recentpopularlog in

aries1988 : doctor   11

China’s Health Care Crisis: Lines Before Dawn, Violence and ‘No Trust’ - The New York Times
The country does not have a functioning primary care system, the first line of defense for illness and injury. China has one general practitioner for every 6,666 people, compared with the international standard of one for every 1,500 to 2,000 people, according to the World Health Organization.

Instead of going to a doctor’s office or a community clinic, people rush to the hospitals to see specialists, even for fevers and headaches. This winter, flu-stricken patients camped out overnight with blankets in the corridors of several Beijing hospitals, according to state media.

Hospitals are understaffed and overwhelmed. Specialists are overworked, seeing as many as 200 patients a day.

China’s “barefoot doctor” system was one of the Communist revolution’s most notable successes. In 1965, Chairman Mao, troubled by the lack of health care in the countryside, envisioned an army of people who spent half their time farming (many worked in the fields without shoes) and half their time treating patients. They weren’t doctors, but rather a sort of health care SWAT team. The authorities gave them a short training period — several months to a year — and a bag of limited medicine and equipment.

When Dr. Huang saw a newspaper article about general practitioners, he decided to enroll in a training program in 2007. He was inspired by his aunt, a “barefoot doctor” in Mingguang, a city in Anhui Province, one of the poorest regions in China.

As a boy, he had followed his aunt as she went to people’s homes to deliver babies and give injections. “After becoming a doctor, I’ve realized that the people’s needs for ‘barefoot doctors’ is still very much in demand,” he said.

Dr. Yang, 31, said her practice was largely free of grumpy patients and, as a result, “yi nao.” She sees 50 to 60 patients in a workday of about seven and a half hours. In the United States, a family doctor has 83 “patient encounters” in a 45-hour workweek, according to a 2017 survey by the American Academy of Family Physicians. That’s about 16 patients in a nine-hour workday.

She’s available to dispense round-the-clock advice to her patients on WeChat, a popular messaging app in China. A patient is generally kept in the waiting room for a brief period and, if necessary, gets to talk with her for at least 15 minutes.
doctor  hospital  china  today  reform  reportage 
october 2018 by aries1988
正午 | 丁香诊所的五个故事 - 中国数字时代







doctor  hospital  private  service  instapaper_favs 
may 2016 by aries1988
Doctors Who Don't Know How to Talk About Death - The Atlantic
The one time I remember discussing mortality was during an hour we spent on The Death of Ivan Ilyich, Tolstoy’s classic novella. It was in a weekly seminar called Patient-Doctor — part of the school’s effort to make us more rounded and humane physicians.
death  doctor  ethic  opinion 
november 2014 by aries1988
The Physical Exam as Refuge -

Countless times, I have found that it is only during the physical exam that patients reveal what is truly on their mind. Whether it is the cough that they are reminded of now that I am listening to their lungs, or whether it is the domestic violence, the eating disorder or the genital symptoms that they feel comfortable revealing once we are in a more intimate setting — there is something about touch that changes the dynamic.

But then the doctor and patient move to the exam table, and everything changes. This is often the first moment that they can talk directly, without the impediment of technology. They are physically closer to each other, actually touching. This is an intimacy, albeit of the nonromantic type, but an intimacy nonetheless. And all intimacies have an effect of changing the dynamics of the interaction. Obviously, there is a risk of changing for the worse, but in my experience it is almost always a change for the better. Once a doctor and patient are at the exam table, touching, talking without the computer between them, conversation of a different sort is possible.
doctor  people  temoignage  body  medicine  opinion  psychology  human  communication  practice 
october 2014 by aries1988
The Best Possible Day

Neither seemed right. But for more than a decade in medical practice, I had not really understood what other choices might exist. I wasn’t effective in these situations. And it bothered me — as a surgeon caring for patients with problems I often could not fix and then as a son with a father in his 70s experiencing mounting difficulties in his life. So for three years, I researched a book on what has gone wrong with the way we manage mortality and how we could do better.

I also discovered that the discussions most successful clinicians had with patients involved just a few important questions that often unlocked transformative possibilities: (1) What is their understanding of their health or condition? (2) What are their goals if their health worsens? (3) What are their fears? and (4) What are the trade-offs they are willing to make and not willing to make? These discussions must be repeated over time, because people’s answers change. But people can and should insist that others know and respect their priorities.

Someone in her position who was offered “death with dignity” — assisted death — might have taken it as the only chance for control in the absence of other options. But hearing her fears, I suggested that Peg try hospice. It’d at least let her get home, I said, and might help her more than she knew. Hospice’s aim, at least in theory, I explained, is to give people their best possible day, however they might define it under the circumstances. It seemed as if it had been a while since she’d had a good day.
death  doctor  life  story 
october 2014 by aries1988
南方周末 - 【南瓜学堂】医学生,你们准备好披上白大褂了吗?

doctor  advice  stage 
september 2014 by aries1988
南方周末 - 【科学松鼠会】当医生的心灵受伤时
china  crisis  doctor 
july 2012 by aries1988
希波克拉底: 见信好。 1990年到1998年,我在协和医科大学认真学过八年医术,正经科班念到医学博士,从DNA、RNA到细胞到组织到大体解剖...
doctor  letter 
november 2011 by aries1988

Copy this bookmark:

to read