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市长,请大力治污不必下河游泳
2017-08-04 17:11:09 中国青年网
新京报发表罗志华的观点: 和买东西“货比三家”一样,“比较式看病”可让患者获得更多信息,有利于纠正医生可能出现的疏漏。但由于从不同的医生那里获得的信息较多,甚至会出现截然不同的说法,有时反而让患者更加不知所措,不知听谁好。“比较式看病”透露出患者看病时的焦虑,也说明患者对医生缺乏信任。另外,基层首诊医生在增进患者信任方面至关重要。这第一道关没有把好,患者很容易走上比较之路。提升基层医生的诊疗水平,才能从源头上减少“比较式看病”。患者也要看到,尽管医生的说法不同,但并不能说明必有医生出错、诊疗效果必然相差甚远。这是因为,诊疗思维和方法很复杂、也很多样,存在排除法、归纳法、试验性诊断等多种方式,而医生各有不同的习惯,采用的方法不尽相同,思路和观点就会迥异,但最终多能到达一个终点,即诊断相同、治疗相似,只不过到达终点的路径不同而已。要想让患者不反复比较,除了医生要精于医术外,更需医生善于沟通,对病情进行全面清晰的解释,把各种可能的情况和思路都讲深讲透。这样可使医生的说法逐渐趋于一致,患者多看无益,“比较式看病”就会随之减少。
小蒋随想: 一个朋友也遇上类似困扰。甲医院的医生认为其彩超中的“异常区域”隐患很大,要立刻手术;乙医院的大夫说“异常区域”没问题,无需手术,只需定期复查。两家医院都是“三甲”,两名医生都是专家。朋友在困惑之余也在琢磨,乙医院的医生要求定期复查,是要继续观察。问题是,如果是恶性疾患,早发现早治疗,治愈概率很大;倘若拖个一年半载,晚发现晚治疗,不良后果不敢想象。这之中,最令朋友不解的是,两个医生对“异常区域”的判断截然不同。为什么会出现这样的差异,只有医生自己知道。如果患者当面拿一个医生的判断与另一个医生“掰扯”,只会招致医生的白眼,甚至甩下一句“你信他找他看”。从另一个角度看,许多医学专业人士都谈过,受各种因素影响,临床误诊率在30%左右。既然误诊确实存在,而且比例不低,面对可能很严重的疾病,患者怎能不找其他医生“比较”?这固然会带来重复就诊与“资源浪费”,但也是没有办法的办法。医学有局限性,医生也会出错,这些患者都理解。可鉴于“排两小时队看两分钟病”的普遍,患者希望医生尽可能认真细致,对患者负责,这要求过分吗?
小蒋的话: 大家好,我是小蒋。国事,家事,天下事,天天都有新鲜事。你评,我评,众人评,百花齐放任君看。观点各有不同,角度各有侧重,只要我们尊重 客观、理性公正。
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