Thursday, February 17, 2011

If your doctor as a disease

 Two end of the day, any time I think no matter the topic for the medical people must be most concerned about. Just to see Dr. Xiao Fei hand in hand to write blog a blog, very inspiring, now reproduced, I think from a new perspective to the interpretation of the problem your doctor would still have great significance. article of a growing trend, while the authorities like a punch, as an important measure of medical reform, the separation of medicine from the hospital to start, start the movement to solve and expensive remediation. However, your doctor is a performance, according to the concept of medical He is a disease, what leads to your doctor (cause)? and expensive how did the (pathological process)? What is a reasonable treatment? How effective? adverse reactions what?
careful analysis, cause diverse and pathological processes complicated. This paper attempts to analyze , its own recorded history, there is medical treatment due to insufficient funds, or drug prices too high can not afford to give up treatment, loss of life recorded. The disease has evolved with the industrial revolution and mutation, and in the global pandemic, which is difficult diseases, there is no cure. the world's politicians, scientists and private groups dedicated to specific drug studies, and the expense of a large number of national life, but so far no breakthrough, but the groups accused each other of events continue to occur intensified. the infectious, chronic, intractable and fatal disease of the rising consumption of social resources, or even bankrupt the country, and even destroy the evil regime, .90 s, the outbreak of the disease in China and spread throughout the country.
and expensive etiology and pathogenesis
1. genes: Medicine is a discipline related to the life and health, as people seek to improve the health, the importance of the value of life, the medical health care system's demand urgent. In ancient times, physicians are mostly ancestral pharmacists, doctors act as barber, although classified as people trained in the medical industry the longest period of higher education and training, the mysterious and noble heritage of the occupational characteristics, therefore, invaluable life used to find high-priced services.
2. medical factors:
a ) excessive examination:
medical science progresses, large hospitals purchased a large number of advanced medical equipment. and in the past, listening, asking doctors to look for other medical treatment as the main means of physical examination, supplemented by three routine laboratory tests, done at the most a chest, spending is very low. and now, doctors rely on the practice in the treatment of advanced medical equipment, a full set of biochemical, CT, magnetic resonance imaging (MRI), PET, etc., will increase the inspection fees. one of my colleagues fell one aunt wrestle, the doctor asked her whether the money, then let her accept the MRI, the results show as high several times in the MRI, increasing the patient's burden. in the United States, often a doctor for the patient open the a large number of rays, an increase of cancer risk, a phenomenon in our country have looked up the phenomenon. on the age of 50 women yearly mammography camera, did not significantly improve early breast cancer diagnosis and treatment rates, which seriously increased the health care burden. a large number of false positive rate, increasing the burden on the patient's spirit.
excessive examination is another promoter of medical identification not according to their personal health practices and determine the best implementation of diagnosis, to leave a .
the past, the use of medical devices are called secondary inspection, and now, a doctor of the patient's physical examination had been relegated to secondary status.
b) over-treatment are often superstitious
new treatments for new drugs and medical devices invented to hold good hope. often see in our surrounding, advanced cancer patients, tumor metastasis has been widely into the end stage of life, in the patient's family's request, the doctor will be the most expensive kind chemotherapy drugs, biological agents and radiation therapy programs for patients, several million yuan to drop down and did not save the patient's life. a cancer treatment drug, as long as the lives of cancer patients show will be extended to four months from two months , that is, to marvelous effect, p values showed significant differences, pharmaceutical sector in the risk-benefit assessment (risk-benefit), the approval of the drug market. in the factory and the media played in promoting the next, the ; beginning of clinical application. several hundred thousand dollars a course, and create the miracle is to extend the life of a patient for several months, resulting in the concentration of a waste of medical resources, huge debt after death of patients. Meanwhile, the life of those months in bed spent, there is no quality of life. As treatment is only concerned about the risk benefit ratio to the neglect of price (cost-effectiveness), and no drugs economics (pharmacoeconomics) concept, so the blind pursuit of high-tech, expensive treatment, is duration of disease and prognosis is good or bad, all the expensive biological agents, the economy can withstand a one to injection, no cure for the chronic diseases that laid the medical devices, the need for a long time and high R & D investment, leading to expensive. the competent authorities of both countries the use of new drugs Pharmacoeconomic evaluation, specify the principles of medical claims. appropriate evidence-based medical professional societies have already summarize and analyze the medical literature, the risk benefit ratio based on the Guiding Principles specify the medication. However, differences in the patient's individual disease clinical manifestations and differences in the development process and complexity, making the treatment guidelines can not be perfectly adapted to clinical practice, doctors must experience combined with his treatment plan. but some doctors not scientific assessment of the patient, feeling alone, the pursuit of new drug applications, unreasonable compatibility, resulting in drug abuse, increased medical expenses directly, and because of adverse reactions caused the patient injury and increase indirect burden.
d) the scientific ignorance
medical science advances in understanding the disease continues to depth, but we are human beings and their body is still very superficial understanding of the disease. We can not control our life path. In therapeutic area, a great , operative findings, tumor one centimeter in diameter, did not break pulp muscle, the success of tumor resection, lymph node biopsy was negative 4. After surgery, she faced the choice of follow-up treatment, consultation, three well-known doctor, there are three different views One is the need of chemotherapy or radiotherapy, because the tumor early, there is no transfer; other views that need chemotherapy and radiotherapy, the guiding principle of 11 lymph nodes to biopsy, and surgery only been done four lymph node biopsy, should be assumed that 7 as a tumor metastasis; third proposal is not regular chemotherapy, but have to eat some chemotherapy drugs. Three different views and allow patients to lose direction. Finally, in accordance with the views of the family, prefer to believe them, without regret, bite on the chemotherapy, and spent hundreds of thousands. because science can not point the way, only the seat of your pants
