A typical example of emergency doctor's work
Besides being busy with rescue and medical treatment all day, Liu Yong, as the director of the emergency department, often thinks about the current 120 in China.
Compared with foreign 120 emergency system, China's 120 is not comparable, "the gap is too big", which is recognized by many emergency doctors. "There are still many things to be done in China emergency system".
We should raise the threshold for doctors to enter the emergency system and ensure the quality of talents. The setting of this threshold is not only reflected in the entrance examination and graduation examination, but also should increase the difficulty of the entrance examination. Of course, the assessment of emergency doctors not only stays at the knowledge level, but more importantly, the assessment of doctors' moral level. Liu Yong emphasized that this moral level is manifested in reverence for life, love for patients and good communication skills with patients.
At present, it is a common problem for most hospitals to choose emergency doctors.
In addition, because emergency doctors have to undertake all the first-aid work before patients enter the emergency room. As an emergency doctor, every time I go out, I just face a sudden scene alone, and I also need strong pressure resistance and independent commitment.
A "cruel" reality is that it is often difficult to recruit suitable talents in hospital emergency departments.
A month ago, Liu Hongmei, chief of the Personnel Department of Beijing Emergency Center, traveled all over the major job fairs in Beijing and announced the recruitment information to the major networks, media and medical institutions in the city. But as of June 28th, Liu Hongmei only received 14 job resumes.
Since 2005, the number of undergraduate graduates enrolled in Beijing Emergency Center has been decreasing year by year. When Liu Hongmei caught up with this year's economic crisis, he thought the harvest would be better. However, after the relevant review procedures, only four people were admitted.
"This has a lot to do with the treatment of emergency doctors," Liu Yong analyzed. Emergency doctors have high labor intensity, hard working environment, high risk of taking responsibility and limited business development, but this is not reflected in "too much" salary. On the contrary, in some hospitals, the "status" of emergency doctors is quite low.
Another reason why most medical students give up entering the emergency system is the high risk faced by emergency doctors. It is necessary to establish a fair and scientific medical accident evaluation mechanism. Liu Yong said that the role of this evaluation mechanism is that "it is necessary to distinguish between absolute misdiagnosis caused by the limitation of medical technology level and relative misdiagnosis caused by doctors' personal problems (such as medical technology level and doctors' attitude)".
Take myocarditis as an example. An ordinary fever patient was taken to the emergency room. Most doctors will not consider the possibility of "myocarditis". It is understood that the incidence of "myocarditis" in patients with fever is one in ten thousand. "If every patient with a fever suspects myocarditis, let the patient do an electrocardiogram first, and the only reaction of the patient is that the doctor will do the examination indiscriminately."
What if the emergency doctor happens to meet this "one in ten thousand" chance? Is it reasonable to attribute this "one in ten thousand" probability to the doctor? Liu Yong said.
In addition, for medical disputes that doctors will encounter all the time, starting from maintaining the normal operation of hospitals and safeguarding the legitimate rights and interests of doctors, Liu Yong believes that "hospitals should buy medical liability insurance for doctors".
And this suggestion has been understood by the medical community. As early as 2007, in view of the rising trend of hospital violence in Guangzhou, which seriously interfered with the normal working order of hospitals, Guangzhou Municipal People's Congress suggested that local regulations should be formed as soon as possible, and medical liability insurance should be promoted by referring to the practices of other regions.
Under the current framework of solving medical disputes, medical disputes are usually very small and trivial, and often end in huge compensation from hospitals. "Medical liability insurance can maximize the recovery of economic losses caused by medical care."
The most important thing is that "the government does something and does not do something". Liu Yong said. "Doing something" means that when hospitals are violently attacked by organizations with ulterior motives, the government should resolutely suppress them. "When disputes between doctors and patients cross legal boundaries, the inaction of the government and law enforcement forces cannot be explained by any' hard work'".
The "doing something wrong" lies in that the government should hand over the rewards and punishments of doctors, the identification of medical accidents and the handling of medical disputes to local doctors' associations, and the government had better not interfere. "The hearing system is also imperative". Only in this way can medical disputes be resolved peacefully.
Interview notes
It's not easy to interview Liu Yong. Not because of the big name, but because he really doesn't have time. On the afternoon of the 6th, when he made an appointment for an interview, he hurriedly interrupted the request of 39 Health Network. The noise on the other side of the microphone tells the author that there is someone in the emergency department. Sure enough, Liu Yong politely told the author that he was "very busy now". I contacted Liu Yong for the second time until 8: 36 pm. At this time, Liu Yong's phone is still busy. After trying to dial several times, the author finally dialed the telephone, but Liu Yong kindly reminded the author, "I'm not busy now. If I am busy, I can't continue the interview. Please forgive me. "
I didn't take out the interview outline in a stylized way, but chatted with Liu Yong casually. So I can capture more details and feel the image of a flesh-and-blood emergency doctor. This image is not "Gao Daquan" or "dissatisfied wife". Like all doctors who stick to the front line of medical treatment, Liu Yong has a passion for this job, a grievance for patients, and a helplessness for various current systems. Despite the bumpy road, Liu Yong stayed in this position for 12 years, and said he would choose to continue. The reason is that when he watched a dying life being dragged back from death by himself and his colleagues, he enjoyed the joy of that moment and was intoxicated.
In the interview, when it comes to the sense of accomplishment and the scene of the construction workers coming back to life, Liu Yong feels like yesterday. As for more deeds, Liu Yong said he didn't want to talk about them, because saving lives is what doctors "should" do. However, for patients who don't understand doctors, and for those medical scenes with lingering fears, it is difficult for Liu Yong to calm down. Just like the scar on your body, it's healed and rotten. Perhaps, this pain will always exist.
Have you ever complained that you have been engaged in medical emergency for twelve years? There was a long silence in the microphone.
"Yes, but not for the job itself, but for some patients and their families," Liu Yong said.
It's nearly ten o'clock in the evening when the interview is over. When the bustling city becomes quiet, when busy people are ready to rest, emergency doctors are waiting for new calls.