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中国儿科医生缺口至少20万 家属辱骂动手是常事

2015-09-18 08:20:14   中国新闻网

核心阅读

儿科医生太缺,导致医生上完白班上夜班,看完门诊看急诊,没有完整的节假日,春节只能休一两天。工作强度大不说,还影响服务质量和医患关系。

解决这一问题,首先要开源,如加分录取、恢复儿科学专业;其次要进一步完善儿科的医疗收费体系;还应鼓励社会资本参与儿科医院建设,增加供给。

儿科门诊人次一年近2亿,医生数量不足10万

“大夫,我孩子不行了!快给抢救吧!”“大夫,我娃儿抽过去了!你快给看看吧!”在北京儿童医院,急诊科主治医师赵光远被患儿家属里三层外三层地围着。

“有时候真希望自己有三头六臂。”赵光远说,有一次,两个没了心跳急需抢救的孩子前后脚进了抢救室,而当时只有他一名值班医生。情急之下医院临时调派了一名正在普通急诊坐诊的医生来帮忙,才把两个孩子都抢救了过来。

抢救室一个班至少要有两名医生、三名护士才勉强够,而现在只有一名医生两名护士。

赵光远和同事们忙得焦头烂额,看病就医的患者也是苦不堪言。一名患儿的奶奶在急救大厅就嚷嚷开了:“你们这儿真是的,耽误了谁负责!孩子都烧到39.5度了!”她坚持要让医生给孩子进行抢救,可是孩子的病情并没有那么严重。赵光远说,实在是没人手,医生太缺了。

儿科缺人,儿童医院急诊科更缺人。赵光远介绍,由于人员紧张,最忙的时候,急诊科医生由5天一倒班变成4天一倒班,没有完整的双休日和节假日,春节7天长假只能休1—2天。

医院只能“拆东墙补西墙”,安排内科病房的医生来支援。他们上完白班后,晚上到急诊科坐诊,有时候甚至会忙到后半夜。

数据显示,目前我国每千人儿科医生比率为0.43,美国是1.46。照此比例,我国儿科医生缺口至少20万。《2014中国卫生统计年鉴》显示,2013年,综合医院的儿科门诊人次接近2亿,占总人次的9.75%,而我国共有93405名儿科职业医师(含助理医师),仅占总数的3.9%。儿童医院病床使用率103%,每床出院人数47.8,病床周转次数达49.3,在所有卫生机构中最高。

人才培养源头的断裂从根本上影响了儿科医生的后备力量。教育部1998年在《普通高等学校本科专业目录》的调整中,将儿科专业作为调整专业,1999年起停止招生。人才供应不足在一定程度上加剧了儿科医生的短缺。

儿童医院不仅招不到人,还面临医生流失。一些儿童医院同年入职的医生有近30%离职。在综合医院,儿科因为收入低,同等工作量的儿科医生绩效低于其他科室,成为医院的包袱,部分儿科医生开始转行。

“就这劳动环境和工作强度,给10万我也不干”

“压力大、风险高、收入低。”北京儿童医院院长助理、门诊部主任赵成松用9个字总结儿科医生的工作状态。

儿童处于生长发育期,身体机能尚未完善,病情瞬息万变,稍有差池便会命悬一线,医生必须保持高度的精神紧张,决不能出现一丁点疏忽。一名急救科的医生说梦话都在喊着“孩子不行了,快叫主任来!”她的丈夫握着她的手告诉说“叫了叫了!”她才继续睡去。

医生少,患儿多,医生们拼尽全力也难免照顾不周。一家只有一个宝贝孩子,面对突如其来的病痛,家属心情尤其急切,指责、辱骂甚至动手就成了常事。北京儿童医院急诊科护士李妍在给孩子输液时扎了两针,就被家长粗暴地拉出了手术室,一边辱骂一边拳脚相加。

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