
9月17日第三屆中歐醫院管理學科建設人才培養全球論壇在中國廈門完美收官。來自歐洲8位關鍵學術領袖和中國18個城市近50家三甲醫院300位中國醫院院長、各學科帶頭人、各行政部門負責人和優秀的青年醫生現場參加了此次全球論壇。微信公眾號6.3萬閱讀量。直播間20萬人次觀看。

本次論壇我們挑選了國家隊的三甲醫院、一線城市的三甲醫院、二線城市三甲醫院、專科醫院和私立醫院,我們從各個層次畫像還原了中國醫院的現狀,一共15個(ge)問(wen)題(ti)與(yu)中(zhong)歐(ou)醫(yi)院(yuan)院(yuan)長(chang)麵(mian)對(dui)麵(mian)交(jiao)流(liu)。共(gong)同(tong)找(zhao)到(dao)解(jie)決(jue)方(fang)案(an)。人(ren)才(cai)才(cai)能(neng)成(cheng)就(jiu)一(yi)家(jia)偉(wei)大(da)的(de)醫(yi)院(yuan),醫(yi)生(sheng)才(cai)是(shi)一(yi)個(ge)國(guo)家(jia)的(de)良(liang)知(zhi)。如(ru)果(guo)你(ni)現(xian)在(zai)正(zheng)是(shi)一(yi)家(jia)中(zhong)國(guo)很(hen)著(zhu)名(ming)的(de)三(san)甲(jia)醫(yi)院(yuan),你(ni)們(men)是(shi)要(yao)有(you)真(zhen)正(zheng)的(de)學(xue)科(ke)帶(dai)頭(tou)人(ren),而(er)不(bu)是(shi)科(ke)主(zhu)任(ren),你(ni)們(men)在(zai)一(yi)線(xian)城(cheng)市(shi)最(zui)好(hao)的(de)位(wei)置(zhi),國(guo)家(jia)給(gei)予(yu)了(le)你(ni)們(men)最(zui)好(hao)的(de)支(zhi)持(chi),才(cai)有(you)了(le)今(jin)天(tian)的(de)成(cheng)績(ji),並(bing)不(bu)是(shi)因(yin)為(wei)院(yuan)長(chang)有(you)多(duo)麼(me)厲(li)害(hai)。隻(zhi)有(you)團(tuan)隊(dui)厲(li)害(hai)才(cai)是(shi)真(zhen)正(zheng)的(de)厲(li)害(hai)。我(wo)們(men)曾(zeng)經(jing)是(shi)這(zhe)個(ge)世(shi)界(jie)上(shang)最(zui)貧(pin)窮(qiong)的(de)國(guo)家(jia)之(zhi)一(yi),我(wo)們(men)花(hua)了(le)近(jin)40年(nian)的(de)時(shi)間(jian),才(cai)讓(rang)中(zhong)國(guo)成(cheng)為(wei)了(le)全(quan)球(qiu)第(di)二(er)大(da)經(jing)濟(ji)體(ti)。三(san)年(nian)疫(yi)情(qing)賦(fu)能(neng)中(zhong)國(guo)的(de)是(shi)醫(yi)療(liao)在(zai)全(quan)球(qiu)的(de)地(di)位(wei)。疫(yi)情(qing)把(ba)醫(yi)療(liao)提(ti)升(sheng)到(dao)了(le)一(yi)個(ge)前(qian)所(suo)未(wei)有(you)的(de)位(wei)置(zhi)。畢(bi)竟(jing)醫(yi)療(liao)是(shi)國(guo)際(ji)名(ming)聲(sheng)。拚(pin)的(de)就(jiu)是(shi)全(quan)民(min)健(jian)康(kang)、幸福指數、疾控係統、物質儲備。隻有醫院管理、學科建設、人ren才cai培pei養yang才cai是shi中zhong國guo醫yi院yuan的de重zhong中zhong之zhi重zhong。院yuan長chang不bu是shi一yi份fen普pu通tong的de工gong作zuo,中zhong國guo每mei一yi位wei院yuan長chang都dou應ying該gai發fa展zhan和he幫bang扶fu基ji層ceng醫yi院yuan,這zhe才cai是shi你ni們men的de使shi命ming。隻zhi有you社she會hui安an定ding,人ren民min幸xing福fu,身shen體ti健jian康kang,一yi個ge國guo家jia才cai能neng真zhen正zheng強qiang大da,才cai能neng繁fan榮rong富fu強qiang。
2023 SEOS
醫院管理環節
大會主持:Prof. Stief、沈潔教授、劉繼紅教授
討論嘉賓:吳鬆教授、Prof. Siebert

1、一家醫院的核心是什麼?
Prof. Stief:這個問題就是怎麼樣解決我們最關鍵的、最(zui)明(ming)顯(xian)的(de)一(yi)些(xie)問(wen)題(ti),在(zai)各(ge)個(ge)行(xing)政(zheng)部(bu)門(men)應(ying)該(gai)怎(zen)麼(me)做(zuo),我(wo)們(men)確(que)實(shi)有(you)很(hen)多(duo)的(de)問(wen)題(ti),也(ye)有(you)很(hen)多(duo)爭(zheng)論(lun),我(wo)自(zi)己(ji)的(de)經(jing)驗(yan)來(lai)看(kan),最(zui)重(zhong)要(yao)的(de)就(jiu)是(shi)我(wo)們(men)應(ying)該(gai)有(you)一(yi)個(ge)開(kai)放(fang)的(de)、透tou明ming的de討tao論lun機ji製zhi,以yi及ji行xing政zheng管guan理li部bu門men還hai有you各ge個ge科ke室shi之zhi間jian,能neng擁yong有you一yi個ge暢chang通tong的de開kai放fang的de溝gou通tong渠qu道dao,大da家jia能neng夠gou開kai誠cheng布bu公gong討tao論lun醫yi院yuan現xian在zai出chu現xian的de問wen題ti。
我wo們men的de目mu的de是shi什shen麼me?最zui重zhong要yao的de就jiu是shi要yao有you一yi個ge開kai放fang的de,一yi個ge在zai我wo們men有you限xian預yu算suan的de基ji礎chu上shang找zhao出chu一yi個ge好hao的de解jie決jue方fang案an。我wo不bu太tai知zhi道dao中zhong國guo是shi否fou如ru此ci,但dan至zhi少shao在zai德de國guo、zaimunihei,womenmianlindeshiyusuanjinquedewenti,meiyoubanfayixiazizhifusuoyouwomenxiangyaocaigoudedongxi,huozhedachengyixieyeji,suoyiyouyigekaifangdetaolunfeichangzhongyao。
suoyiyaogaosudajiawomendeyusuanshiduoshao,womendemubiaoshishenme,zhiguanzhongyaodejiushi,ruguoyouyixietedingdewentihetedingdemubiao,womenyaozaibumenneibujiejue,erbushitongguoyiyuanguanlicenglaijiejuegegekeshidewenti。wojiaodeduiyuyiyuanlaishuo,huanzheshiwomendehexin,yaozhiliaohuanzhesuohuandejibing,womenxuyaozuohenduodeshiqing,birushuoxiangshirenliziyuan,womenxuyaokuabumenderencai,tongshigeidajiatigongbangongchangsuohezhuxiu,yeyouxiangguandeshebei,tongshihaiyaoyoujishurenyuanlaiduisheshi、設備進行監測,以及醫護人員。
劉繼紅教授:實shi際ji上shang綜zong合he醫yi院yuan的de情qing況kuang是shi一yi樣yang的de。中zhong國guo目mu前qian各ge大da醫yi院yuan也ye是shi有you預yu算suan的de,年nian底di就jiu做zuo第di二er年nian的de預yu算suan。預yu算suan的de執zhi行xing情qing況kuang也ye是shi國guo家jia非fei常chang強qiang調tiao的de。第di二er,我wo覺jiao得de醫yi院yuan還hai是shi核he心xin人ren力li資zi源yuan最zui重zhong要yao。醫yi生sheng是shi很hen重zhong要yao的de核he心xin人ren力li資zi源yuan,管guan理li部bu門men也ye是shi,護hu士shi也ye是shi,高gao級ji的de管guan理li團tuan隊dui也ye是shi核he心xin。所suo以yi整zheng體ti來lai講jiang,核he心xin人ren力li是shi醫yi院yuan的de核he心xin競jing爭zheng力li。但dan是shi我wo們men所suo做zuo的de一yi切qie,最zui後hou還hai是shi要yao服fu務wu病bing人ren,解jie決jue病bing人ren的de疾ji苦ku,提ti高gao醫yi療liao水shui平ping,提ti高gao服fu務wu質zhi量liang。
吳鬆教授:在(zai)中(zhong)國(guo)還(hai)有(you)一(yi)個(ge)比(bi)較(jiao)重(zhong)要(yao)的(de)因(yin)素(su),就(jiu)是(shi)政(zheng)府(fu)給(gei)醫(yi)院(yuan)的(de)定(ding)位(wei)。如(ru)果(guo)定(ding)位(wei)是(shi)基(ji)層(ceng)醫(yi)院(yuan),那(na)就(jiu)聚(ju)焦(jiao)在(zai)社(she)區(qu)服(fu)務(wu)中(zhong)心(xin)。如(ru)果(guo)定(ding)位(wei)為(wei)高(gao)水(shui)平(ping)醫(yi)院(yuan)或(huo)者(zhe)區(qu)域(yu)的(de)醫(yi)療(liao)中(zhong)心(xin),可(ke)能(neng)服(fu)務(wu)的(de)是(shi)一(yi)個(ge)省(sheng)或(huo)者(zhe)一(yi)個(ge)片(pian)區(qu)。作(zuo)為(wei)醫(yi)院(yuan)的(de)管(guan)理(li)者(zhe),公(gong)立(li)醫(yi)院(yuan)的(de)管(guan)理(li)者(zhe)更(geng)像(xiang)一(yi)個(ge)國(guo)企(qi)的(de)董(dong)事(shi)長(chang),任(ren)務(wu)就(jiu)是(shi)在(zai)國(guo)家(jia)的(de)指(zhi)令(ling)和(he)定(ding)位(wei)下(xia),發(fa)揮(hui)我(wo)們(men)自(zi)己(ji)的(de)特(te)點(dian)或(huo)者(zhe)特(te)長(chang),從(cong)而(er)再(zai)物(wu)色(se)、配套相應的人才設備和相應的規劃。
