学生论坛-英文3

1、 走进乡村医生 Yanhong liu etal.A survey related to the rural doctors professional spiritconstruction in Hebei province Research results 1 The working environment 2 The working intensity 3 Ways to improve professional ability 4 The influence of thenewruralcooperativemedical care system on their work* 5 The

2、 change of the doctor-patient relationship in the country *The working environmentThe ownership of the clinic ：The ownership of medical devices ：The satisfaction of current medical conditions ：The ownership of the clinicChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive City Build

3、ed by village collective26.323.519.6Builded by government finance43.912.54.550.05.929.7Personal house24.666.772.732.158.843.9Other - - - - 5.9 0.7 We can see from the working hours schedule: the village doctors in Chengde working hours is less than the other four cities, the time to get o

4、ff from work is also earlier.the reason to this maybe due to the limitation of mountain region ,maybe because of the few villages or being a small village.other 4cities are located in the plain,with relatively concentrated residents 。This obviously leads to longer working hours thanChengdeThe owners

5、hip of medical devicesChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities Private36.854.272.742.982.451.4public31.65.923.0The government provides 20%14.011.814.2The government provides 40%15.88.3-7.4Other - 12.5 4.5 - - 2.7From the aspect of equipments

6、: its seen that the privatization in Handan, Langfang is higher than 70% .And in Chengde, Baoding its less than 40%.The satisfaction of current medical conditionsChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities Very satisfied3.5-13.6-3.4Compared to meet26.320.818.217.941.

7、224.3ok35.145.831.860.741.241.9Basic enough 64.9 66.6 63.6 78.6 82.4 69.6lack28.116.718.221.411.721.6Serious lack7.016.718.2-8.1lack 35.1 33.4 36.4 21.4 11.7 29.7According to the analysis of overall :In terms of basic medical equipments,the governments investment is different . In terms of the Satis

8、faction of the village doctors , the difference is not big between five cities , but its still a little insufficient. We Suggest thataccording to the actual circumstance of village doctor, the investment of medical equipments have to be increased accordingly.Chengde CityQinhuangdao City Handan CityB

9、aoding CityLangfang City 2the working intensitiesThe intensityof timeThe time to get off workThe number of patients needed to be treatedThe evaluation of workload the intensityof timeChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities Within eight hours-21.89-10 ho

10、urs40.454.223.828.617.635.410-12 hours5.341.771.471.482.442.29 hours or more 45.7 95.9 95.2 100 100 77.6The nature of urban hospitals are different, therefore their working time is longer.The time of ending workChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities Around 5 p.m

11、.28.14.2-3.6-12.2Around 6 p.m.45.625.023.8Around 7 p.m.10.723.511.6Around 8 p.m.5.312.523.821.435.315.6Around 9 p.m.3.533.323.828.617.617.7Around10 p.m. - 12.5 28.6 32.1 17.6 14.3Late than 7p.m 19.3 62.5 76.2 92.8 94.0 59.2From the working time, in Cheng de, the village doctors w

12、orking time is less than other four cities,.Ending time is also earlier. The reason maybe is the limitation of the mountain ,or maybe the cause of the few villagers or being small village. Other cities, are located in the plain. The residents are relatively concentrated. In terms of the working time

13、, its obviously longer than Cheng de.The number of patients needed to be treatedChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities 0-5 17.5 4.2 4.8 - 5.9 8.86-10 40.4 - 14.3 - 5.9 18.411-15 31.6 41.7 14.3 17.9 23.5 27.216-20 1.8 34.5 23.8 39.3 5.9 18.421-25 5.3 8.3 4.8 17.9

14、 5.9 8.226-30 3.5 8.3 9.5 10.7 5.9 6.8More than 30 - - 28.6 14.3 47.1 12.2it can be seen that the number of patients treated by doctors in village are mainly 10-20 people. Whereas in Handan, Lang fang its different. Every day more than 30 patients are attended,which is a very important proportion. F

15、rom this data We can predict that they could get more busier.The evaluation of the workloadChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities Extremely busy 12.3 4.2 23.8 3.6 47.1 15.0busy 50.9 54.2 47.6 71.4 23.5 51.7 71.4 70.6Moderate 33.3 33.3 28.6 25.0 17.6 29.3Comparat

