If God can give a chance to start over, I must not be a doctor, accurately, is not in China to be a doctor, especially the emergency department doctors.
(1) Eight years of bachelor's degree, 15 years of seniority, an annual income of more than 100,000
In the eyes of the Chinese people, the doctor is a highly educated, high-income group, with salaries, bonuses, benefits, red packets, kickbacks, work and stability, high social status, respect, teach envy and so on.
The truth is, this is appropriate to put American doctors, Chinese doctors, full not that.
In 2017, the average annual income of U.S. emergency medicine doctors was 330,000 U.S. dollars, which translates into 2.14 million yuan, while I, a fifteen-year attending physician in the emergency department of a tertiary hospital in Beijing, earned less than 200,000 yuan a year. Yes, you read that right, less than 200,000 yuan, which includes salary, performance incentives, housing subsidies, holiday overtime pay, night shift pay, year-end bonuses, and all other income paid by the hospital, and that's before taxes!
And then add the tax deduction, deduction of three insurance and one gold, really really to hand even less. On average, it's only about fifteen thousand per month.
Knowing that this is in Beijing, the average house price of 60,000 Beijing, housing prices comparable to New York and Los Angeles, the doctor's income is only a fraction of others.
If the doctor is a good trainer and belongs to a low-skilled job, it would be fine, but the problem is that it is difficult to learn medicine, and the requirements are high, and the input and gain are not proportional to each other at all.
Like me, the country's top ten medical university graduates, eight years of cardiovascular master's degree, finished the book has been 26 years old, if the study of computer science, this time the starting salary has been more than 100,000 up.
But waiting for me is three years of residency training, this three-year period no holiday can be rested, the Spring Festival also have to be in the post, the second year of training, my father is seriously ill, I want to ask for three days of leave to return home to visit, the leadership said that unless my father died of the disease, or else come back to the penalty of one year of training, I do not dare to go back to the news of my father's death, only to go back to the ...
This experience is the first time that I have ever been in the hospital. p>This experience is a permanent pain in my life.
And during the training period, the salary is very low - three thousand a month (twelve years ago), in addition to rent and basic living expenses, nothing left.
Even today, the treatment of residents in training is still very poor, with some earning 7,000 to 8,000 per month, and others earning 6,000 to 7,000 per month, which is an income that you'd have to subsidize if you were renting an apartment in Beijing.
After enduring the training, the monthly income rose to 4,000, and after 12 years of work, it rose to 15,000 now.
I'm forty years old and the only thing I'm happy about is that I bought a house in Beijing in 2006 - relying on my family to borrow money to support me. Otherwise, I would have been working for a landlord on my income.
Some people say, you can receive red packets ah, well, surgical surgeons, well-known experts to receive red packets of phenomenon does exist, but and our emergency doctors can not be next to us, we contact with the patient's time is short, most of the salvage income from the hospital, by the specialists to take over the condition of the light will go straight home, do not have prolonged contact with the patient and his family, naturally, no one to send a red packet.
Sometimes, I envy those doctors and departments that can receive red packets, this idea is very immoral, alas, are poor!
(2) no day and night, overtime bottomless
Patients can not because of the holiday will not be sick, other departments during the holiday season may not be admitted to the patient, and there is no outpatient clinic, but the emergency department absolutely can not be away from people.
So ever since I got into this business, I've been destined to have nothing to do with the holidays. This year's Spring Festival seven days off, I took the 30th and 4th, two day shifts, two night shifts (day shift 8 hours, night shift 16 hours).
Fifteen years, every year, either the 30th or the first day of the shift, owe too much to their families.
Each position in the emergency department by four doctors shift, each day shift, night shift, rest day, so four days a cycle, the country's public hospitals are this setup. A carrot, you rest, others will have to work around the clock.
Some people say, you have holiday overtime pay ah! There is, a day shift 100 yuan, night shift 150 yuan. During the Spring Festival, I got 250 yuan overtime pay (overtime pay only counts from the 30th to the second day of the month).
I'm willing to put up the money, as long as I can enjoy the holidays like everyone else, spend Spring Festival, National Day, Mid-Autumn Festival with my kids, and travel with my family.
