贫困山区村医的困境与出路——贵州五县(市)20名村医访谈

Difficulties and Solutions of Rural Doctors in Poor Mountainous Areas:The Interview to Twenty Rural Doctors at Five Counties and Cities of Guizhou

通过对贵州省五县(市)20个村卫生室的实地研究,以观察和访谈等方法对20名村医进行调查,结果发现,目前山区村医老龄化现象明显,乡村医生学历低,业务素质不高,村医收入低、缺乏适合的养老保险制度,社会认同感不足、职业安全感低,村卫生室面临面积不足、医疗设备陈旧缺乏、卫生状况堪忧等困境,山区村医的状况不容乐观。建议结合贫困山区的特点建设县、乡(镇)、村三级医疗卫生服务网;加强村医培训,改善其待遇;建立有效评估机制;整顿农村医疗市场,以解决村医的困境。

A field research in twenty rural clinics in five counties and cities of Guizhou province was conducted, with the investigation of twenty rural doctors by observation and interview. The results showed that the aging of rural doctors was significant, who were with low-level education background, low professional quality and low income. The under development of rural doctors in mountainous areas was the results of the absence of pension insurance, lack of social identity, low job security, insufficient working area of village clinics, outdated medical facilities and bad sanitary conditions etc. In the end, this paper put forward some countermeasures and solutions to solve the problems, such as building up a county-town-village three-level network of medical services according to the specialty of poor mountainous areas, improving continuing training and increasing income for rural doctors, setting up effective assessment mechanism and regulating the rural healthcare market.