16、ively relaxed 3.5 8.3 - - 11.8 4.1According to the village doctors ,the survey of the evaluation to workload, the doctors in Handan, Langfang , believe that the work is heavier than other areas. its consistent with our previous prediction.The village doctors can take a break only when they finish al

17、l work of a patient. This includes patients interrogation, physical examination, and simple check of instruments (blood pressure, electrocardiogram, etc.) ,and also diagnosis the patients, and at last give appropriate treatment.The only difference is patients dont need to admit to the hospital. But

18、as for treatment, the different way makes a difference for the rural doctors. if it is just prescribing, giving an injection ,working time will be less. But if infusion , it requires more time. Here, we can guess how can they usuallyimprove their professional ability?We can see , more than 60% docto

19、rs are in a busy state. Although the village doctors daily reception of patient is about 20, in several regions more than 30 people. Compared with doctors in the big hospital, the number of patients is less , But as we know, they may be far busier. 3 The way to improve professional ability There is

20、a phenomenon that the training is controversial. Maybe many people think the training is a good thing, but it is not found in our survey. Sometimes the training is a way to introduce themselves and their hospital for getting more patient resources and benefit. There are advantages and disadvantages:

21、 they can be more convenient when they need referral （guide patients get better treatment).On the other hand, it impacts on the village doctor. We found that ：Chengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities always - 4.2 9.1 - 4.2 2.0often 14.0 4.2 13.6 10.7 4.2 10.1somet

22、imes 49.1 25.0 27.3 32.1 25.0 36.5seldom 24.6 58.3 31.8 35.7 58.3 33.1Never 21.4 4.2 13.6 21.4 4.2 16.9Troubles they experienceAffecting their work 23.0 % Affecting e17.6 % go and back18.2 % Wasting time 20.9 % the knowledge is not practical18.9 % The troubles what they face , should we come up with

23、 a method to deal with it? Village doctors, however, as the basic health care workers, its necessary to have good ability of referral and guide the patients to get better treatment . To that, we want to find a better solution.trainings （ year）Chengde CityQinhuangdao City Handan CityBaoding CityLangf

24、ang CityFive Cities 0-4.2-3.6-1.41 time31.645.813.639.370.630.42 times33.320.8 36.425.011.830.4264.970.850.067.982.462.23 times 21.18.3 15.54 times14.08.3 13.614.311.812.14-12.527.3-10.1training The percentage% 01.4130.4230.4 62.2315.5412.2410.1Green and brown stand for 1 and 2 times train

25、ing per year. It is not hard to see, more than 60% accepting only once or twice a year, and around 50%0f them, their training time is less than half a monthThe time of training The percentage %no 1.4Within half a month 49.31/2month - 1 month 29.71- 2 months 8.12months - 3 months 10.8每次进修时间构成比In our

26、survey, the most accepted training is within half a month or up to a month. This sums up around 79% . As far as we know , training and working is done together. It is not difficult to realize that how hard their work is.Doctors/Teachers those teach The percentage % no 1.4doctors in city hospital 20.

27、0 20.0doctors in county hospital53.1teachers in Secondary health school 7.6doctors in town hospital 17.2 77.9other 0.7Satisfaction of the trainingGreat 9Good 52General65Bad 16Terrible 6The requirements for the training The percentage % no 1.4doctors from big hospitals23.0more training time 14.9a per

28、iod of time no working 18.2More clinical skills 40.5Better teaching conditions 1.4other 0.7 Their biggest desire is a period of time to train ,with no requirement to work and good teachers to train .The reason unable to attend the training The evaluation of the workload The percentage %Extremely bus

29、y 15.0busy 51.7 66.7Moderate 29.3Comparatively relaxed 4.1 Again , indicates that the rural doctors working intensity is strong.The main way to improve professional ability：looking books by their own Due to their busy work, their communication is relatively small, and their studying time, is affecte

30、d by patients. it is not hard to realize what their inner most desire is “a concentrated training time.”The times of communicating with colleagues on diseases The percentage % Once or twice a month 38.55 times a month23.010 timesa month9.5Once every three months3.4Once half a year1.4no chance or nev