沈潔教授:醫yi院yuan的de核he心xin是shi什shen麼me,其qi實shi包bao括kuo了le醫yi院yuan核he心xin的de價jia值zhi觀guan,醫yi院yuan核he心xin的de人ren才cai,還hai有you醫yi院yuan核he心xin的de發fa展zhan定ding位wei。我wo覺jiao得de大da家jia經jing曆li過guo疫yi情qing之zhi後hou,現xian在zai重zhong新xin想xiang一yi下xia疫yi情qing後hou時shi代dai,我wo們men要yao做zuo什shen麼me。我wo認ren為wei醫yi院yuan的de學xue科ke發fa展zhan是shi醫yi院yuan的de核he心xin和he未wei來lai的de發fa展zhan動dong力li。大da家jia知zhi道dao,“十四五”期間國家也在做“百千萬工程”。“百千萬工程”其實是一百個國家的重點專科,一千個省的重點專科和一萬個縣級的重點專科。我們現在都在向華西、向(xiang)同(tong)濟(ji)學(xue)習(xi),但(dan)是(shi)我(wo)們(men)不(bu)可(ke)能(neng)所(suo)有(you)醫(yi)院(yuan)都(dou)這(zhe)樣(yang)發(fa)展(zhan)。所(suo)以(yi)我(wo)覺(jiao)得(de)不(bu)管(guan)是(shi)哪(na)家(jia)醫(yi)院(yuan),都(dou)有(you)自(zi)己(ji)定(ding)位(wei),而(er)在(zai)這(zhe)個(ge)定(ding)位(wei)的(de)發(fa)展(zhan)下(xia),可(ke)能(neng)學(xue)科(ke)發(fa)展(zhan)非(fei)常(chang)重(zhong)要(yao),學(xue)科(ke)發(fa)展(zhan)是(shi)它(ta)的(de)核(he)心(xin)和(he)動(dong)力(li),同(tong)時(shi)學(xue)科(ke)發(fa)展(zhan)的(de)核(he)心(xin)內(nei)容(rong)是(shi)人(ren)才(cai)。
Prof. Siebert:wozhichuyidian,jiushihuanzheshuliang。womenzhiliaodehuanzheshuliangbuduanzengjia,womenyaorangzhiliaojinkenengyouxiao,yaometongguorengongzhinengdengjishudezhichi,yaometongguoyiyuandeshuzihualaizhichi。zaideguo,womenyaogaishanzhenggegongzuoliuchengdexiaolv。zheyangdehua,mei1meiyuandetourudounenggouranggengduodehuanzhededaozhiliao。womenzaizuoyusuandeshihou,yaokaolvdaorangyishengjinkenengdefuwuhuanzhe,bimiantaiduoxingzhengshangdefangai,womenguanzhudezhongdianshizhongshihuanzhe。
2、作為院長如何協調臨床科室與行政部門的關係?
Prof. Stief:shouxianshishuangfangyaoxianghuzunzhong,xingzhengbumenyaozunzhongyishengdekanfa,yinweiyishengshiweihuanzhezhexiangde。eryishengyaozunzhongxingzhengbumen,lejietamenyusuanyouxian。tamenxuyaoyongzheyouxiandeyusuanlaizhichizhenggeyiyuandeyunzuo,yincizhexuyaodachengyigepingheng,butongdebumenzhijianyaojinxinggongkaitoumingdetaolun,laiqingxibiaodabicidesuqiu。zuizhongdajiaxianghuzunzhong,dachengyizhi。
彭女士:wojiaodezhongguoyiyuandexingzhengbumenzuodehaodeyiyuanzhendebuduo。qianbujiuzaiguangzhoudeyijiayiyuan,tamendeyigejizhukeyishengfeichangshangjinnuli,tayijingnadaolemuniheihalaxinggukeyiyuandefangxueyaoqinghan,qianzhengyezuohaole。xingzhengbumenjujuegeitaqingjia,yinweitajiaodeniquxuexigenwomeishenmeguanxi。ruguowozhichinichuquxuexi,ruguochuxianlewenti,woyaochengdanzeren。danshideguodeyiyuanweiletazhecixuexi,basuoyougongzuodouyijinganpaihaole。wojiaodezheyangdeyijiayiyuan,xingzhengbumenshixiangdangdebufuzeren。woqulehenduoyiyuan,wodougenyuanchangshuo,xingzhengbumenshiyaofuwuyishengde。weishenmene?menzhenshiyishengzaikan,shoushushiyishengzaizuo,yishenghaiyaoduixingzhengbumenkukuaiqiu。houlainagezhurengeiwodadianhua,tashuotaxiangcongzhejiayiyuancizhi。qishitamenyuanchangtebiehao,tamenyuanchangyehenzhichita,danshiyuanchangwunengweili。zhezhongshiqingzaiwomenzhongguodeyiyuantaiduole,womenzuozhegeluntandemude,jiushiyaogaibianzhongguohenduobuhaodeyiliaoxianzhuang。
Prof. Siebert:現(xian)在(zai)德(de)國(guo)的(de)醫(yi)療(liao)形(xing)勢(shi)已(yi)經(jing)有(you)別(bie)於(yu)十(shi)年(nian)前(qian)。在(zai)十(shi)年(nian)前(qian),確(que)實(shi)在(zai)行(xing)政(zheng)部(bu)門(men)和(he)醫(yi)生(sheng)之(zhi)間(jian)有(you)一(yi)些(xie)爭(zheng)執(zhi),我(wo)們(men)後(hou)來(lai)學(xue)習(xi)如(ru)何(he)尋(xun)求(qiu)共(gong)同(tong)的(de)目(mu)標(biao)以(yi)確(que)保(bao)醫(yi)院(yuan)持(chi)續(xu)地(di)運(yun)作(zuo)。現(xian)在(zai),我(wo)們(men)麵(mian)臨(lin)的(de)更(geng)大(da)挑(tiao)戰(zhan)在(zai)於(yu),新(xin)的(de)法(fa)律(lv)規(gui)定(ding)、對(dui)原(yuan)有(you)醫(yi)療(liao)法(fa)規(gui)的(de)新(xin)改(gai)動(dong),我(wo)們(men)需(xu)要(yao)時(shi)刻(ke)打(da)醒(xing)十(shi)二(er)分(fen)精(jing)神(shen),讓(rang)醫(yi)生(sheng)和(he)整(zheng)個(ge)醫(yi)院(yuan)了(le)解(jie)和(he)適(shi)應(ying)新(xin)規(gui),以(yi)便(bian)他(ta)們(men)能(neng)夠(gou)快(kuai)速(su)適(shi)應(ying)新(xin)的(de)形(xing)式(shi),因(yin)此(ci)團(tuan)隊(dui)要(yao)一(yi)起(qi)協(xie)作(zuo)才(cai)能(neng)夠(gou)成(cheng)功(gong)。我(wo)們(men)的(de)行(xing)政(zheng)工(gong)作(zuo)人(ren)員(yuan)他(ta)們(men)清(qing)楚(chu),要(yao)打(da)造(zao)一(yi)家(jia)成(cheng)功(gong)的(de)醫(yi)院(yuan),讓(rang)醫(yi)生(sheng)加(jia)入(ru)董(dong)事(shi)決(jue)策(ce)層(ceng)是(shi)非(fei)常(chang)重(zhong)要(yao)的(de)。
劉繼紅教授:彭總說的情況比較特殊。早年出國的時候是有些影響。但是隨著社會的進步,這種情況越來越少了。我記得我們老院長的一句話,“我們全院要一心為病人服務,病人是第一位的”。臨床醫生是麵對病人的,醫技科室要為臨床一線的醫生服務,所有的行政管理部門要為臨床、醫(yi)技(ji)科(ke)室(shi)服(fu)務(wu)。管(guan)理(li)者(zhe)更(geng)多(duo)的(de)是(shi)做(zuo)服(fu)務(wu),所(suo)以(yi)首(shou)先(xian)要(yao)克(ke)服(fu)官(guan)本(ben)位(wei)主(zhu)義(yi),他(ta)不(bu)是(shi)一(yi)個(ge)官(guan),而(er)是(shi)一(yi)個(ge)服(fu)務(wu)者(zhe),但(dan)是(shi)同(tong)時(shi)有(you)管(guan)理(li)的(de)職(zhi)能(neng)。行(xing)政(zheng)部(bu)門(men)應(ying)該(gai)要(yao)了(le)解(jie)一(yi)線(xian)的(de)疾(ji)苦(ku),也(ye)要(yao)把(ba)國(guo)家(jia)的(de)大(da)政(zheng)方(fang)針(zhen),行(xing)業(ye)的(de)管(guan)理(li)規(gui)範(fan)傳(chuan)達(da)給(gei)每(mei)個(ge)醫(yi)務(wu)人(ren)員(yuan),提(ti)高(gao)他(ta)們(men)的(de)服(fu)務(wu)質(zhi)量(liang)。行(xing)政(zheng)人(ren)員(yuan)和(he)臨(lin)床(chuang)一(yi)線(xian)都(dou)要(yao)互(hu)相(xiang)尊(zun)重(zhong),互(hu)相(xiang)理(li)解(jie),都(dou)是(shi)為(wei)了(le)共(gong)同(tong)的(de)目(mu)標(biao),做(zuo)好(hao)為(wei)臨(lin)床(chuang)病(bing)人(ren)服(fu)務(wu),解(jie)決(jue)病(bing)人(ren)的(de)疾(ji)苦(ku)。
