When people need medical treatment, they often fall into a dilemma. When you go to a general hospital, you will face the problems of difficulty in registering and waiting in line. However, when you go to a community medical institution, you will inevitably worry: Is the doctor professional enough, and will it delay your illness? During this epidemic, I personally felt the importance of vigorously developing primary health care. In the future, how to strengthen primary health care and make it more convenient and reassuring for people to seek medical treatment?
-Chen Kang (media person)
Dai Qing (attending physician in a 3A hospital):
The impact of the epidemic is not only a test for hospitals and medical workers, but also exposes some problems and shortcomings that have not been fully paid attention to before.
The relative shortage of human resources in the medical system is the most intuitive thing I feel. Before the arrival of the epidemic peak at the end of last year, the work of the hospital was already very busy. After the arrival of the infection peak, there was a large-scale phenomenon of medical staff "going into battle with illness". In the most difficult time, there were two doctors and four nurses in the ward, and some graduate students and regulatory students rushed to the front line. This phenomenon can be effectively alleviated by increasing the input of resources to the first-line medical institutions with definite needs.
At the same time, the hospital’s emergency ability in the face of special circumstances is relatively lacking, which is also a short board that needs to be filled. At the peak of the epidemic, surgery, obstetrics and gynecology, pediatrics, etc. all opened wards to treat COVID-19 patients, but the front-line doctors did not receive relevant training, so they had to "drive ducks to the shelves" under the guidance of respiratory doctors, and the treatment effect was not satisfactory. If there is a medical run, a large number of emergency patients will be anxious but helpless. In this regard, both hospitals and public health systems should pay more attention to prevent this from happening.
The three-year epidemic prevention course has also allowed the hospital to accumulate some experience that it did not have before. Before the peak of the epidemic, the hospital prepared more ventilators and drugs in advance, and the medical order was basically maintained. How to sum up the epidemic experience and optimize the future medical work needs to be studied at the policy level.
Chen Yingjun (community doctor):
The ideal community medical service should enable ordinary people to solve their daily health problems at home, which is inseparable from a series of humanized and refined service measures.
In reality, in order to reduce people’s psychological burden of seeking medical treatment, community hospitals can establish a long-term and fixed "friend-like" partnership between residents and doctors through family doctors’ contract service. In this way, once residents encounter health problems, they can communicate with family doctors at any time. The active concern of family doctors and friends can also help residents eliminate health hazards in time.
In addition, community medical institutions can rely on information services to optimize the medical treatment process and improve the medical experience of residents in their jurisdiction. The Majiapu Community Health Service Center where I am located has launched the "Pocket Service", where contracted residents can communicate with family doctors online, make online follow-up visits, and make appointments for registration. Through the "internet plus", hospitals, medical insurance and drug distribution enterprises and other systems have been opened up, and "drugs are delivered online, delivered to the door, and services are superior" has been realized, and residents’ sense of obtaining medical treatment and satisfaction have been greatly improved.
Linking with higher-level hospitals, perfecting department settings and creating characteristic service projects according to the characteristics of the community can better meet the medical needs of residents. For example, for the disabled, semi-disabled and other elderly groups with mobility difficulties, we can provide services such as sending medicines to the hospital and hospice care. In view of the common diseases of the elderly such as lumbago and leg pain, we can also create a special service consultation area of traditional Chinese medicine, and relieve the pain of patients through traditional Chinese medicine massage and acupuncture.
Zheng Shanhai (doctor):
To strengthen primary health care, we can focus on the following aspects.
First of all, primary health care is a healthy "goalkeeper" and should undertake the first consultation task of general outpatient service. If patients feel unwell, they should first go to a nearby community medical institution for treatment. The community medical institution will make a preliminary differential diagnosis and analysis of the patient’s condition, and then treat or refer them to the corresponding superior medical institution according to the actual situation of the patient. This can not only liberate the general hospital from the tedious outpatient work, but also ensure the community medical institutions to play their due role at the source.
Secondly, in order to attract patients, community health institutions must have the ability to refer patients to higher medical institutions. Otherwise, if the community is finished, it needs to be referred, but the follow-up work completely requires the patient to go to the "road" himself, and the initial diagnosis in the community becomes "unnecessary".
Third, establish a rational flow mechanism of doctors between community hospitals and general hospitals. Different doctors have different specialties, some like to bury their heads in medical treatment, some have strong theoretical foundation, but their clinical application ability is poor. Establishing the up-and-down flow mechanism of doctors at different levels is of great benefit to strengthening primary medical institutions. To do this, it is necessary to reform the assessment mechanism of community doctors. When the treatment of community doctors is improved, more outstanding talents can be attracted to take root at the grassroots level, and medical "strong grassroots" can come naturally.
Source: China Youth Daily
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