3.
commercial promoting the drug and medical device manufacturers was undoubtedly the largest expenditure in clinical practice. academic and pharmaceutical companies, often through economic means clinicians to promote prescription drugs. Some companies use the low wages of doctors irrationality, drug rebates for illegal means, the temptation to doctors, some of the clinical efficacy of drug abuse is not clear, increasing the financial burden of patients. There are some pharmaceutical companies have been evolved into a travel company, in order to achieve the purpose of sale of drugs, seduce a doctor, great rivers and mountains in the Wanbian country, began to international forward, currently out of Asia into the Middle East. This is no academic value in order to sell drugs the purpose of commercial tourism, all of the developed and developing countries are prohibited, but such marketing model has become very popular in our country, nothing to fear, there is no obstacle. even in their law-abiding individual multinational pharmaceutical companies, also use ; conditions and customs
a) treatment method
uneven economic development in China, along with the great gap between the medical standards, the patient superstition big cities, large hospitals, whether or not it is necessary, both to travel long distances, to the provincial capital, and even municipalities to see a doctor, often travel, accommodation and other expenses counted in the total costs of medical care. Meanwhile, the relatives who accompanied the loss of working time to see a doctor fees, did not hesitate to increase in medical costs, so that your doctor feel more severe.
b) the demands of patients in the outpatient
, is no stranger to these words: to my children with the best treatment is outrageous, forcing relatives and friends lend a helping hand to patients at critical moments, the full funding, to find the most famous hospitals and specialists for treatment, referrals, and patients sometimes find out the number of red packets should be given. In our country, if not to give red envelopes before surgery, heart patients and their families is not practical. But when the disease has gone remission or patients, family members tend to feel tremendous economic pressure, and even enemies due to their inability to repay debt and for the enemy, and put this huge amount of expenses (including the red envelope ) operator in your doctor's books.
or colleague's aunt, when diagnosed as list, starting from the top, her whole family. My colleagues pharmaceutical industry through the famous journalist, to find the list of top doctors, found that admissions for Liu doctor, expertise, sports medicine, and business in the field, he moved to another Suiyou a big city hospital. would have been a simple orthopedic surgery, have been repeatedly delayed, the disease became more complex, medical and non-medical expenses increased significantly, while the 5. counterfeit and substandard drugs harm
four thousand years of history, the ancients left us a lot of valuable wealth of traditional medicines and therapies, but also a lot of dross mixed. Some unscrupulous businessmen and became a doctor officers the name of the use of modern technology, Western medicine in Chinese medicine mixed (such as: corticosteroids), poses a great security risk. The patients are often in the media, advertising, relatives, friends and patients, encouraged buy fake drugs. And this account is considered the doctor's expenses, adding to the medical resources, established a barefoot doctors, commune health clinics, county hospitals, to city hospitals, provincial and teaching hospitals as the main line of the hierarchy of medical security system, covering the whole country. was not the money to see a doctor, and habits of such a concept has been continues to this day now, see a doctor to spend money, the feeling is the additional expenditure.
7. of the hospital ward bed outpatient registration fees and charges are surprisingly low, less than the admission fee to see a doctor to see the film, charging less than the hostel beds . But the hospital's equipment and staffing and the cost to be much more complex than the former. the price of drugs is also uneven, and some very low drug prices. In all, while prices of production, and only continued in the lower drug prices, resulting in infusion compared with the same dose of mineral water, cola and cheaper supermarket, and some pharmaceutical companies use their own water purification system producing mineral water, its profits exceeded production intravenous infusion.
national investment and commitment of less disposable income for the country 24% of GDP, combined with large national savings 10% GDP of capital income, disposable wealth to 34% of the GDP, is the highest in the world. China's medical health has not been released, should be 3% GDP, the lowest ranks of the world. EC countries and Canada's government health input to 8% of GDP, the U.S. health care consumption was 16% GDP. As early as 100 years ago, the German Emperor to win over the occupation of the country, the implementation of a universal health insurance, the United Kingdom and Canada also implemented the national burden of health care system, national institutions to assess and enforce the principle of reasonable treatment, severely punish the abuse of drugs, and pharmaceutical companies to bargain. of the past 30 years to the gradual abolition of the main line of public health labor, rural cooperative medical care and demise of barefoot doctors, Youyi witchcraft rampant in rural areas, the health care burden of corporate and personal push and make the hospital their own money to survive. In the worst health care system in the United States, 40 million people without health insurance, and only until the condition worsened, to the emergency room for treatment. because of the law, emergency rooms can not refuse to re-patients, emergency treatment must be free of charge to patients, the state pays the bill. But in our country, often critically ill patients denied coverage in the emergency room beyond.
8. National
inequality between doctor when some people do not want money from the state pays the bill, some people need their own pay part or all medical expenses, with the formation of a citizen of the Republic and enjoy the different treatment, which would be more the former, even if their much burden will Xiangui. some of the patients over the age of 100 years old, has been unconscious for several years, blowing several ventilators bad, because it is the senior retired cadre, expensive and pointless treatment in the continuation of wasting a lot of human, financial and space. unequal and unreasonable medical resources distribution, resulting in poor people's basic health is no guarantee of individual elite brutal occupation of medical resources.
Therefore, we have implemented health care reform, To solve your doctor ills, Wan can not

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