吳鬆教授:我wo特te別bie支zhi持chi的de是shi,行xing政zheng是shi為wei醫yi療liao服fu務wu的de。但dan我wo們men要yao用yong什shen麼me指zhi標biao去qu評ping價jia?在zai中zhong國guo各ge個ge醫yi院yuan有you一yi個ge做zuo法fa,就jiu是shi滿man意yi度du調tiao查zha。滿man意yi度du調tiao查zha裏li麵mian分fen為wei兩liang部bu分fen,一yi部bu分fen是shi患huan者zhe的de滿man意yi度du。在zai我wo們men醫yi院yuan,不bu管guan是shi門men診zhen還hai是shi住zhu院yuan,你ni對dui我wo們men醫yi院yuan醫yi護hu人ren員yuan的de服fu務wu、診(zhen)療(liao)滿(man)不(bu)滿(man)意(yi)。第(di)二(er),就(jiu)是(shi)我(wo)們(men)員(yuan)工(gong)的(de)滿(man)意(yi)度(du)調(tiao)查(zha)。在(zai)我(wo)們(men)院(yuan)內(nei),或(huo)者(zhe)是(shi)我(wo)們(men)各(ge)級(ji)的(de)衛(wei)健(jian)委(wei),都(dou)組(zu)織(zhi)了(le)相(xiang)應(ying)的(de)滿(man)意(yi)度(du)調(tiao)查(zha),在(zai)滿(man)意(yi)度(du)調(tiao)查(zha)裏(li)麵(mian)就(jiu)有(you)區(qu)分(fen),有(you)行(xing)政(zheng)人(ren)員(yuan)、醫護人員,還有第三方人員等等。所以作為管理者,我覺得拿到這份滿意度調查的表格,就可以出台相應的激勵措施。
在我們醫院,我提出來要打造一個溫情的醫院,對患者要有溫度,也要有感情。但對我們的員工,對我們的醫護人員、行(xing)政(zheng)人(ren)員(yuan)怎(zen)麼(me)樣(yang)體(ti)現(xian)溫(wen)情(qing),就(jiu)要(yao)有(you)一(yi)係(xi)列(lie)的(de)具(ju)體(ti)的(de)激(ji)勵(li)措(cuo)施(shi)。如(ru)果(guo)這(zhe)次(ci)的(de)滿(man)意(yi)度(du)調(tiao)查(zha)非(fei)常(chang)低(di),那(na)我(wo)們(men)就(jiu)要(yao)出(chu)台(tai)相(xiang)應(ying)的(de)提(ti)升(sheng)措(cuo)施(shi)。最(zui)後(hou)讓(rang)我(wo)們(men)這(zhe)家(jia)醫(yi)院(yuan)充(chong)滿(man)溫(wen)情(qing),大(da)家(jia)對(dui)醫(yi)院(yuan)充(chong)滿(man)溫(wen)度(du)。
沈潔教授:行政和醫療其實是一個院科兩級的管理,不可偏廢,這是我的第一個觀點。
第di二er個ge觀guan點dian,我wo們men這zhe幾ji年nian在zai強qiang調tiao學xue科ke發fa展zhan的de同tong時shi,人ren才cai培pei養yang的de同tong時shi,可ke能neng會hui忽hu略lve行xing政zheng人ren員yuan的de培pei訓xun。這zhe一yi點dian,我wo覺jiao得de這zhe幾ji年nian我wo們men國guo家jia各ge類lei的de醫yi院yuan管guan理li的de培pei訓xun班ban,其qi實shi都dou在zai提ti升sheng行xing政zheng人ren員yuan的de管guan理li能neng力li。現xian在zai管guan理li人ren員yuan能neng力li的de提ti升sheng,我wo覺jiao得de是shi有you目mu共gong睹du的de。
第di三san個ge觀guan點dian,就jiu是shi行xing政zheng人ren員yuan一yi定ding是shi為wei臨lin床chuang服fu務wu的de,這zhe個ge位wei置zhi一yi定ding要yao擺bai正zheng。我wo們men說shuo一yi家jia醫yi院yuan是shi為wei醫yi生sheng這zhe支zhi筆bi服fu務wu的de。因yin為wei醫yi院yuan最zui核he心xin的de就jiu是shi醫yi生sheng,但dan是shi也ye少shao不bu了le行xing政zheng對dui他ta的de支zhi持chi。所suo以yi一yi家jia好hao的de醫yi院yuan,一yi定ding要yao有you好hao的de行xing政zheng管guan理li團tuan隊dui。
同時滿意度非常重要。我們說及時發現問題,解決問題很重要。我記得有一個文件說到,行政人員不能超過10%,業務人員不能少於60%。大da家jia對dui此ci也ye有you很hen多duo看kan法fa。臨lin床chuang覺jiao得de我wo賺zhuan的de錢qian是shi養yang了le行xing政zheng人ren員yuan,但dan是shi行xing政zheng人ren員yuan也ye是shi經jing常chang加jia班ban,非fei常chang辛xin苦ku的de。所suo以yi我wo覺jiao得de,行xing政zheng人ren員yuan一yi定ding要yao做zuo好hao服fu務wu的de理li念nian,有you這zhe樣yang的de態tai度du就jiu一yi定ding能neng做zuo好hao一yi家jia醫yi院yuan。我wo記ji得de我wo10年(nian)前(qian)提(ti)拔(ba)作(zuo)為(wei)院(yuan)長(chang)人(ren)選(xuan)的(de)時(shi)候(hou),領(ling)導(dao)找(zhao)我(wo)談(tan)話(hua),他(ta)跟(gen)我(wo)說(shuo)了(le)一(yi)句(ju)話(hua),我(wo)印(yin)象(xiang)特(te)別(bie)深(shen),就(jiu)是(shi)你(ni)委(wei)以(yi)重(zhong)任(ren),不(bu)是(shi)說(shuo)你(ni)做(zuo)官(guan)了(le),而(er)是(shi)你(ni)的(de)責(ze)任(ren)更(geng)大(da),你(ni)是(shi)要(yao)做(zuo)更(geng)好(hao)的(de)服(fu)務(wu),我(wo)覺(jiao)得(de)隻(zhi)有(you)這(zhe)樣(yang)我(wo)們(men)才(cai)能(neng)有(you)未(wei)來(lai)。
Prof. Siebert:在德國過去20年(nian)當(dang)中(zhong),總(zong)是(shi)不(bu)夠(gou)預(yu)算(suan),因(yin)此(ci)醫(yi)生(sheng)跟(gen)行(xing)政(zheng)人(ren)員(yuan)他(ta)們(men)坐(zuo)下(xia)來(lai)討(tao)論(lun)預(yu)算(suan)的(de)時(shi)候(hou),他(ta)們(men)有(you)時(shi)候(hou)會(hui)遺(yi)漏(lou)掉(diao)在(zai)病(bing)房(fang)與(yu)手(shou)術(shu)室(shi)中(zhong)工(gong)作(zuo)的(de)護(hu)士(shi),或(huo)者(zhe)其(qi)他(ta)的(de)人(ren)員(yuan),也(ye)因(yin)此(ci)讓(rang)這(zhe)些(xie)工(gong)種(zhong)在(zai)就(jiu)業(ye)市(shi)場(chang)中(zhong)變(bian)得(de)越(yue)來(lai)越(yue)沒(mei)有(you)吸(xi)引(yin)力(li)。現(xian)在(zai)在(zai)德(de)國(guo),我(wo)們(men)有(you)很(hen)多(duo)有(you)資(zi)質(zhi)的(de)醫(yi)生(sheng)和(he)足(zu)夠(gou)的(de)行(xing)政(zheng)人(ren)員(yuan),但(dan)護(hu)理(li)人(ren)員(yuan)緊(jin)缺(que)。我(wo)希(xi)望(wang)中(zhong)國(guo)不(bu)要(yao)重(zhong)蹈(dao)我(wo)們(men)的(de)覆(fu)轍(zhe),我(wo)希(xi)望(wang)中(zhong)國(guo)的(de)醫(yi)院(yuan)做(zuo)到(dao)人(ren)員(yuan)一(yi)定(ding)要(yao)足(zu)夠(gou),負(fu)責(ze)治(zhi)療(liao)患(huan)者(zhe)的(de)這(zhe)一(yi)套(tao)班(ban)子(zi)的(de)人(ren)員(yuan)必(bi)須(xu)是(shi)充(chong)足(zu)的(de)。不(bu)能(neng)為(wei)了(le)讓(rang)醫(yi)生(sheng)滿(man)意(yi)而(er)減(jian)少(shao)其(qi)他(ta)輔(fu)助(zhu)人(ren)員(yuan)的(de)數(shu)量(liang)。
當dang然ran臨lin床chuang科ke室shi跟gen行xing政zheng部bu門men要yao有you非fei常chang好hao的de配pei合he,特te別bie是shi在zai預yu算suan很hen低di的de時shi候hou,大da家jia必bi須xu以yi患huan者zhe為wei重zhong點dian,因yin為wei我wo們men的de最zui終zhong的de目mu標biao是shi好hao好hao地di治zhi療liao患huan者zhe。在zai德de國guo我wo們men現xian在zai很hen多duo醫yi生sheng在zai醫yi學xue院yuan時shi期qi,或huo者zhe是shi住zhu院yuan醫yi生sheng時shi期qi,並bing沒mei有you接jie受shou如ru何he成cheng為wei一yi個ge好hao的de管guan理li人ren員yuan的de培pei訓xun或huo者zhe課ke程cheng,所suo以yi我wo覺jiao得de這zhe個ge是shi我wo們men缺que失shi的de部bu分fen。這zhe方fang麵mian我wo們men需xu要yao有you一yi些xie提ti升sheng,不bu要yao等deng他ta們men已yi經jing來lai入ru職zhi了le,在zai工gong作zuo的de時shi候hou再zai來lai培pei訓xun,那na個ge時shi候hou可ke能neng已yi經jing晚wan了le。
3、無wu論lun是shi醫yi生sheng,護hu士shi,行xing政zheng部bu門men,大da家jia追zhui求qiu的de都dou是shi病bing人ren的de健jian康kang福fu祉zhi。但dan有you時shi病bing人ren到dao大da型xing三san甲jia醫yi院yuan就jiu醫yi,感gan覺jiao沒mei有you得de到dao足zu夠gou的de尊zun重zhong和he關guan懷huai。如ru何he在zai不bu提ti高gao醫yi護hu工gong作zuo量liang的de同tong時shi提ti高gao病bing人ren就jiu醫yi滿man意yi度du?
