In the last 20 ~ 30 years of this century, with the improvement of people's living environment and economic conditions, as well as the improvement of their cultural quality, their lifestyle, medical care needs and disease types have undergone significant changes. This change has greatly promoted the unprecedented rapid development of medical science and technology and the transformation of medical service model.
At present, the achievements in many fields of clinical medicine have been recognized by people, and it is expected that there will be further development and fruitful results in the next 2 1 century. In this regard, according to the current development trend, the possible changes of clinical medicine specialty and service model in the future are predicted as follows, and discussed with colleagues.
1. The development of medical science and technology and the change of medical model have accelerated the reorganization of clinical disciplines.
1) In the traditional internal medicine system, many diseases infected by bacteria and parasites will gradually decrease, replaced by diseases caused by virus infection and its complications, and there will be more and more complex senile diseases such as affluence, obesity, hypertension, diabetes, physiological and metabolic degenerative diseases, arteriosclerosis, brain cell degeneration and paralytic dementia.
2) In recent years, through the study of experimental animal models such as nematodes and fruit flies, it is found that genes are closely related to aging.
Due to the development of electronic and information technology, the appearance of various endoscopes, and the popularization of imaging medicine and interventional diagnosis and treatment methods, the treatment scope of traditional surgery has changed greatly.
(4) The reason why this phenomenon has become a social motive force to promote the development of obstetrics and gynecology and pediatrics technology is because parents protect their children's health.
5) The development of Chinese medicine has always been attached importance by the Party and the government. In recent years, Chinese medicine has gone abroad and is increasingly welcomed by people in western countries.
6) The progress of society, the development of technology and the demand of society will inevitably change the present situation of clinical medicine. Some specialties of traditional disciplines may gradually shrink and some specialties will be merged, which is an inevitable development trend.
7) The advent and application of ultra-high power microscope has broadened our understanding of the micro-world of human body and found many unknown disease information, which not only helps to make a clear and rapid diagnosis of diseases, but also opens up a new way for clinical medical research.
Second, social progress and demand have accelerated the transformation of medical service model.
With the change of society, the change of medical model and the improvement of people's self-care consciousness, the requirements for medical and health services are bound to be higher. Reduce diseases, reduce injuries, provide special care and family services, spend less money, and get satisfactory medical care services without leaving home. This social demand has promoted the change of the old concept and system of social health care.
1) establish and implement a national medical and health insurance system with the national social security department as the main body and non-state-owned insurance companies as the supplement. The former set up public accounts and personal accounts to ensure the basic medical care of the people; The latter is a supplement to other types of selective insurance and charges a certain fee. This combination, coupled with various medical service institutions, has enabled the broad masses of the people to be in a reliable and complete health protection circle, which has not only changed the original "free medical care" system, reduced waste, but also met the medical care needs of the social population and increased civic awareness.
2) The establishment of community medical centers is a basic medical service institution to meet people's medical care needs.
3) The perfection of social security system and the establishment of community medical centers will inevitably have a certain impact on the specialized or general hospitals run by the original country.
Medical and health work is carried out according to the needs of society, and the relationship between supply and demand for providing medical and health services for the social population controls the development direction of hospitals to a great extent.
At the same time, the severe competition situation will force the medical staff and managers of large hospitals to go out of the hospital, to the community, to the grassroots, to the patients' homes, to extend the scope of medical services and continuously expand the market. It makes the traditional hospital remove the fence and become a "hospital without fence". This kind of hospital without walls will actively improve the cooperative relationship with community medical centers and general practitioners and give full play to the guiding role of large hospitals.
Under the impetus of social change and the development of medical science and technology, various medical institutions coordinate and complement each other, forming a closely linked whole. Focusing on the medical and health care needs of the broad masses of the people, we will give full play to our talents and energy so that people's prevention, health care, treatment and rehabilitation can be implemented in this medical and health care entity.