Transformation of the concept of medical service
For a long time, the asymmetry of medical information has consciously or unconsciously cultivated a group of "condescending" doctors, and also created an "elite consciousness" in the medical profession. Therefore, the traditional medical service emphasizes "doctor-centered", and clinical decisions are made by doctors based on clinical data, scientific evidence and patient interests. In this case, the doctor plays the role of "God".
Based on the fact that every patient's experience is different. The current technology-driven healthcare industry focuses more on "treating the disease" than on "treating the person," ignoring or downplaying the needs of the patient as a "human being," and instead focusing on the "doctor" and the "patient. "Instead, they talk about "medicine", "disease", "illness", and "system". system" on "disease" and "system" on "system". In particular, public hospitals are constantly pursuing to become technology centers, and in the process of launching the equipment race, they are constantly reinforcing the hospital's "condescending" attitude and the medical staff's "elite consciousness".
The transformation of medical services has forced hospital administrators to start thinking about the path to quality assurance, the rising burden of individual medical costs, the pressure on hospitals, and the issue of income security for medical staff. Consumers are now concerned about the health care industry has been directly from the doctor to see a doctor, focusing on the doctor on what exactly medical technology to serve consumers? The question is not how much money is spent, but what does that money get the consumer in return? The role of the patient has changed.
Currently, the doctor-patient relationship is tense, doctors and patients have an unshirkable responsibility. Please ask each doctor to ask themselves in the diagnosis and treatment activities to do "patient-centered"? If so, please continue; if not, learn how to provide "patient-centered" medical services. With the increasing awareness of patients' rights, more and more E-patients under the popularization of the Internet, and the viral spread and influence of new media, more and more patients and their families are becoming knowledge-based. In this case, the balance of the doctor-patient relationship gradually tilted to the patient side. The doctor-patient relationship has become a contractual one, with both parties ****taking on the same responsibilities, obligations and risks, and seeking to align interests and values.
Often, "smart" patients will search the Internet and review the medical literature as soon as they learn the basics of their condition. The patient is psychologically driven to be aware of the medical advances, treatment options, and prognosis of his or her disease, so as to avoid being passive in the upcoming conversation with the doctor. Obviously, the doctor needs to do a detailed analysis and research and judgment of such patient's disease to provide the patient with the most secure treatment plan, and also for the patient's family to do their best to understand the condition and come to discuss it with the doctor. In fact, the process of effective communication between the doctor and the patient or the family, but also between the doctor and the patient a kind of heart-to-heart communication, although the process has some twists and turns, but the basic harmony. Mutual trust in each other, it will achieve results beyond the expectations of both parties. When information technology has become the main force of health care, doctors and patients will become more transparent, patients become more and more "smart", know more and more, can greatly change the information asymmetry between doctors and patients. Doctors how to face these "smart" patients, worth thinking about.
With the help of information technology, patients will be able to understand the basis of the doctor's diagnosis, understand the doctor's diagnostic and therapeutic activities, so as to participate in the diagnostic and therapeutic process. After knowing more information, if the doctor's statement does not convince them, they will question the doctor's diagnosis, and even give the treatment plan that they think is reasonable. Doctors need to listen to the patient's and family's point of view and respect the patient's and family's choices. The patient's and family's range of knowledge, values, beliefs, and cultural background should be taken into account in the delivery of health care.
Modern patients are slowly becoming consumers, and physicians are lagging far behind in this shift to consumerism, and physicians are not ready for this era. Consumers are still evaluating doctors on the basis of value for money, and the more the quality of the doctor meets the consumer's preference, the more the consumer will feel that the doctor treating him or her is clearly different from other doctors, and this difference is that the consumer feels that the value for money is refreshing.
How is the role of the doctor changing?
As we all know, in the past, the doctor is to look directly to the doctor to see a doctor to prescribe medication or surgery and then go home, nowadays people's health consciousness has changed significantly, began to pay attention to changes in the physical condition of the process of medical treatment is more focused on the medical experience. The essence of the doctor's service to the patient is to provide high-quality services to patients to save lives or reduce pain. Hospitals have captured the essence of the doctor's role, which is to provide high-quality services at a low cost under the principle that the patient's interests are paramount.