Prof. Stief:wojiaodezheshiquanshijiedoupubiancunzaideyixiewenti,bujinjinshisanjiayiyuan,zaiqitadifangyecunzai,womenbixuyaozhidao,dangwomenyouyigehendadeyiliaotixidewentichuxiandeshihou,womenbixuyaodaoyiyuanshidijiejue。duiyuhuanzhelaishuo,yiyuanshiyigemoshengdedifang,shiyigejumuwuqindedifang,shengbingderenhuihenjuewang,zhegexinqingwomenyinggailijie,womenyinggaiyouyizhongfangfabangzhuzhexiehuanzhe,zaitamenchuzaizhezhongguduwuzhudeshihougeitamenbangzhu。
我們泌尿科有一個做法,我們有很多的醫生,這一群醫生他們要照顧大概7-8名或者7-12minghuanzhe。womenhuiyaoqiuzhexieyishengruhehaohaozhaogutedingdebingren,bujinjinshigexinghuadeshoushu,haiyourenwenguanhuai。huanzhelaidaowomenyiyuandeshihou,yishengjiucongtoudaoweigenzongfuwuzhegebingren。
我wo們men的de係xi統tong有you什shen麼me要yao求qiu能neng夠gou讓rang患huan者zhe感gan受shou更geng好hao呢ne?任ren何he跟gen患huan者zhe有you關guan的de東dong西xi,我wo們men都dou會hui把ba它ta打da印yin出chu來lai,並bing且qie有you電dian子zi文wen檔dang備bei案an,詳xiang細xi列lie明ming每mei一yi點dian是shi不bu是shi做zuo好hao了le。當dang病bing人ren離li開kai的de那na一yi刻ke,我wo們men就jiu保bao證zheng所suo有you都dou已yi經jing做zuo好hao了le。我wo們men的de醫yi生sheng包bao括kuo主zhu任ren醫yi師shi或huo者zhe其qi他ta的de住zhu院yuan醫yi生sheng,或huo者zhe是shi其qi他ta的de員yuan工gong,我wo們men的de郵you箱xiang係xi統tong是shi開kai放fang的de,任ren何he時shi候hou都dou可ke以yi通tong過guo郵you件jian聯lian係xi到dao他ta們men。我wo來lai到dao中zhong國guo這zhe兩liang天tian已yi經jing回hui複fu了le至zhi少shao40fengdeyoujian,zhexieyoujiandoubushitebiechang,danwojinlihuifuzhexielaiziwodehuanzhedewenti。womenyaozuodejiushisuishisuidiranghuanzheganjiaotayaoqiudeshihou,womenjiuhuichuxian,huozheshuotayoushenmeyaoqiu,womenjiuhuimashanghuiying,zheshifeichangzhongyaode。
劉繼紅教授:ruhetigongyouzhidefuwu,shiyiyuanfazhandeyonghengzhuti。zhegelinianzaizhongguoyiyuanyinggaiwanquandadaole,jiushiquanxinquanyiweibingrenfuwu。zaizhegeqiantixia,womentongguogezhongfangfa,biruyouhualiucheng。wojingchangjiang,womenxingzhengguanlirenyuanyaodaoyixianqudangdangbingren,zouwanbingrenjiuyideliucheng,jiunengganshoudaonagehuanjieyouwenti。babuzhounengjianjiujian,nengshaopaolujiushaopaolu。
在目前形勢下,我覺得最重要的是科學技術的發展,優化流程,包括自動掛號、網上預約、自動繳費,這種信息化的人工智能的發展,會大大的減少我們人力的投入。
zaiyigejiushidalifazhanhulianwangyiyuanhefenjizhenliao。henduojiandandebingqingjiubuyaodaosanjiayiyuanlaile。bazhenzhengdeyiliaoziyuanranggeixuyaozhegefuwudebingren。bingrendouxiangxinsanjiayiyuan,douyaolaijiuyi。danshirenquanshipingdengde,zheshitajiuyidequanli,suoyiwomenyaohelideyindao。yongxuanchuance、海報、電話、微信給病人服務,讓病人少跑路。總的原則,就是我們用各種方法,包括行政手段、醫療手段、技術手段等各種手段來優化流程,提高服務質量。
Prof. Siebert:我(wo)們(men)要(yao)知(zhi)道(dao)的(de)是(shi)患(huan)者(zhe)的(de)身(shen)體(ti)感(gan)到(dao)非(fei)常(chang)不(bu)適(shi),且(qie)處(chu)在(zai)一(yi)個(ge)陌(mo)生(sheng)的(de)環(huan)境(jing)裏(li),所(suo)以(yi)我(wo)們(men)要(yao)竭(jie)盡(jin)所(suo)能(neng)地(di)讓(rang)患(huan)者(zhe)盡(jin)可(ke)能(neng)的(de)舒(shu)適(shi),讓(rang)他(ta)們(men)盡(jin)快(kuai)熟(shu)悉(xi)醫(yi)院(yuan)的(de)環(huan)境(jing)。剛(gang)才(cai)大(da)家(jia)都(dou)講(jiang)到(dao)了(le),我(wo)們(men)希(xi)望(wang)一(yi)直(zhi)都(dou)是(shi)那(na)個(ge)團(tuan)隊(dui)的(de)醫(yi)生(sheng)和(he)護(hu)士(shi)來(lai)照(zhao)料(liao)同(tong)一(yi)位(wei)患(huan)者(zhe),讓(rang)患(huan)者(zhe)盡(jin)可(ke)能(neng)地(di)感(gan)到(dao)舒(shu)適(shi),同(tong)時(shi)我(wo)們(men)的(de)高(gao)年(nian)資(zi)醫(yi)生(sheng)可(ke)以(yi)分(fen)散(san)到(dao)更(geng)多(duo)的(de)團(tuan)隊(dui),讓(rang)患(huan)者(zhe)能(neng)夠(gou)接(jie)受(shou)同(tong)等(deng)質(zhi)量(liang)的(de)服(fu)務(wu),在(zai)整(zheng)個(ge)治(zhi)療(liao)的(de)過(guo)程(cheng)當(dang)中(zhong),就(jiu)像(xiang)我(wo)剛(gang)才(cai)說(shuo)的(de),讓(rang)同(tong)一(yi)個(ge)團(tuan)隊(dui)由(you)始(shi)至(zhi)終(zhong)照(zhao)料(liao)同(tong)一(yi)位(wei)病(bing)人(ren),這(zhe)樣(yang)才(cai)能(neng)讓(rang)患(huan)者(zhe)從(cong)入(ru)院(yuan)到(dao)出(chu)院(yuan)都(dou)盡(jin)可(ke)能(neng)的(de)感(gan)受(shou)非(fei)常(chang)舒(shu)適(shi)、高質量的服務。
沈潔教授:這(zhe)個(ge)問(wen)題(ti)說(shuo)明(ming)了(le)三(san)甲(jia)醫(yi)院(yuan)確(que)實(shi)人(ren)比(bi)較(jiao)多(duo)。一(yi)個(ge)方(fang)麵(mian)就(jiu)是(shi),一(yi)定(ding)要(yao)做(zuo)流(liu)程(cheng)改(gai)造(zao)。現(xian)在(zai)的(de)醫(yi)院(yuan)空(kong)間(jian)越(yue)來(lai)越(yue)大(da),人(ren)也(ye)越(yue)來(lai)越(yue)多(duo),不(bu)像(xiang)原(yuan)來(lai)的(de)小(xiao)醫(yi)院(yuan),一(yi)個(ge)人(ren)通(tong)過(guo)一(yi)個(ge)大(da)腦(nao)可(ke)以(yi)完(wan)成(cheng)所(suo)有(you)部(bu)門(men)的(de)銜(xian)接(jie)。現(xian)在(zai)由(you)各(ge)個(ge)部(bu)門(men)多(duo)個(ge)腦(nao)子(zi)來(lai)完(wan)成(cheng)所(suo)有(you)流(liu)程(cheng)的(de)動(dong)線(xian)。
第di二er,我wo覺jiao得de要yao用yong好hao客ke服fu中zhong心xin還hai有you輿yu情qing監jian控kong係xi統tong。我wo記ji得de新xin加jia坡po的de服fu務wu做zuo得de最zui好hao的de就jiu是shi他ta的de反fan饋kui意yi見jian。我wo們men經jing過guo新xin加jia坡po的de機ji場chang,都dou會hui有you這zhe樣yang的de感gan受shou,在zai任ren何he一yi個ge地di方fang都dou會hui來lai跟gen你ni谘zi詢xun他ta的de問wen題ti所suo在zai。所suo以yi客ke服fu中zhong心xin及ji時shi發fa現xian問wen題ti非fei常chang重zhong要yao。
第三,信息化的支持也非常重要。在分級診療當中,把普通的病人下沉下去以後,我們的學科才能夠有時間和精力去發展、優化自己的學科。
我wo覺jiao得de非fei常chang重zhong要yao的de就jiu是shi,做zuo一yi個ge有you溫wen度du的de醫yi院yuan。我wo記ji得de有you一yi位wei醫yi院yuan管guan理li者zhe曾zeng經jing講jiang過guo,一yi家jia醫yi院yuan要yao以yi患huan者zhe為wei中zhong心xin這zhe是shi一yi定ding的de,如ru何he做zuo到dao員yuan工gong至zhi上shang這zhe個ge也ye很hen重zhong要yao,員yuan工gong幸xing福fu了le,患huan者zhe就jiu幸xing福fu了le,員yuan工gong安an全quan了le,患huan者zhe就jiu安an全quan了le。所suo以yi我wo們men在zai注zhu重zhong患huan者zhe滿man意yi度du的de同tong時shi,也ye要yao非fei常chang注zhu重zhong我wo們men員yuan工gong的de滿man意yi度du。
4、chulehuanzhemanyiduzhiwai,yiliaozhiliangshipingdingyiyuanzhiliangdezhongyaobiaozhun。duiyuyiliaozhiliang,yishiyaotigaoliaoxiao,ershiyaojiancejiguibifengxian。congguanlicengdejiaodu,ruhezuodaoyishangliangdian?