31、er 24.366.2% the communication is relatively small.4 The influence by thenewruralcooperativemedical care system *the workload when carried out thenewruralcooperativemedical care system the time and emotion of printing the medical expense accounttheir affected ethe delayed government subsidiesThe pre

32、ssure of thenewruralcooperativemedical care system the workload when carried it outChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities no-4.5-0.7Same as before50.954.260.932.129.447.32 times than before48.958.838.53 times than before25.011.811.55times th

33、an before-8.34.5-2.02 times54.245.531.867.970.652.0 Survey shows that the workload after thenewruralcooperativemedical care system , all of them increase differently, more than 50% doctors feel its doubled.How much time they use per week The percentage % Less than 2 hours18.24 hours 35.86 hours 10.1

34、8 hours 4.110 hours 26.4other 0.7 Printing has increased their workload, and they need to spend a lot of time to deal with it per week.Even though it is boring , many of them show understanding and acceptance.oktheir affected eChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cit

35、ies Same as before29.870.872.746.482.452.02 times than before6.117.620.93 times than before17.5-10.7-8.8increase 56.1 8.3 9.1 16.8 17.6 29.7One half17.9-6.1A third5.312.54.514.3-7.4decrease 8.8 16.7 9.0 32.2 - 13.5其他 5.3 - - 3.6 - 2.7You can see there are a few of them have been a

36、ffected, and are more developed than before. Maybe its because of the increased workload, delayed subsidy ,making clinic workImproper work and the e is affected.The main difficulties that they are faced：1 The workload is too heavy 51.3% 2The lack of medical devices 29.6%3 The decreasing e 13.5% 4 Th

37、e doctor-patient relationship is more and more difficult to deal with 21.7 %5the delayed Government subsidies35.0%6the lack of ability to diagnose and treat ,and need training 12.8% 5In recent years,the changes of the doctor-patient relationship in the country * The degree of trust in village doctor

38、sThe number of medical accidentThe condition of raising an objection to their treatmentsIn general ,can they continue to be a village doctor?The degree of trustChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities Same as before40.479.245.535.764.749.3Slight reduction31.68.313

39、.610.711.818.9Moderate reduction21.417.615.5Severe reduction 3.54.2-reduction52.616.738.5More trust7.04.227.325.0-12.2The degree of trustChange of five cities From trust changes, we can see very clearly, all the region has declined differently , especially in Chengde.

40、overall, a fall of 38.5% on trust degree is seen, its a wake-up call for us. The doctor-patient relationship in big cities are likely to affect the doctor-patient relationship in the countryside.Analyze the reasonsMore and more TV, news channels, newspapers and other media that report events in medi

41、cal disputes, and even some mass media, or over report alters rural awareness of the doctor-patient relationship Mutual discussion between rural villagers about medical reports on TV media, word of mouth, results in nervousness between doctors and villagers.With the increase of the medical professio

42、n and the villagers health awareness, also the increasing number of the medical accident, causes the change in the relationship.Along with the increasing number of villagers going out to work in big cities, the change in doctor-patient relationship in big cities may bring back to the countryside.The

43、 number of medical accidentChengde CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities Obviousincrease19.3-9.13.6-9.5slight increase10.723.518.9increase14.323.528.4Same as before45.670.845.557.164.754.1Slight decrease5.3-18.225.05.910.1Obviousdecrease3.525.04.5

44、Trust changes are related to medical accident. The rest of four cities , also showed decrease at various levels.The number of medical accidents in Chengde is seen to be the most ,resulting in the maximum decrease between in the degree of trust.raising an objection to their treatmentsChengde

45、 CityQinhuangdao City Handan CityBaoding CityLangfang CityFive Cities no-2.0ObviousIncrease1.8-0.7slight increase24.68.313.621.429.420.3increase26.48.313.621.429.421.0Same as before51.670.863.646.464.758.8Slight decrease14.012.513.617.95.913.5Obviousdecrease14.3-4.7Increase in trea

46、tment challenged by patients , indicate that the relationship between the doctor and the villagers has been changed. Possible reasons: first, the villagers pay more attention to their health . second , the trust for doctors declined. third , the villagers had been affected by the current doctor-patient relationship in big city. This results in putting forward the question to the villager doctor.Can they continue to be a village doctor?Cheng