The so-called high-quality medical services, not only from the advanced equipment and first-class information system, but also rely on the diagnosis and treatment of a team of doctors with excellent skills. For example, in surgery, half of it is technology and half of it is art. Only technology, no art, surgery is difficult to perfect; only art, no technology, surgery can not be successful. And the commander-in-chief of technology and art is philosophy, without philosophy, surgery will lose direction, no aura. It is not enough to say that a certain disease is suitable for a certain kind of surgery, because two people are neglected here: the physician and the patient. It should be the patient and his disease that is suitable for a certain surgery, and the surgeon who performs the surgery. It is only when these four factors are perfectly matched that the most appropriate choice is made.
So it's especially important for physicians to bring value to their practice. The doctor will first understand the current treatment situation and treatment needs from the patient, and comprehensively collect a full range of relevant information about the patient's medical history, physical condition, etc. After obtaining this information, he or she will use the latest scientific research, medical journals, health data, and cases to make comparisons and, with the help of a team of specialists and big-data analytics, will give the treatment that offers the highest chances of recovery, and will provide the patient with a detailed report. The content of the report will include the diagnostic results, various risk situations that aggravate the condition, and a number of detailed treatment options available. Not only can it directly address the treatment of the disease, but it can also provide targeted guidance on how to stay healthy and more.
Value-based medicine is a serious issue that was once avoided, but now must be addressed, or the positioning of medical value and optimal operational strategies are often in the process of multi-party games, only gradually surfaced. Value-based medicine is based on the best evidence of evidence-based medicine, the quality of life of the patient and the economic cost of treatment to the maximum extent possible, and seeks to provide patients with higher quality health care services, while minimizing the social and economic burdens, is a kind of quality of life of the patient to improve the quality of life, life expectancy and other factors and the cost of treatment of the organic combination of the medical model. For example, decision-making accounts for 75% and skill for 25% of a successful surgery. The basic principles of clinical decision-making are: (1) adequate facts and evidence; (2) careful design and planning; (3) prudent implementation and operation; (4) flexible contingency and response; and (5) comprehensive consideration and consideration. A surgeon should master a variety of surgical modalities and be adept at developing his or her own specialties. A mature surgeon knows when to operate, when to extend the scope of surgery, and when to stop. Only through dialectic can one cope with the situation with ease. All gynecologic surgery cannot, and should not, be performed in one way; and all gynecologists cannot, and should not, be required to perform any surgery in one way. Therefore, value-based medicine cannot simply be understood as whether the diagnosis and treatment of a particular disease or patient is valuable, or whether a particular kind of assistance or rescue is necessary.
For example, the current promotion of personalized medicine and consulting services, are to allow patients in today's one-size-fits-all treatment methods, can have more choices, to obtain a truly personalized treatment plan for their own. This is because doctors and patients*** share the same values of the human being and human life. Given that doctors and patients have different value orientations. What is the value proposition? For example, for the treatment of malignant tumors, doctors think more about reducing complications, reducing recurrence, and delaying progression from a medical perspective or law. Most malignant tumors are incurable, and all doctors do is relative risk reduction (RRR). The patient, on the other hand, from his own point of view or feelings, wants the treatment to be completely free of side effects, should be completely cured and painless, and what he asks for is absolute risk reduction (ARR). Both demands are valid, but there is a gulf between them. How to fill the gap? It comes down to how life and death, injury and pain are viewed, both by doctors and by the public.
If you understand from a deeper level, recognize medicine, medical treatment and doctors from the stage (or limitation) of medical development, and discuss value medicine from the perspective of humanistic medicine. This includes all kinds of difficult diseases and all kinds of difficult people. Avoiding the isolation of physicians from patients by instrumental examinations and the tendency of clinicians to "leave the bed" is particularly important in the proper handling of difficult cases. Doctors between peers, whether inside or outside the hospital, up and down the mutual accusation is to tear each other down. Mutual respect. Respecting others is also respecting yourself and respecting reality. Respect for others does not mean for whom to hide defects, but to better make up for the defects.