Prof. Stief:我覺得這是非常重要的,醫療服務的質量至關重要。在主要的一些指標當中,比如心肌梗塞、心xin髒zang驟zhou停ting以yi及ji手shou術shu流liu程cheng。對dui我wo們men來lai說shuo,我wo們men需xu要yao一yi個ge全quan國guo範fan圍wei內nei的de數shu據ju庫ku,這zhe樣yang的de話hua我wo們men就jiu能neng夠gou看kan到dao我wo們men的de手shou術shu時shi間jian是shi多duo少shao,還hai有you輸shu血xue率lv是shi多duo少shao,主zhu要yao的de並bing發fa症zheng又you是shi什shen麼me,像xiang肺fei動dong脈mai栓shuan塞sai這zhe種zhong問wen題ti,我wo們men就jiu能neng夠gou更geng好hao地di了le解jie整zheng體ti的de數shu據ju。作zuo為wei院yuan董dong事shi會hui我wo們men要yao仔zai細xi審shen視shi這zhe些xie數shu字zi。至zhi少shao每mei年nian所suo有you的de科ke主zhu任ren要yao和he院yuan董dong事shi會hui進jin行xing溝gou通tong。比bi如ru說shuo像xiang心xin血xue管guan領ling域yu的de數shu據ju,我wo們men要yao和he科ke主zhu任ren溝gou通tong,看kan療liao效xiao、manyiduzenmeyang。ruguomanyiduhengao,nakeyijixunuli。ruguoliaoxiaobugouhao,nawomenjiuyaofenxiyixiaweishenmehuichuxianzheleiwenti,weishenmezhegeshushidelinchuangliaoxiaobuhao,suoyiruguodiernianwomenzhegeliaoxiaomeiyoumingxiandegaishan,jiuhuiyouxiangyingchengfacuoshi,yinciwomenzaijiejinquanligaishangegezhuankedeliaoxiao。
吳鬆教授:醫療質量、yiliaoanquanduiyumeiyigeyiyuanguanlizhelaishuo,doushifeichangzhongyaoderenwuzhiyi。ruhebayiyuandeyiliaozhiliangdadaozuigao,yiliaofengxianjiangdaozuidi,womenyiyuandegegeguanlibumendouyouyixiliedejutidecuoshi。wojiaodedajiadouhenshuxizhexiecuoshi,zuoweiyijiabijiaochengshudeyiyuan,wojiaodexiangduilaishuodoubijiaohaoguanli,gengnandeshiyijiaquanxindeyiyuanqujianliyiliaozhiliangheyiliaoanquan。kongzhiyiliaofengxiantixijianlideshihou,haishiyouyidingdetiaozhanxingde。yinweishejidaorenyuanduizhidudeshuxidu,haiyouzunshoudu,haiyouzhidunengbunengzhixing,liuchenghebuheli,haiyougenjunidangqiandeshebeipeitao,haiyouzhenggeziyuannengbunengfugaidao,suoyilimianjiuyougengduodetiaozhan。
我看到國考指標提出行政人員不能超過10%。我wo覺jiao得de在zai一yi方fang麵mian是shi對dui的de,控kong製zhi行xing政zheng人ren員yuan,不bu用yong控kong製zhi人ren力li成cheng本ben。但dan是shi對dui於yu醫yi療liao質zhi量liang和he醫yi療liao安an全quan來lai說shuo,我wo覺jiao得de一yi定ding的de行xing政zheng人ren員yuan的de配pei比bi還hai是shi需xu要yao的de。這zhe就jiu需xu要yao我wo們men引yin進jin或huo者zhe培pei訓xun高gao水shui平ping的de管guan理li者zhe,從cong我wo們men整zheng個ge的de醫yi療liao環huan節jie之zhi中zhong,我wo們men都dou有you設she計ji,同tong時shi我wo們men有you很hen好hao的de信xin息xi化hua係xi統tong,能neng夠gou收shou集ji到dao這zhe樣yang的de數shu據ju。從cong而er在zai新xin的de醫yi院yuan或huo者zhe老lao的de醫yi院yuan裏li麵mian,我wo們men才cai能neng真zhen正zheng提ti升sheng醫yi院yuan的de醫yi療liao質zhi量liang和he醫yi療liao安an全quan。
劉繼紅教授:醫療的質量與安全是永遠的話題,我們醫院,包括國家一直注意這個問題。最近我看了第二屆“中國醫療質量大會”,固化了中國醫療領域18項核心製度,保障醫療安全。包括病曆書寫、查房、核he對dui,包bao括kuo手shou術shu安an全quan管guan理li等deng等deng。我wo當dang醫yi務wu處chu長chang的de時shi候hou,就jiu開kai展zhan各ge個ge科ke室shi互hu查zha七qi個ge本ben,包bao括kuo死si亡wang病bing例li討tao論lun,死si亡wang病bing人ren吸xi取qu教jiao訓xun。這zhe些xie工gong作zuo都dou是shi基ji本ben的de,所suo以yi一yi個ge醫yi院yuan首shou先xian就jiu是shi要yao提ti高gao療liao效xiao、降低死亡率。第二,就是安全,藥物的並發症,各種不必要的跌倒、損傷,醫源性的損傷等等。所以我想全世界醫院都一樣,我們要把醫院整個基本製度建好,樹立醫療質量與安全的理念。
Prof. Siebert:wowanquantongyi。danshiwomenbuxuyaoquanbucongtouzailai。yinweiguoqudewenxianyanjiulimianjiutigonglehenduojizhuncaozuo,zhexiedoushiwomendeyiliaobumennenggouzhaodaode。zhishaozaiouzhou,womenyoubutongderenzhengliucheng,fenxizaiyiyuandejiegouzhong,guoqucunzaishenmewenti。guanjianzaiyuyinruzhexiejizhun,congerdajianyigewendingdetixi;你ni需xu要yao達da成cheng一yi個ge平ping衡heng,也ye就jiu是shi醫yi生sheng應ying該gai花hua多duo少shao時shi間jian在zai質zhi量liang控kong製zhi和he風feng險xian減jian少shao方fang麵mian,當dang然ran這zhe也ye意yi味wei著zhe醫yi生sheng投tou入ru到dao治zhi療liao和he照zhao顧gu患huan者zhe的de時shi間jian會hui相xiang應ying變bian少shao。在zai德de國guo我wo們men有you一yi個ge標biao準zhun來lai對dui比bi這zhe些xie結jie果guo。我wo們men有you一yi個ge衛wei生sheng監jian測ce部bu門men,一yi直zhi監jian測ce院yuan內nei的de細xi菌jun感gan染ran情qing況kuang,然ran後hou定ding期qi更geng新xin這zhe些xie數shu據ju。因yin此ci我wo們men的de行xing政zheng部bu門men來lai支zhi持chi各ge個ge專zhuan科ke,幫bang助zhu醫yi生sheng實shi現xian高gao效xiao工gong作zuo。我wo們men也ye設she置zhi了le一yi個ge重zhong大da事shi故gu上shang報bao係xi統tong,用yong以yi監jian測ce出chu萌meng芽ya階jie段duan的de風feng險xian,從cong而er避bi免mian患huan者zhe受shou到dao損sun害hai。
沈潔教授:醫院的質量與安全是醫院永遠追求的話題,它是一個醫院的生命線,我覺得18項核心製度是用血的教訓寫出來的,所以在三甲醫院的評審當中,院科兩級的管理,尤其是PDCA,我覺得這個是非常重要。就是“三甲工作日常化,日常工作三甲化”。suiranwomenshizaimeiyoupingchangyingjiandeshihou,kenenghuihulveyixiewenti,danshiworenweikeshidingqifenxitadezhilianghaishifeichangzhongyao。yinweiwomensuizhexuekedefazhan,yuelaiyueduoyinanweizhongzhengdebingren,qishishixuyaowomendingqiqukaoliangde。
第二,我們還是要做好患者住院十大安全目標的管理,其實這個很重要,包括手術的安全,包括輸血,包括靜脈血栓的形成、預防等等,醫院要定期檢查。
第三,最近大家都關注到,手術安全的三年行動計劃馬上就要鋪開了,公立醫院績效考核都非常重視外科發展、手術能力和安全問題。隨著國考的推進,每家醫院都在重視“內科醫生外科化,外科醫生微創化,微創醫生精細化”等等。
彭女士:有you一yi句ju很hen經jing典dian的de話hua,你ni飛fei得de多duo高gao不bu重zhong要yao,你ni要yao平ping安an落luo地di才cai重zhong要yao。所suo以yi對dui每mei家jia醫yi院yuan來lai說shuo,其qi實shi醫yi院yuan是shi一yi個ge非fei常chang複fu雜za的de體ti係xi,每mei天tian所suo有you醫yi生sheng護hu士shi的de工gong作zuo如ru履lv薄bo冰bing,如ru臨lin深shen淵yuan,所suo以yi控kong製zhi風feng險xian這zhe是shi最zui重zhong要yao的de,隻zhi有you你ni醫yi院yuan的de醫yi療liao質zhi量liang沒mei有you風feng險xian,這zhe家jia醫yi院yuan才cai是shi平ping安an的de。
5、大多數院長從臨床業務中來,如何成為一名專業的管理者?如何在前人的基礎上再創高峰?
