I agree patients shouldn't be foreced to choose between knowledge and attitude. But the reality is that they often have to choose either knowledge or attitude.
I didn't say "once we solve the resource shortage, our system will be rescued." My point was: from the whole society/system point of view, we have to correct the medical system before we can really restore/cultivate the professionism in the medical industry.
I didn't say we should "neglect the teaching because we think it will not help." I just feel we have to give the schools incentives to teach ethics and the students incentives to learn ethics. When ethics don't really matter in the current medical system, very few doctors and doctors-to-be would care about it.
Hi Luohua, I am not disputing all the observation you had. But my questions are why and how it happened? How should we fix it? The reason that doctors are trained without much professionism is that professionism is not required in the current medical system. Sure, medical students in China are hard to find a job 'cause all the hospitals don't have many open positions. But do we have enough hospitals? No, we don't. Do we have enough experienced doctors? No, we don't. The whole medical system is in malfunction. Why would a medical student need to care about professionism? The spots are limited, so you have to get them either by (your family's) networking or by good academic scores. Why would an experienced doctor need to care about professionism? There are only so few good hospitals and so few good doctors.
As a patient, if I have a choice, of course you would like to go to a knowledgeable, experienced and caring doctor. But what if I have to choose between a knowledgeable but less caring and a caring but less knowledgeable doctor? The resources are limited. All the good doctors are fully booked. I would go to a knowledgeable but less caring doctor. Two things can make things better. 1) produce more good doctors. but it often takes time. 2) make better use of resouces, such as improving the primary care system as you suggested.
So here is our difference. You think the root cause is the medical education system doesn't teach professionism. But I believe the root cause is even higher up. Even if medical schools teach professionism, it won't be very good and effective anyway. The whole medical system has problems. It's just like we all learned about Marx Lenning at school, but do we really give it a damn? We don't really need Marx Lenning to find a good job.
落花飘零 发表评论于
hehe, bolb,it is really hard to change somebody's opinion by several words, that's why i usually don't argue with people too much.
but as it comes to medical career in china, where i spent several years practiced, i would like to talk a little bit more. it is just about this topic, nothing personal, we are still friends.:)
i have worked in several wards which were not busy at all, but the attitude of doctors are exactly the same as those of working in busy wards. the point is, this is how we were educated, this is what medical students learned from residents, and residents learned from attendings, it is nothing to do with whether we are short of hand or not, it is how we develop the perspective of medical practice. with this education which largely neglects medical ethics, even if enough doctors are trained, most of them are just well knowledged but less caring people.
as a matter of fact, medical students in china nowadays are struggling to find a job, because the amount of medical students are rapidly increasing while most hospitals' spots are comparatively fixed.
the thing we urgently need to improve now in china, is not the quantity of physician, but the quality.
the other thing we should push, is the primary care system. when i was working in the university hospital, people came for common cold, medicine refill, this wastes lots of physician resource which can be easily solved by primary physician.
tanyway, hank you for discussing this topic with me.:)
bolb 发表评论于
But why don't doctors have good ethics and why aren't they more caring to the patients? Because they are in demand. It's still a market economy problem. We don't have enough good doctors, so they don't feel the need to provide good service.
bolb 发表评论于
落花, I was talking about damaof's comment.
Also, you can find really good doctors in Africa, in China, in India. But an average doctor that ordinary people can access in those places is still pretty bad. It's still a technology issue. When you don't have the technology, it really doesn't help much now matter how good-hearted you are. Sometimes too much heart can even cause more harm. The current problem in developing countries (and even in the US to some extent) is we don't have enough number of good doctors.
bolb 发表评论于
You have to look at from the doctor's perspective as well. What you need is good doctors. But good doctors usually have plenty of patients. If somebody has no chance to be cured, doctors tend to spend more time in other patients who would have more chances to recover. This is competition for limited resource. Doctors and hospitals are limited resources. It's so sad but true. If I am sick and have no chance to recover, I would rather commit suicide. But again, sometimes we also need determination to overcome disease. Hard to way.
