医师职业精神培养和提升有赖于良好的医疗体制

Cultivation and Improvement of Professional Spirit of Physicians depends on Good Medical System

针对一直以来社会上多有抱怨的医师职业精神问题进行反思和剖析,认为各级医师是医疗卫生事业的主体,其精神风貌与现有的医疗体制存在不可分割的关系。现行医疗体制下的诸多弊端是影响医师职业精神的培养和提升的主要原因,主要体现在一是以市场经济为取向的改革背景下,政府减少经费投入,主张以药补医,而片面鼓励医院科室创收,导致了医学专业核心价值的服务宗旨偏移,出现了许多问题;二是医疗体制下没能很好地解决看病难、看病贵的问题使医务人员代受社会不满的压力,加之医疗纠纷实行举证倒置,为回避风险和利益驱动而出现了过度医疗行为,引发了医患关系紧张,之间诚信缺失;三是医药市场竞争机制下,患者利益、医药公司利益之间的冲突和染缸无时无刻不在冲击着每个医生的良知和行为;四是片面的以医师发表论文数量评定其能力不利于医师职业精神的培养;五是临床教学中人文医学和医师职业精神教学培养缺失,临床技能实践培养缺乏社会普遍的理解与支持。要解决职业医师精神的回归和提升必须建立在客观分析现实的基础上,有益于破除体制上带来的根本问题。

The problem of professional spirit of physicians complained about in the society for a long time is thought about and analyzed. I think that all levels of physicians are the main part of the medical and health undertaking. Their spirit is inseparable with the existing health care system. Many disadvantages of current medical system are the main reasons for the cultivation and improvement of physician＇s professional spirit. It is mainly reflected in the following aspects. First, under the background of market economy-oriented reform, the government reduces spending, proposes to compensate the medical care with medicine, and encourages hospital departments to create income unilaterally, leading to the migration of service tenet of medical professional core value and a lot of problems; second, under the medical system, the problem of difficulty and high cost of getting medical service is not solved well, so that medical staffs are under the pressure of social discontent. Inversion of presenting evidence is implemented for medical disputes. To avoid risks driven by interest excessive medical behaviors appear, causing the difficult doctor-patient relationship and lack of good faith. Third, under the medical market competition mechanism, the conflict and dye vat between the interests of patients and those of pharmaceutical companies always impact every doctor＇s conscience and behavior.Fourth,assessing the abilities of a doctor via the quantity of paper that he/she has published partially goes against the cultivation of doctor＇s professionalism; Fifth, inclinical teaching there is lack of cultivation of humanistic medicine and professional spirit teaching of physicians, and the cultivation of clinical skill practice is not generally understood and supported by the society. The retuming and improvement of the professional spirit of physicians must be on the basis of the objective analysis of reality, which is good for abolishing the fundamental problems caused by the system.