Prof. Stief:我認為是在工作曆程中學習管理,如我的德國同事Siebertjiaoshou,congyixueyuanbiyeyihou,kaishishizhuyuanyisheng,houlaimanmanxuexichengchang,zenmeyanggenxingzhengbumenhezuo,pengdaoyixieshijianyinggaizenmechulidengdeng,zheyangnijiuhuiziranerranchengweizhegelinchuangkeshidezhuyaoguanlizhe,yinweinimeitiandouyaomianduizhexiewenti,biruniyaogenxingzhengbumentanyusuandewenti。zuoweiyiyuandezhuyaoguanlizhe,nibixuyaoxiangdaoruhecongrongdimianduizhexiewenti,jiuxiangwomeitianchulilinchuangshangdegongzuoyiyang。wogerendejingyanlaikan,ruguocongyigelinchuangyishengzouguolesuoyoulicheng,yijiyijizoushanglai,qishinidejingyanyijingfeichangduole,yinweigegebumendegongzuonidouyouqinshentiyanguo。
吳鬆教授:其實每個人的感受不一樣。以前我做手術的時候,我重複做100台、200tai,jiaodezhegeshoushuyijinghenyoubawole,woyijinghenyouzixinle,erqiewoyefeichangzihaodigenhuanzheshuo,wonenggoubatazuohao。zuokeyanhuozhezuozhuanhua,woganjiaoyoushihoubizuoshoushuyaonandeduo。yinweikeyanmianlinzhebuquedingxing。niyaoqutansuokongbailingyu,nayounameduokongbailingyugeiniqukaituo。
tandaozuoguanli,woganjiaojiugengnan,kenengwomenzaizuohenduoguanlizhedouyourenyouyu,danshiduiwogerenlaijiang,wojiaodeguanlibikeyanhezuoshoushugengnan。yinweiguanlishejidaoduogebumen,nameduofuyuanchang、上級部門、行xing業ye部bu門men管guan理li,剛gang才cai還hai說shuo到dao預yu算suan,中zhong國guo的de院yuan長chang還hai得de拉la資zi源yuan。這zhe麼me多duo人ren要yao跟gen著zhe你ni的de整zheng體ti布bu局ju去qu走zou。當dang然ran現xian在zai有you黨dang委wei領ling導dao下xia的de院yuan長chang負fu責ze製zhi,更geng多duo的de是shi給gei院yuan長chang的de工gong作zuo保bao障zhang和he護hu航hang。
這zhe三san個ge方fang麵mian就jiu像xiang剛gang才cai說shuo的de醫yi療liao質zhi量liang和he安an全quan,要yao一yi輩bei子zi平ping衡heng,一yi輩bei子zi做zuo選xuan擇ze,可ke能neng沒mei有you哪na一yi個ge一yi定ding是shi最zui好hao的de選xuan擇ze。但dan是shi我wo覺jiao得de能neng夠gou體ti現xian到dao為wei更geng多duo的de老lao百bai姓xing服fu務wu,為wei更geng多duo的de人ren創chuang造zao機ji會hui,為wei國guo家jia或huo者zhe為wei當dang地di創chuang造zao更geng多duo的de新xin平ping台tai,那na也ye就jiu很hen欣xin慰wei了le。
劉繼紅教授:這是我們在座的共同話題。因為我從一個臨床醫生成為一個醫院院長,做了很多年的手術、看門診、做科研、做教學。我們同濟醫院是一家8000多個病床位,1萬多名職工的大型醫院。所以我個人認為,做一個醫生相對比較容易的,但作為一個好的院長,我覺得還是很難的。
wojiaodeshouxianyaozhuanxinzhizhi。wodangyuanchangyihoujiumeiyoukanmenzhen,meiyouzuoshoushu。yinweishijianbugou,yiyuantaida。wohaiyouyigetihui,jiushiyigeyiyuandefazhan,yigekeshidefazhan,zaimouyijieduanshihenkuaide,zhiyaoyongyouzhengquedefangfa,keshifazhantengfei,yiyuangexiangzhibiaojinyigehenhaodetaijie。womentongjiyiyuan,xiangyigejuxinghangmu,womensangeyuanqu8000多個病床,1萬多名職工,在職的9600人,退休的1400人。醫院發展到今天各種排名也靠前,但是如何真正突破,跟上國家的頭部醫院,做到世界一流的、中國一流的醫院,我覺得還是很難的。
youhenduofangfa,henduosikao,jueduibushiyongwomenmuqiandechangguifangfa,nazhishinengzuoyigedadefeiyue,danshiyaozuojingzuoxi,muqianguoneihenduoyiyuanwomenyizhizaixuexi。baokuoquxiaoyaopinjiacheng、取消耗材加成、DRG支付、yibaoyusuanzhexiehuati。suoyiyiyuanguanlizhemianlindewentishiyuelaiyuefuza,ruheyaorangbingrenmanyi,fuwuliuchengzaizao,youyaorangwomendezhigongmanyi,rangzhigongyouzunyandishenghuo,duiyuanchanglaishuo,shishifenjingshoukaoyande,woxiangweiyoujingxihuaguanli。
很多發展的紅利已經消失了,所以對於醫院來講,人才、科研、教學、信息化、運營、行政管理、yiyuanwenhuajianshedenggegefangmian,wojiaodeyidingyaojingxihuaguanli。buzaishiyibanguanli,tebieduiyuwomendedayiyuan,caikenengzaipingjingjieduangengshangyicenglou。wojiaodewomenweiyouxuexishijiedejingyan,womenzijihuxiangxuexijiaoliu,yiyuanguanlicainengzuodegenghao。
Prof. Siebert:wobuchongyidian。woshiyigechushenyulinchuangbumendeguanlizhe,suoyiyizhihuizaizijidelinchuangtuanduilimianzhenbiekeyongzhicai,womenxuyaoxuehuizhenbiezijituanduizhongyounaxierenshanchanggaoyanjiu、哪些手術做得特別好、哪na些xie會hui是shi未wei來lai的de管guan理li人ren才cai,再zai給gei他ta們men的de成cheng長chang推tui一yi把ba手shou。我wo也ye需xu要yao重zhong申shen自zi己ji之zhi前qian的de觀guan點dian,一yi個ge人ren並bing不bu是shi在zai被bei提ti拔ba為wei管guan理li者zhe之zhi後hou才cai悟wu出chu管guan理li之zhi道dao的de。我wo們men可ke以yi送song創chuang傷shang醫yi生sheng去qu學xue習xiAO課程來精進自己的創傷診療技巧、送song研yan究jiu潛qian力li股gu去qu研yan究jiu項xiang目mu組zu去qu學xue習xi研yan究jiu技ji巧qiao,但dan很hen少shao有you醫yi院yuan會hui把ba嶄zhan露lu頭tou角jiao的de管guan理li人ren才cai送song去qu學xue習xi管guan理li課ke程cheng。其qi實shi這zhe些xie冒mao尖jian管guan理li人ren才cai也ye應ying該gai得de到dao進jin修xiu的de機ji會hui,這zhe樣yang的de話hua,之zhi後hou遇yu到dao討tao論lun預yu算suan的de場chang合he,還hai有you遇yu到dao管guan理li的de難nan題ti就jiu會hui更geng加jia有you經jing驗yan。總zong而er言yan之zhi,其qi實shi你ni的de團tuan隊dui裏li麵mian肯ken定ding會hui有you很hen多duo可ke用yong之zhi才cai,善shan於yu發fa現xian和he識shi別bie這zhe些xie人ren才cai,再zai加jia以yi利li用yong網wang上shang的de資zi源yuan、交流項目。當然因為現在德國的醫療人員緊缺現狀讓支持潛在人才發展的規劃變得有些困難了。
沈潔教授:我wo們men的de學xue科ke發fa展zhan很hen重zhong要yao。我wo覺jiao得de專zhuan業ye人ren員yuan做zuo行xing政zheng管guan理li,我wo的de感gan受shou就jiu是shi,專zhuan業ye是shi向xiang深shen度du發fa展zhan,行xing政zheng是shi向xiang廣guang度du發fa展zhan,所suo以yi從cong專zhuan業ye人ren員yuan走zou到dao行xing政zheng人ren員yuan,他ta有you他ta的de優you勢shi。同tong時shi,我wo覺jiao得de開kai闊kuo了le視shi野ye。在zai管guan理li上shang有you幾ji大da優you勢shi,一yi個ge是shi在zai學xue科ke的de布bu局ju上shang,因yin為wei他ta懂dong得de這zhe個ge專zhuan業ye,所suo以yi他ta對dui於yu學xue科ke的de整zheng合he,對dui於yu學xue科ke群qun的de規gui劃hua,對dui於yu“專科要有特色病種,學科要有優勢病種,醫院要有戰略病種”,甚至對醫院未來的發展,我覺得是有優勢的。
第(di)二(er),如(ru)何(he)用(yong)好(hao)專(zhuan)業(ye)的(de)來(lai)做(zuo)好(hao)創(chuang)新(xin)性(xing)的(de)發(fa)展(zhan)和(he)差(cha)異(yi)性(xing)的(de)發(fa)展(zhan),醫(yi)工(gong)融(rong)合(he)等(deng)各(ge)類(lei)新(xin)技(ji)術(shu)的(de)融(rong)合(he),需(xu)要(yao)有(you)更(geng)寬(kuan)的(de)專(zhuan)業(ye)視(shi)覺(jiao)和(he)敏(min)銳(rui)的(de)嗅(xiu)覺(jiao)整(zheng)合(he)專(zhuan)科(ke)發(fa)展(zhan)的(de)意(yi)見(jian)。習(xi)總(zong)書(shu)記(ji)講(jiang)過(guo),“謀創新才能謀發展,謀創新才能謀未來”。所以我覺得無論是科技上的推動或是融合,專業對行政的帶動也是非常重要的。
第di三san,對dui於yu專zhuan科ke建jian設she來lai講jiang,有you一yi些xie科ke主zhu任ren是shi好hao的de專zhuan家jia,但dan不bu一yi定ding是shi好hao的de行xing政zheng人ren員yuan,所suo以yi我wo們men會hui通tong過guo專zhuan科ke的de評ping估gu或huo者zhe學xue科ke的de評ping估gu,來lai幫bang他ta們men分fen析xi,為wei他ta們men引yin導dao,推tui動dong他ta成cheng長chang為wei一yi個ge優you秀xiu的de管guan理li者zhe。
2023 SEOS
學科建設環節
大會主持:Prof. Hildebrand、李旭教授、李緒貴教授
討論嘉賓:Prof. Mueller、Dr. Stinus

1、如何歸納、分析、整理臨床病例資料及數據,並從中挑選合適主題/病例開展臨床研究?如何配置臨床工作與科研的資源?