Annual vacation, indeed. Like me, with fifteen years of service, I get ten days of annual leave. But if you take a vacation, the other three will have to work shifts every day to make up for your potholes, and the next time someone else takes a vacation, you'll be equally obligated to make up for someone else's potholes. This is the same as no vacation, all pits.
On a normal day, if you go to work, you have to work overtime. The first thing you need to do is to get out of the office on time, hand over the patients, disinfect them, queue up to take a shower, how can it cost an hour or two, and then run into difficult family members, critical rescue patients, then there is no point, I've tried to go on from eight in the morning to five o'clock in the afternoon the next day, when I got off work I wanted to vomit, there is a ticking sound in my head, the touch of the skin is numb, I can't feel the pain.
Interestingly, I've heard more than one complaint from a patient in this situation, "How come the doctor still eats when there's a patient waiting, and the doctor still rests and dozes?" --Doctors would be better off as robots, powered up and ready to go.
This kind of overtime is, of course, free, and the Labor Law is completely ineffective against us. After work, you have to worry about whether you have missed a diagnosis and misdiagnosed, and whether you will be sued.
Because of frequent overtime work and night shifts, most of my colleagues are suffering from occupational diseases such as aging before age, hair loss, gray hair, lumbar disc protrusion, and stomach ulcers. A young female colleague had to leave her emergency medicine post because of breast cancer from exhaustion.
(3) Being beaten and scolded is a common household occurrence
"Being beaten and scolded is a common household occurrence." This is the mantra of our colleagues in the emergency department.
People get sick, and when they get sick, they need to see a doctor.
Doctors in this business, contact with the patients of three religions and nine streams, what kind of all, which is a lot of low-quality, unreasonable, self-centered, shouting at every turn to kill the guy.
And the emergency department is the hardest hit, looking for the door is mostly self-considered urgent condition, the matter of survival of the patients, people are anxious, easy to lose their heads, look at who all seem to be intent to harm him, so the conflict came.
In fact, a considerable number of people who come to the emergency room are not really acutely ill, but simply do not like to wait, do not like to go to the general outpatient queue, which is contrary to the principle of emergency medical emergency.
There is that Beijing moncler, guilty of palpitations for more than a year he is not anxious, in the emergency waiting for five minutes on the spot fried scolding, "I hung up the emergency number, you have to give me the first to see, I can not wait a moment, waiting for what is called the emergency ah!
There are also dermatologic patients, because it is not an acute disease, after being rejected with three words of greeting me for half an hour.
Another woman pointed her nose at me and scolded me "no medical ethics, see adults but not children," I told her that our hospital's pediatric emergency room has been canceled for four years, because the pediatrician was scolded by the patients lost, can not be recruited, and now the pediatrics is only a general outpatient clinic, the woman back to me "what the thing, what attitude! If you don't show me today, I'm going to scold you until my anger subsides".
And the old man who is a professional bumper car, the drunken socialist late at night, the white-collar woman who pretends to be sick and wants a leave slip, and the man who takes the results of the outpatient gastroscopy to the emergency room to find out the truth, they are not any serious condition, but if you don't comply with him, you will be able to curse the street on the spot.
And then there are the ones who pretend to have hysterical convulsions. A young man, in the unit and colleagues quarreled, came to the hospital to ask for static push valium, I let him go to the nurse's station to take vital signs, which is a matter of safety and normal procedures, the result of his rage, scolded me "bullshit doctor, what disease will not see". I have to ask the leadership, the young man immediately lying on the ground began to convulse, claiming that the emotional stimulation, guilty of illness, so before and after the toss me nearly 4 hours, and then asked me to pay compensation.
Being scolded every day and beaten is not uncommon. Once at night, a few drunken men holding a drink dizzy came in, into the door grabbed me by the collar, "hurry to rescue, or get you dead! I have not reacted, a fist smashed me in the face, even the female nurses over to pull the fight, but also to the fight, the hospital security guards hide far away, next to some of the patients watching with great interest, almost applauded, and finally the police came, the attitude of the police is to detain him for fifteen days, and so out of his harassment of you, looking for you trouble, why not let him pay 500 yuan, this is over!
