专科医生全科化!一种医疗新模式正在萌芽

2017-04-10 石破天 看医界

余金泉医生是一名风湿免疫专科医生,在加入卓正医疗前曾先后于中山大学附属第一医院、港大深圳医院工作近10年,他是系统性红斑狼疮病友会“蝶友会”的创办人,也曾是港大医院狼疮门诊的创建人、痛风门诊的主要创建人之一,在免疫病妊娠方面更是有深入的研究,有很好的专科基础。从他朋友圈分享的图片,我们可以得悉,加入私立医疗机构以来,他的专科病人仍从各地坐高铁、坐飞机,继续跟着他看诊。

余金泉医生是一名风湿免疫专科医生,在加入卓正医疗前曾先后于中山大学附属第一医院、港大深圳医院工作近10年,他是系统性红斑狼疮病友会“蝶友会”的创办人,也曾是港大医院狼疮门诊的创建人、痛风门诊的主要创建人之一,在免疫病妊娠方面更是有深入的研究,有很好的专科基础。从他朋友圈分享的图片,我们可以得悉,加入私立医疗机构以来,他的专科病人仍从各地坐高铁、坐飞机,继续跟着他看诊。

不过,据说在卓正医疗,内科的专科医生同时也要负责全科的诊疗,他们是如何平衡专科和全科的工作的?让专科医生来做全科的诊疗,是否是一种资源的浪费?

从政策背景来看,新医改越来越强调完善全科医生制度,普遍认为全科医生应该成为居民医疗保障的主体,并实现与专科医生的相互补充。全科医生与专科医生恰是医疗体系的两架马车,应该并驾齐驱--这给我们的印象常常是,非全科即专科,不过,一种基于专科医生的全科医疗新模式,正在萌芽于改革先锋城市深圳,而卓正医疗已经在这么做并且日趋成熟了。

其实在国外,很多内科医生、妇产科医生都是具备GP(General Practitioner,全科医生)性质的,首先你是一个GP,然后你才可以进一步成为专科医生、亚专科医生。余医生认为专科医生同时从事全科诊疗,不但不是一种资源浪费,反而是一种医疗资源的节约,而且更高效便利。

据悉,在卓正,各个专科医生会根据最新的国内外指南和循证医学证据编写本专科常见病的诊疗规范指引用以培训新加入的医生,因为招聘的都是各个知名医学院校硕士以上毕业并且有比较长工作经验的专科医生,经过系统培训,基本很快就能很好的处理全科的常见病。

专科医生掌握全科知识有什么好处?病人都不是照书生病的,尤其慢性疾病患者常常会有多种情况,比如类风湿关节炎的病人同时有过敏性鼻炎,专科医生具备了全科技能,就能同时处理类风湿关节炎和过敏性鼻炎,避免了病人在不同专科之间奔波多处看诊--这种情况在原先的诊疗模式里还真不少见。

又比如说,系统性红斑狼疮患者妊娠,妊娠期又常容易合并甲状腺疾病问题,如果专科医生掌握了全科的知识,避免病人在不同专科之间奔走是小,能有更全面的全局观处理问题是大--专科医生夯实了全科技能,让专科病人能够得到更安全优质的服务。

专科医生全科化的另一好处就不用赘述了,国家新医改这么重视全科医生制度的建设,用原卫生部副部长黄洁夫教授的话说,“因为全科医生是群众基础医疗的守门人。”但是,在中国,往往民众会觉得全科医生是初级医生,专科医生才是更高级的医生,因此都不太愿意在全科医生处就诊。

实际上,全科医生与专科医生是互补的,是团结协作并驾齐驱的关系,只是医生间的分工不同,并非高级、初级之别。基于专科医生主导的全科医疗模式,可能更有利于民众接受全科医疗的模式。

有人说“全科医生制度是中国医改破局的金钥匙”,而基于专科医生的全科医疗模式的尝试和探索,或许可能成为打开全科医生制度的敲门砖?

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    2017-04-16 1e21e016m53(暂无匿称)

    医师的学习真辛苦,但是社会资源对我们太差了

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6lQViaiaazgKwu3ASkx2y57ib6ISo2VFcU2BYlssBOpcOQcjB5rSVpl36mTeQD5lzAvY9wwxyOuebVA/0, createdBy=57c11919303, createdName=wl1122050, createdTime=Wed Apr 12 08:27:51 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186744, encodeId=7de6186e44d5, content=专科医生全科化!一种医疗新模式正在萌芽, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRrYOibkVibW9vAkCfb2F55aHjqMoqUVaF9fuXIMCxexawSOsicpbF7Ria7o54zPK65PodlkwhPrNhLhS/0, createdBy=12f71314239, createdName=ann y, createdTime=Wed Apr 12 00:14:35 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186660, encodeId=adb618666005, content=做得好,应该实事求是, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Tue Apr 11 09:32:22 CST 2017, time=2017-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186606, encodeId=94d818660649, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Apr 11 09:00:54 CST 2017, time=2017-04-11, status=1, ipAttribution=), 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    2017-04-12 wl1122050

    天下之事,合久必分,分久必合。

    0

  5. 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    2017-04-12 ann y

    专科医生全科化!一种医疗新模式正在萌芽

    0

  6. 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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Tue Apr 11 09:32:22 CST 2017, time=2017-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186606, encodeId=94d818660649, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Apr 11 09:00:54 CST 2017, time=2017-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186562, encodeId=13e618656244, content=专科医生没做好,索性做全科医生!这就是现状!未来也是如此………, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36431584645, createdName=wwjxx, createdTime=Tue Apr 11 06:46:35 CST 2017, time=2017-04-11, status=1, ipAttribution=)]
    2017-04-11 lyh994

    做得好,应该实事求是

    0

  7. 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    2017-04-11 shaosai

    好好学习,涨知识

    0

  8. 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    2017-04-11 医艺依意

    专业性和全面性并不矛盾

    0

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objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Tue Apr 11 09:32:22 CST 2017, time=2017-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186606, encodeId=94d818660649, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Tue Apr 11 09:00:54 CST 2017, time=2017-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186562, encodeId=13e618656244, content=专科医生没做好,索性做全科医生!这就是现状!未来也是如此………, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36431584645, createdName=wwjxx, createdTime=Tue Apr 11 06:46:35 CST 2017, time=2017-04-11, status=1, ipAttribution=)]
    2017-04-11 飛歌

    学习了很有用

    0

  10. 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createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM6lQViaiaazgKwu3ASkx2y57ib6ISo2VFcU2BYlssBOpcOQcjB5rSVpl36mTeQD5lzAvY9wwxyOuebVA/0, createdBy=57c11919303, createdName=wl1122050, createdTime=Wed Apr 12 08:27:51 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186744, encodeId=7de6186e44d5, content=专科医生全科化!一种医疗新模式正在萌芽, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRrYOibkVibW9vAkCfb2F55aHjqMoqUVaF9fuXIMCxexawSOsicpbF7Ria7o54zPK65PodlkwhPrNhLhS/0, createdBy=12f71314239, createdName=ann y, createdTime=Wed Apr 12 00:14:35 CST 2017, time=2017-04-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=186660, encodeId=adb618666005, content=做得好,应该实事求是, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, 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    2017-04-11 wwjxx

    专科医生没做好,索性做全科医生!这就是现状!未来也是如此………

    0