Prof. Hildebrand:非常感謝Stief教授之前講到國家級數據庫的重要性,像創傷和骨科有很多的數據庫,涉及到不同創傷和骨病,我們有記錄嚴重創傷數據、老年骨折,還有脊柱/gupenchuangshanghuanzhedeshujuku。zhongyaodeshiduishujudefenxi,yaotongguochongfenliyongzhexiebutongdeshujukulaishixian,zheyangnenggouduibinideyiyuanhedeguoqitayiyuandeshuju。tongshiwomenyekeyitongguoshujukulaizhaodaolinchuangyanjiudexinfangxiang。biru,deguoyijingjianchiluruyanzhongchuangshanghuanzhedeshuju25年nian之zhi久jiu,這zhe個ge數shu據ju庫ku已yi經jing有you幾ji萬wan名ming患huan者zhe的de數shu據ju,我wo們men可ke以yi在zai這zhe個ge數shu據ju庫ku中zhong看kan到dao不bu同tong治zhi療liao的de發fa展zhan情qing況kuang,這zhe對dui於yu改gai善shan療liao效xiao很hen有you幫bang助zhu,幫bang助zhu我wo們men找zhao到dao臨lin床chuang研yan究jiu的de新xin方fang向xiang。如ru何he對dui資zi源yuan進jin行xing平ping衡heng呢ne?我wo覺jiao得de這zhe個ge問wen題ti很hen難nan回hui答da。臨lin床chuang的de治zhi療liao永yong遠yuan是shi我wo們men的de第di一yi要yao務wu,然ran後hou我wo們men需xu要yao處chu理li的de就jiu是shi如ru何he給gei研yan究jiu找zhao到dao資zi源yuan,也ye許xu有you第di三san方fang的de出chu資zi。德de國guo的de大da學xue常chang常chang會hui有you一yi些xie項xiang目mu,比bi如ru一yi些xie推tui動dong年nian輕qing住zhu院yuan醫yi生sheng的de研yan究jiu。所suo以yi你ni可ke以yi通tong過guo這zhe種zhong辦ban法fa尋xun求qiu一yi些xie研yan究jiu資zi源yuan。但dan是shi最zui重zhong要yao的de是shi要yao有you一yi個ge全quan職zhi的de研yan究jiu部bu門men,這zhe樣yang的de話hua我wo們men才cai能neng夠gou對dui研yan究jiu形xing成cheng一yi個ge清qing晰xi的de架jia構gou。
Prof. Mueller:有(you)時(shi)候(hou)我(wo)會(hui)有(you)新(xin)的(de)研(yan)究(jiu)想(xiang)法(fa),因(yin)此(ci)我(wo)需(xu)要(yao)數(shu)據(ju)的(de)支(zhi)持(chi)。如(ru)果(guo)進(jin)行(xing)一(yi)個(ge)前(qian)瞻(zhan)性(xing)的(de)研(yan)究(jiu),那(na)就(jiu)需(xu)要(yao)很(hen)多(duo)時(shi)間(jian)來(lai)收(shou)集(ji)研(yan)究(jiu)結(jie)果(guo),所(suo)以(yi)我(wo)會(hui)看(kan)數(shu)據(ju)庫(ku)做(zuo)回(hui)顧(gu)性(xing)的(de)研(yan)究(jiu)。然(ran)後(hou)研(yan)究(jiu)數(shu)據(ju)的(de)時(shi)候(hou)我(wo)發(fa)現(xian)有(you)很(hen)多(duo)患(huan)者(zhe)數(shu)據(ju)是(shi)缺(que)失(shi)的(de)。因(yin)此(ci)從(cong)一(yi)開(kai)始(shi),我(wo)們(men)就(jiu)要(yao)采(cai)集(ji)患(huan)者(zhe)的(de)高(gao)質(zhi)量(liang)數(shu)據(ju)。每(mei)個(ge)患(huan)者(zhe)都(dou)要(yao)有(you)基(ji)礎(chu)的(de)資(zi)料(liao),並(bing)且(qie)與(yu)其(qi)他(ta)的(de)醫(yi)院(yuan)和(he)科(ke)室(shi)進(jin)行(xing)信(xin)息(xi)共(gong)享(xiang),這(zhe)樣(yang)的(de)話(hua)就(jiu)能(neng)夠(gou)獲(huo)得(de)初(chu)始(shi)的(de)數(shu)據(ju)。有(you)了(le)研(yan)究(jiu)想(xiang)法(fa)之(zhi)後(hou),才(cai)有(you)機(ji)會(hui)創(chuang)新(xin),以(yi)及(ji)對(dui)收(shou)集(ji)患(huan)者(zhe)數(shu)據(ju),再(zai)通(tong)過(guo)回(hui)顧(gu)性(xing)的(de)研(yan)究(jiu)來(lai)審(shen)視(shi)你(ni)的(de)想(xiang)法(fa)。我(wo)們(men)需(xu)要(yao)大(da)量(liang)的(de)數(shu)據(ju),因(yin)此(ci)我(wo)們(men)要(yao)有(you)很(hen)好(hao)的(de)係(xi)統(tong)來(lai)納(na)入(ru)這(zhe)些(xie)信(xin)息(xi),並(bing)且(qie)讓(rang)所(suo)有(you)醫(yi)生(sheng)都(dou)可(ke)以(yi)獲(huo)取(qu)這(zhe)些(xie)信(xin)息(xi)。
我的觀點和Hildebrand教jiao授shou的de看kan法fa不bu太tai一yi樣yang。我wo們men需xu要yao專zhuan職zhi的de研yan究jiu人ren員yuan,但dan是shi我wo們men的de臨lin床chuang醫yi生sheng也ye必bi須xu要yao做zuo研yan究jiu,因yin為wei他ta們men是shi接jie診zhen患huan者zhe的de人ren,他ta們men也ye會hui有you新xin的de想xiang法fa,所suo以yi我wo們men必bi須xu攜xie手shou。現xian在zai我wo們men很hen多duo的de大da學xue醫yi院yuan都dou設she有you基ji礎chu研yan究jiu團tuan隊dui,主zhu要yao是shi工gong程cheng師shi、生sheng物wu化hua學xue家jia和he基ji礎chu研yan究jiu人ren員yuan,反fan而er醫yi生sheng不bu做zuo研yan究jiu。但dan是shi有you的de時shi候hou主zhu治zhi醫yi生sheng也ye看kan不bu懂dong這zhe些xie研yan究jiu,所suo以yi我wo們men醫yi院yuan的de專zhuan科ke要yao和he醫yi生sheng一yi起qi聯lian手shou來lai合he作zuo。
李旭教授:從我自己的經曆,我想談幾個點。我在一家公立醫院做了8年的科主任,然後到民營醫院又做了大概5年的科主任,也兼任著院長。在我13年帶領學科發展的過程當中,如何提取有效的或者說有價值的真實數據,對於一個學科的建設發展,對於做研究是非常重要的。
我wo在zai公gong立li醫yi院yuan的de經jing曆li,有you深shen刻ke的de體ti會hui,在zai我wo們men的de公gong立li醫yi院yuan中zhong,特te別bie是shi三san甲jia醫yi院yuan,由you於yu非fei常chang繁fan忙mang的de臨lin床chuang工gong作zuo,我wo們men寫xie病bing曆li記ji錄lu病bing人ren的de資zi料liao和he信xin息xi,有you時shi候hou難nan以yi留liu下xia很hen多duo真zhen實shi、詳(xiang)細(xi)的(de)數(shu)據(ju),雖(sui)然(ran)我(wo)們(men)有(you)非(fei)常(chang)好(hao)的(de)醫(yi)院(yuan)信(xin)息(xi)係(xi)統(tong)幫(bang)我(wo)們(men)篩(shai)選(xuan)。比(bi)如(ru)說(shuo)我(wo)提(ti)供(gong)一(yi)個(ge)疾(ji)病(bing),信(xin)息(xi)科(ke)幫(bang)我(wo)們(men)把(ba)這(zhe)個(ge)疾(ji)病(bing)所(suo)有(you)的(de)病(bing)例(li)資(zi)料(liao)篩(shai)選(xuan)出(chu)來(lai),名(ming)單(dan)提(ti)供(gong)給(gei)我(wo)。但(dan)是(shi)當(dang)我(wo)回(hui)過(guo)頭(tou)來(lai)看(kan)調(tiao)取(qu)的(de)病(bing)曆(li)資(zi)料(liao),我(wo)發(fa)現(xian)其(qi)中(zhong)很(hen)多(duo)我(wo)需(xu)要(yao)的(de)信(xin)息(xi)並(bing)沒(mei)有(you)記(ji)錄(lu)下(xia)來(lai),甚(shen)至(zhi)很(hen)多(duo)可(ke)能(neng)並(bing)不(bu)是(shi)真(zhen)實(shi)的(de)記(ji)錄(lu),是(shi)很(hen)隨(sui)機(ji)的(de),或(huo)者(zhe)一(yi)拍(pai)腦(nao)袋(dai)拍(pai)大(da)腿(tui)隨(sui)便(bian)寫(xie)的(de)數(shu)字(zi),這(zhe)就(jiu)使(shi)我(wo)在(zai)做(zuo)回(hui)顧(gu)性(xing)、總結性臨床研究的時候非常難堪。
