The author of this article:Tuntun
The complaint telephone, probably It can be ranked in the top 3 phone calls that doctors do not want to receive.
“What are you talking about, doctor! What attitude!”
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This is the fourth time Dr. Wang has received such a complaint this month. Wang unconsciously developed the habit of speaking loudly.
“Doctor, speak louder, I can’t hear you at all.”< /p>
This is the fifth time Dr. Wang has received such a complaint this month. Wang out of the clinic will deliberately control his volume.
Dr. Wang, trapped in the complaint, muttered for the 365th time this month:< span>Never neglected any case, why was it still complained by the patient?
“silenced” Patient
The patient complaining aggressively on the other end of the phone is actually a medical Absolute underdog in service. During the entire medical treatment process, the doctor is the one who leads the whole process, and the patient is almost “invisible”.
The first reason is that patients have limited understanding of medical treatment and are unknowingly treated. was excluded from the discussion of diagnosis and treatment.
Eight years of medical education and clinical work, doctors have long understood that medicine can cure Disease is limited. However, for patients, under the influence of a large number of drug advertisements and case propaganda, they have too high expectations for “cure”.
In a study of 1139 lung and rectal cancer patients, 69% of lung cancer patients and 81 % of colorectal cancer patients are unaware that chemotherapy simply cannot cure their cancer.
Treatment in the way the patient expects may not necessarily lead to good results. In 2012, a study published in JAMA showed that patients with the highest satisfaction had an 8.8% increase in total healthcare expenditures, a 9.1% increase in over-the-counter prescription drug expenditures, and higher patient mortality.
Therefore, in order to let patients give up their beautiful fantasies and accept a suitable diagnosis and treatment plan, sometimes doctors have to A little pressure can persuade the patient to cooperate with the treatment.
Behind this diagnosis and treatment plan, how the doctors scratch their heads and how to operate cautiously on the operating table , patients who do not know much about medicine may not be able to feel it.
On the other hand, the development of modern medicine has given the right to speak to the instrument and data, the patient’s expression is nearly invisible.
Before the development of natural science, the subjective feelings of patients were medical At the center, the patient’s suffering is the reason for medical intervention. Adequate communication between doctors and patients is not only for extracting disease-related information from patients’ narratives, but also for comforting and encouraging patients.
After the sixteenth century, medicine led by the West entered the era of “science”, and the instruments were almost completely reversed the doctor-patient dialogue. With the help of stethoscopes, sphygmomanometers, CT and other instruments, doctors can more intuitively observe the morphological changes of organs and quickly locate the problem.
It is also the development of science. Now doctors are faced with laboratory reports. Diagnosis relies on the comparison of reported data with standard values, and the judgment of operation or not depends on indication judgment. Behind these data, the patients’ feelings as “people” are gradually marginalized with the development of technology.
In the hospital, there is no very clear and convenient channel for patients to express their rights. unhappy. If you are not satisfied with eating in a restaurant, you can find a waiter, a manager, a boss, or a consumer association. In the hospital, patients do not know who to complain to, and in the end they can only call the mayor’s hotline 12345 to be transferred to the specific department of the hospital.
The “Measures for the Management of Complaints of Medical Institutions” issued in 2019 stipulates that medical institutions above the second level should set up medical institutions. The Patient Relations Office or the designated department shall be responsible for the management of complaints.
Measures for Complaint Management in Medical Institutions”
Being separated by the barriers of medical knowledge, personal subjective expressions are also replaced by data, all kinds of grievances and helplessness tell. When the other end of the complaint phone asked, “What problem did you encounter?”, a thousand words could only be summed up in one sentence:
< p>“The doctor here is so bad!”
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Why is it so hard to “have a good attitude”?
The “Chinese Doctor-Patient Relationship Survey” shows thatpoor service attitude is the main reason for patients’ dissatisfaction with doctors, accounting for 51.4%.
It’s not just pretentious to want a “better service attitude”. When describing the disciplinary attributes of medicine, “Cambridge History of Medicine” said, “Medicine is the most human in the natural sciences and the most scientific in the humanities.” Since its birth, the dual attributes of natural sciences and humanities of medicine mean that while diagnosing and treating diseases, patients should also be given spiritual, psychological, emotional and other care.
But for doctors, a bad attitude is not intentional, it’s just “too busy” The workload had to make some trade-offs.
Especially in the top three grades, a doctor’s outpatient volume in a single day is 40 to 50, and sometimes even more. See 70 patients a day. According to the normal working hours from 8:00 to 12:00, even if only 40 patients are seen a day, the average admission time for each patient is 6 minutes. Many patients have to follow up after getting their test results, which means extra time. Therefore, the time for a single consultation is likely to be divided again.
In order to see more patients, doctors can only sacrifice each patient Some inquiries, explanation of illness, emotional comfort and other links. And these cut-off times are precisely what the patients look forward to most.
From the perspective of a patient, going through a hasty medical treatment process, you will feel I have not been taken seriously, and I have not received the humanistic care that I expected. In a survey, 46.7% of respondents felt that seeing their doctor was “a bit perfunctory.”
Compared with primary medical service centers such as village hospitals and township health centers, there are more patients here. Few, and mostly chronic diseases. Patients with chronic diseases often come, and can talk to the doctor more every time. Research shows that the lower the level of the hospital, the higher the trust and satisfaction of the patients.
However, on the other hand, the consistent orientation of the entire medical environment does not revolve around Humane care.
Performance assessment of national public hospitals from the previous year, all 55 Among the indicators, only two indicators focus on patient satisfaction, two indicators focus on appointments and waiting time, and a large number of remaining indicators focus on technical and operational dimensions such as medication, cost, and surgery.
Hospital rankings released by the Institute of Hospital Management of Fudan University every year. The evaluation dimensions include discipline construction, clinical technology and medical care Quality, scientific research level, and do not focus on patient service.
Institute of Hospital Management, Fudan University >
Under such a professional environment, for doctors, only by improving clinical skills and scientific research capabilities can they help their careers Development, providing better services to patients, does not directly point to the benefits of doctors.
When the patient’s urgently needed humanistic care has been neglected for a long time under various factors, it seems disturbing. The unbelievable complaint phone became their last channel of communication:
“Doctor, I’m not calling to complain about you, but to complain about the society.”
Planning: yuu . | Producer: gyouza Source: Visual ChinaReferences:
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