So remember, readers, it only costs 500 bucks to play drunk and beat up a doctor, and 500 bucks to beat up a doctor, which is the most affordable way for urbanites to relieve stress!
More chilling than the beating was the hospital's attitude.
My former colleague, Dr. Lin, who is the mildest in the department, saw a patient who was transferred from outpatient to emergency - he was in serious condition and had to be stabilized in the emergency room first. But the patient's family insisted on direct hospitalization, because the reimbursement for emergency medical insurance is only a few tens of thousands of dollars, and the reimbursement for inpatient hospitalization is hundreds of thousands of dollars. Just like that, the family and Dr. Lin argued, "you are nothing, hurry to contact me hospitalization, I want to be hospitalized specialist examination and treatment!
After scolding him, he threw his fist at him and fractured his ring finger! Dr. Lin didn't fight back - we doctors don't fight back when we're being beaten, there's a surveillance camera watching us, and if we do, the nature of the fight will change, and it'll become a fight.
Guess what happened? The family member who hit the patient was not punished, and the patient was still seen in the emergency room and admitted to the ward as expected. And this is not an isolated case! It's a common phenomenon in the grand scheme of things! When it comes to medical disputes, patients are often seen as 'weak' and are sympathized with and condoned. That's why groups like the 'professional medical troublemakers' have emerged in China.
And Dr. Lin was beaten, his finger was fractured, and he had to report it as a work-related injury, but the hospital wouldn't allow him to pay for his own treatment, so he jumped ship and went to a private hospital.......
Sometimes it feels like doctors are the outcasts of the country, the unloved and unprotected group of marginalized people.
We have ****12 doctors in our emergency department who have all been scolded and beaten. I can't talk about this kind of thing for three days and three nights, and I should be depressed by the time I'm done.
(4) Noisy and chaotic working environment
I've been to hospitals in the UK and Hong Kong and observed them on the ground, and they are all quiet, people waiting patiently to be seen, and nobody interrupting patients who are being seen to ask questions. I don't know what the problem is with our patients. Hospitals are always noisy, small clinic room often crowded into a dozen people, chattering to interfere with your patients; feel that everyone is living so irritable, and so arbitrary, where they have to show that they are the center of the world, the center of the universe.
When I was a child, there was a big "quiet" in the hospital, and the nurses would reprimand the patients and their families for making noise. Nowadays, the nurses still dare to reprimand them? I miss the old days, and I miss the peace and quiet!
(5) The plight of the emergency room staff
What is the emergency room? You have to take risks every day if you can't perform. Surgery is different, this change of heart and liver, is able to change the expert masters. This is a line from the TV series "Emergency Medicine Doctor", which speaks to the dilemma of emergency medicine.
Specialists become more and more popular as they get older, and emergency physicians become more and more miserable as they get older.
Emergency physicians are doomed to a miserable career outlook if they are in their forties or fifties and are still on the first or second line of clinical care. There is only one chief of emergency medicine, and if you can't be a chief in the emergency department, and you're not on the first or second line, what else can you be?
And the title promotion of emergency personnel is much more difficult, other industries, to my age, have been senior title, and I have all the conditions, because the department does not have a quota, not allowed to declare within three years.
Numerous emergency predecessors of the end, as if a mirror, out of their own tomorrow.
(F) Afterword
Sorry to say so much, pouring all the bitter water.
According to the saying, saving a life is better than building a seven-story pagoda, and there is no greater fulfillment than watching a patient come to life in your hands. Years ago, because of the success of the rescue of a Tsinghua University students, I have also been on the news, then, I think the doctor is a great, noble profession.
It's just that later on, I realized that the pain was so much more than the sense of accomplishment. I am a mortal, have a family to support, have a normal human temperament and feelings, take scolded and beaten against the grain, single-minded selfless dedication of the saint's standards require me, I can not do.
Writing this article, I do not expect you to empathize, and may have to be scolded - net bad words about the patient - but I hope that everyone on the doctor a little bit more small understanding of the health care system has a little bit of a small push, that will be.