有发生,有时甚至出现医师护士遭受暴力袭击的事件。医院管理层至少在五个方面为面临医疗投诉和纠纷的医师提供帮助和保护。

在药品价格环节,为了保证医院能够采购到价格相对低廉的药品,香港实行严格的药品公开采购制度,整个过程中,医生都不会参与。加之各个环节都受到各个方面严格的监督,一旦出现徇私,将受到严厉的惩处。

在这样的环境中执业,从容自信或许不是难事。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1646210, encodeId=5b7d1646210c6, content=<a href='/topic/show?id=080d5469e79' target=_blank style='color:#2F92EE;'>#执业#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54697, encryptionId=080d5469e79, topicName=执业)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95a523305089, createdName=维他命, createdTime=Tue Jan 16 14:08:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236894, encodeId=bf6c236894f4, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Fri Aug 25 07:21:27 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236836, encodeId=ee3b2368361d, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Aug 25 00:30:29 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236823, encodeId=ac1523682310, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Thu Aug 24 23:50:09 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236800, encodeId=421e236800da, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 24 22:59:48 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236774, encodeId=cc45236e7400, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Thu Aug 24 22:01:50 CST 2017, time=2017-08-24, status=1, ipAttribution=)]
    2018-01-16 维他命
  2. [GetPortalCommentsPageByObjectIdResponse(id=1646210, encodeId=5b7d1646210c6, content=<a href='/topic/show?id=080d5469e79' target=_blank style='color:#2F92EE;'>#执业#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54697, encryptionId=080d5469e79, topicName=执业)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=95a523305089, createdName=维他命, createdTime=Tue Jan 16 14:08:00 CST 2018, time=2018-01-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236894, encodeId=bf6c236894f4, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Pw2csslt7CukWiabqiblnQAXaDEiaxhu025c3P0XshccTrbvGWBjKvnHIxbK3vqa80P7WGIFuicCFet97TicrNKpgB3TdabxP1vMh/0, createdBy=28851960965, createdName=榄枷檬, createdTime=Fri Aug 25 07:21:27 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236836, encodeId=ee3b2368361d, content=厉害了我的哥, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Fri Aug 25 00:30:29 CST 2017, time=2017-08-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236823, encodeId=ac1523682310, content=学习了.谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Thu Aug 24 23:50:09 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236800, encodeId=421e236800da, content=学习了.谢谢., beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 24 22:59:48 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=236774, encodeId=cc45236e7400, content=学习了受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Thu Aug 24 22:01:50 CST 2017, time=2017-08-24, status=1, ipAttribution=)]
    2017-08-25 榄枷檬

    谢谢分享

    0

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    2017-08-25 飛歌

    厉害了我的哥

    0

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    2017-08-24 changjiu

    学习了.谢谢

    0

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    2017-08-24 惠映实验室

    学习了.谢谢.

    0

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    2017-08-24 184****9840

    学习了受益匪浅

    0

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