Combine: Break the barrier among the clinical specialities

Combine: Break the barrier among the clinical specialities
Combine: Break the barrier among the clinical specialities
Cub reporter staff reporter Yang YongZhi and Li TianShu Develop through the branches of several hundred years, medical science develops into and includes more than 50 disciplines and large system of several hundred branched disciplines. The high training of medical care, branch is more and more detailed. But the treatment of the training type becomes and carries on the single treatment to a certain organ of patient gradually, some understanding of disease has restricted doctor's understanding of overall whole of disease. Under this background, exactly formate for the new trend of medical development. A few days ago, in the first medical development combined the summit forum, came from every medicine administrator and expert who was studied the universities and colleges, medical organization and held a conference or consultation to combine, think medical science will combine a kind of long-term situation that will be medical development, but some problems faced merit attention. Can't see disease only without see patient fall ill go hospital, how many No. of departments patient worry, register for, this kind of phenomenon is more and more general. Wu XianZhong, academician of Chinese Academy of Engineering, thinks, medical branch is more and more detailed, " whole disease " Have turned into " Systematic disease " ,And then by " systematic disease " Have turned into " The organ disease " . The control that should be appropriate to this kind of development trend, otherwise medical science will be incoherent. The knowing vascular disease credit of Chinese medical science is known to a great professor of moustache of General Board, the People's Hospital of Peking University and thought, branch is careful to promote the progress of medical technology on one hand, limited the doctor's visual field at the same time, have caused" see pathological change, does not see the disease " , " see disease, see ill person " Consequence. The key of making a diagnosis and giving treatment is not to do on patient anything, but the patient needs something most, design safe, effective scheme of making a diagnosis and giving treatment for the patient. Relevant expert point out because of hold a consultation, branch and transfer from one department to another procedure to be miscellaneous, lead to the fact patient long medical quality can't ensure and medical cost increase hospital stays. As to this, some hospitals and experts are exploring the integration way among the clinic diagnosis specialities. It is still the integration between clinical discipline of the number integration that the organization combines, it is construction and recombination of traditional clinical discipline branch, carry on the technological integration of the extensive type? How could produce the greatest function after combining again among the specialities? There is some enlightenment on this in the exploration of some hospitals. In 2007, the university China Western medicine institute of Sichuan explores that combines the brain blood vessel and nerve field disease of the function multi-disciplinarily, take the department of nerve internal medicine, department of neurosurgery as the core, including multi-disciplinary personnel such as nerve getting involved, recovering, emergency department,etc. set up the new comprehensive ward of nerve, establish the comprehensive ward to manage the group, accept cerebrovascular diseases and epilepsy patient for medical treatment in unison. The head of the department of surgery of courtyard nerve of China's Western medicine of university of Sichuan visits saying to the professor, this is that a more typical organization reconfigures the type. Nerve on after it combine comprehensive for ward can with emergency call, recover department maintain close ties, still can cross with the personnel of department of nerve internal medicine, and merge with speciality of getting involved of the nerve closely. Relevant expert make a diagnosis patient together, make, make a diagnosis clinical route and measure of making a diagnosis together, consultation that this kind of form merged closely has reduced the patient effectively, assigning to examining, making the procedure of the department, have shortened and is admitted to hospital for time, has reduced holding a consultation, time of changing the place of examination between the departments, have standardized the making a diagnosis and giving treatment of disease. The statistics show, after the comprehensive ward of nerve of this institute is established, the patient is in hospital to reduce from 15.04 days of 2006 until 13.41 days of 2008 on day on average, wait for, drop will it be 4.54 day 2008 to from 2006 6.33 day day in front of the skill, postoperative mortality reduce 1.40% for 2008 to from 3.05% for 2006. Comprehensive integration mode that the first affiliated hospital Zhengzhou University adopts clinical disease and cooperates multi-disciplinarily. Cooperate while being multi-disciplinary personnel of group form mainly including group leader, contact people, and assigned to and attended to the group, postoperative and followed up a case by regular visits to and recovered and guided the group, data processing group etc. for the group, relevant department expert's group, speciality of department that play a mainly making a diagnosis role On the basis of set making a diagnosis procedure and healing solution, and then combine each patient's concrete condition, make out the individual comprehensive healing solution, meet the need of making a diagnosis with the patient. Vice President of Zhengzhou University first affiliated hospital Wang Jiaxiang thinks, according to the existing actual conditions of most hospitals of our country, on the multi-disciplinary foundation that cooperates, regard disease number as the breakthrough point, hold the patient's scheme of making a diagnosis on the whole, solve doctor's professional knowledge and the skill is narrow, patient's excessively making a diagnosis, problem method that the relationship between doctors and patients is nervous,etc.. It also needs to explore the expert points out, combining will bring a series of question to combine intensity and way, a great deal of respects such as the management related to evaluation, recombination, discipline classification, special society of interests relation of the original professional post, also include development problem of discipline and personnel belong to and distribute the question etc. with economy after combining. Likewise, the cooperation between a plurality of specialities will reduce the procedure while making a diagnosis to make up, its balanced development problem of technology of system, responsibility, management and every discipline while cooperating needs solving. Nanjing medical university cures the policy institute Professor Liu Hong to think, in medical science is combined and gone on, every discipline, every organization will present the new imbalance, will produce the new problem, even present the contradiction or conflict. For example, while pushed into and is combined, how do original organization, department, discipline leader contribute? Should it be to perhaps the situations of the desalinization and marginalisation how? How to think about the function of the training in medical science in the future is developed? How to exactly built jointly and construct the effective platform for medical science? Even so, many experts think, the integration among the clinical specialities of medical science is still the main trend, help to promote dialogue and common development between discipline, help the doctor's cultivation and growth, favorable to the integration of second and tertiary discipline inside clinical medicine.


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