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医生评职称发论文现“买版面”现象 体系亟待改善

2017-06-30 09:39:15   经济参考报

我国目前的医生职称评审和聘任制度,规定医生晋升职称必须要发表相应数量的论文,并且要在核心期刊发表。部分医生过于重视“发论文、搞科研”,忽视了普通临床工作和广大患者。业内人士表示,公立医院改革应注入人文关怀,改善医生评价体系。

“有个现象:一些医术厉害的人不写文章,而一些写论文的人不看病。”记者采访到的一位副主任医生说,平均每天要做2到3台手术,忙的时候要做4台手术,一天站六七个小时是常有的事情,根本没有精力再搞科研,更别说要在医学核心期刊发表论文,还不是“东抄抄,西抄抄,买版面”?

这位医生说,医生可以找枪手写论文。一般找人写论文、联系杂志社发论文,需要3000元到4000元左右,要是想发在非常有名的核心期刊,一篇论文得上万元。亟待建立科学的医生职称晋级及评审制度,降低论文数量要求,要发挥临床医生的主观能动性,更好地为病人服务。

一些医生直言,目前,医生晋级职称发论文其实已经演变异化为“抄论文”,而发论文已经变为通过中介向杂志社“买版面”。

做研究和从事临床工作本来就是相辅相成的,将临床实践的经验转化为论文,是临床医生的天职。然而,目前,临床医生承担着看病救人的重任,特别是一些大医院的临床医生,做好临床工作就已是“超负荷”运转,就更别提要搞科研、写论文了。

目前,医生的职称晋升制度过于侧重“是否发表论文、是否有科研项目”,导致部分临床医生“重视论文,重视科研”,不少基层医院存在医生职称高能力低的状况。一些职称高的医师反而临床诊疗能力一般,一心想着“发论文、找项目”,反而忽略了出门诊,从而与病人之间的关系渐行渐远。

业内人士指出,目前,医师的职称评审制度出现了一定程度上的“错位”,对于所有临床医生采取“一刀切”的方式,要求人人晋升都要发论文,还要发表在核心期刊,这让一些拥有刊号的医学杂志,光靠“卖版面”就能“坐地生财”。

在一些大医院,科研能力很强的医生临床经验较少。有人编了顺口溜来描述这部分专家,“教授不拿手术刀,学术会议到处跑,著名医生不坐诊,讲课费用收腰包。”

“看到一些临床能力一般的医师,在发表了若干学术论文,就晋级专家行列,我心里不是滋味,像我们这种给患者看了几十年病的老医生,到退休都是副主任医师,有的由于不会写论文,也不想找人写论文,还顶着主治医生的头衔原地踏步,叫人心寒。”一位基层从业多年的内科副主任医生告诉记者。

业内人士指出,随着医改的逐渐深入,原本的职称与论文挂钩的评价标准在可操作性、行为导向方面已经出现了问题。应调整卫生系列职称评审标准,降低论文数量要求,重视实践与医疗安全以及操作能力。对主要承担临床任务的医生的评定应强化临床导向,推出临床医生技术等级评价体系。

患者期待与医生坦诚相对,医生期待患者的信任与理解,这就需要医院管理者在承担创收任务的同时,关注患者体验,注入人文关怀,而若想要医生关心患者,卫生行政主管部门和医院管理者首先要关心医生,让医生有一个良好的执业环境。

“我希望我下次询问医生问题的时候,他不要躲我,不要让我追着问,能够耐心地给我解释清楚病情,然后帮助我们做出最合适的决定。”一位患者说。

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