舉個簡單的例子,去年我們向GCS投(tou)了(le)一(yi)篇(pian)文(wen)章(zhang),寫(xie)到(dao)我(wo)們(men)改(gai)良(liang)的(de)一(yi)個(ge)手(shou)術(shu)方(fang)式(shi)。在(zai)過(guo)去(qu)的(de)五(wu)年(nian)以(yi)上(shang)的(de)隨(sui)訪(fang)病(bing)例(li),它(ta)的(de)具(ju)體(ti)信(xin)息(xi),其(qi)中(zhong)我(wo)就(jiu)需(xu)要(yao)一(yi)個(ge)點(dian),是(shi)什(shen)麼(me)呢(ne)?我(wo)做(zuo)每(mei)一(yi)台(tai)手(shou)術(shu),它(ta)的(de)失(shi)血(xue)量(liang)是(shi)多(duo)少(shao),但(dan)是(shi)當(dang)我(wo)回(hui)顧(gu)很(hen)多(duo)5nianyiqiandebinglideshihou,wofaxianlimianyouxiemeiyoujilu,youxieshixiangduisuiyidejilu。zuoweiwaikeyisheng,womendouhenqingchu,dangnizuowanyitaishoushuyihou,ruguomeiyouxiangxideshuzipinggu,kenengshisuibianyipainaodai,dagaishile500血,大概失了300血,其實這些都是非常不準確的。
後hou來lai出chu於yu一yi些xie考kao慮lv,我wo到dao了le現xian在zai這zhe個ge單dan位wei以yi後hou,我wo會hui要yao求qiu手shou術shu室shi的de同tong事shi們men,手shou術shu當dang中zhong給gei了le多duo少shao水shui,衝chong洗xi的de鹽yan水shui,必bi須xu給gei我wo精jing確que到dao毫hao升sheng,必bi須xu用yong注zhu射she器qi每mei次ci50毫升或者60毫hao升sheng來lai衝chong洗xi,所suo有you的de失shi血xue盡jin可ke能neng用yong吸xi引yin器qi吸xi走zou,因yin為wei可ke以yi量liang化hua。如ru果guo用yong紗sha布bu擦ca的de話hua,必bi須xu術shu後hou給gei我wo稱cheng重zhong,這zhe樣yang的de話hua,我wo們men就jiu把ba失shi血xue量liang至zhi少shao精jing準zhun在zai10毫升這個級別。對於我們的臨床研究評估手術外科操作,它的價值就有非常重要的參考依據。
第(di)二(er),舉(ju)個(ge)簡(jian)單(dan)的(de)例(li)子(zi),關(guan)節(jie)活(huo)動(dong)度(du)的(de)數(shu)據(ju),在(zai)我(wo)們(men)很(hen)多(duo)以(yi)前(qian)的(de)病(bing)例(li)記(ji)錄(lu)當(dang)中(zhong)同(tong)樣(yang)是(shi)不(bu)精(jing)準(zhun)的(de)。因(yin)為(wei)我(wo)們(men)要(yao)評(ping)估(gu)治(zhi)療(liao)的(de)臨(lin)床(chuang)價(jia)值(zhi),我(wo)們(men)需(xu)要(yao)很(hen)多(duo)評(ping)分(fen),很(hen)多(duo)評(ping)估(gu)分(fen)級(ji),這(zhe)些(xie)分(fen)級(ji)往(wang)往(wang)是(shi)來(lai)自(zi)英(ying)語(yu)的(de)文(wen)獻(xian)或(huo)者(zhe)教(jiao)科(ke)書(shu),非(fei)常(chang)詳(xiang)細(xi)的(de)。我(wo)們(men)以(yi)前(qian)很(hen)多(duo)公(gong)立(li)院(yuan)的(de)病(bing)例(li)往(wang)往(wang)是(shi)由(you)進(jin)修(xiu)醫(yi)生(sheng)、研究生去書寫的,上級醫生可能由於臨床工作太忙,他疏於仔細核對,也確實沒有時間和精力,導致我們記錄的很多病例、病(bing)人(ren)的(de)信(xin)息(xi)都(dou)是(shi)不(bu)準(zhun)確(que)的(de),甚(shen)至(zhi)有(you)時(shi)候(hou)是(shi)錯(cuo)誤(wu)的(de)。也(ye)就(jiu)是(shi)說(shuo),在(zai)這(zhe)種(zhong)繁(fan)雜(za)的(de)浩(hao)如(ru)煙(yan)海(hai)的(de)臨(lin)床(chuang)病(bing)例(li)當(dang)中(zhong),如(ru)何(he)去(qu)偽(wei)存(cun)真(zhen),提(ti)取(qu)真(zhen)正(zheng)有(you)價(jia)值(zhi)的(de)信(xin)息(xi),在(zai)很(hen)多(duo)醫(yi)院(yuan)當(dang)中(zhong),很(hen)多(duo)臨(lin)床(chuang)醫(yi)生(sheng)當(dang)中(zhong)都(dou)是(shi)非(fei)常(chang)難(nan)的(de)一(yi)件(jian)事(shi)情(qing)。
suoyizaiwomenkeshi,womenzijidetuanduidangzhong,womenhuiyoumishulaizhuanmenzuozhejianshiqing,wogeiwodemeiyiweizhuzhiyishengdoupeiyiweilinchuangzhushou,rangwodezhuzhiyishengzhizuozuiyoujiazhideshiqing,bataconglinchuangdewenshudangzhongbaituochulai,erlinchuangzhushouyaobangtapinggu,birubutaiheguanjiehuodongdu。woyouzhuanmendesheyingshijiluhaizidemeiyigebutai,zouludeshipin,guanjiedehuodongdengdeng,jinkenengliuxiazuizhenshi、最詳盡的信息,來為我們以後的臨床研究提供數據。
李緒貴教授:我非常讚同建設數據庫。其實我們臨床過程當中接診大量病人,每一個病人、meiyigejibingdexiangguanxinxidoushiyigeshujuku。womenweishenmeyaoquzuokeyan?womenzenyangbashujukuhekeyanxiangjiehe?qishiwomenlinchuangkeyandemudejiushiweiletigaojibingdezhiyunengli,huozhetansuoyizhonggenghaode、gengyouxiaodezhiliaofangfa。wulunshinayizhongjibing,nayigebingzhong,zuijibencongshujukujianlihaoleyihou,womencaicongshujukuzuoshujudefenxi,quzongjieshenzhiqingxiexiaoyanfangmiandegongzuo,zailiyonggezhongtongjifangfabijiao,congerxuanzehuozhexunzhaoyizhonggenghaodezhiliaofangfa。
2、團隊中每位醫生的風格、能力都有差異,如何為患者提供同質化的手術和照護?
Prof. Hildebrand:首shou先xian我wo們men必bi須xu要yao有you一yi個ge指zhi南nan,同tong時shi針zhen對dui每mei一yi種zhong疾ji病bing要yao有you標biao準zhun的de流liu程cheng,醫yi生sheng可ke以yi依yi據ju推tui薦jian的de指zhi南nan來lai工gong作zuo。第di二er點dian,我wo們men要yao定ding期qi查zha房fang。比bi如ru早zao上shang我wo們men看kan到dao所suo有you患huan者zhe的de情qing況kuang,我wo們men會hui觀guan察cha,過guo了le一yi晚wan之zhi後hou,他ta們men的de影ying像xiang的de變bian化hua。下xia午wu的de時shi候hou又you有you另ling外wai一yi次ci查zha房fang,我wo們men會hui討tao論lun第di二er天tian的de手shou術shu情qing況kuang,分fen享xiang具ju體ti的de入ru路lu和he手shou術shu方fang式shi,大da家jia再zai進jin行xing討tao論lun,有you的de人ren可ke能neng持chi反fan對dui意yi見jian,那na麼me我wo們men可ke以yi提ti出chu修xiu改gai意yi見jian。因yin此ci要yao定ding期qi,每mei天tian至zhi少shao要yao有you兩liang次ci跟gen患huan者zhe見jian麵mian,比bi如ru看kan他ta軟ruan組zu織zhi的de情qing況kuang,還hai有you他ta的de運yun動dong情qing況kuang等deng等deng,這zhe些xie是shi我wo們men的de責ze任ren。科ke室shi主zhu任ren要yao有you這zhe個ge責ze任ren,保bao證zheng所suo有you的de住zhu院yuan醫yi生sheng、主治醫生能做到定期對患者進行麵對麵的查房。
李旭教授:我們通過每天的早查房,晚討論,下午討論再巡視等等,保證每一個病人都接受到同一質量的、高標準的醫療照顧。考慮到醫生的個性化風格問題,我稍微花一點時間談一下。
在我的科室,因為我是個兒童骨科醫生,做了十多年的兒童骨科醫生,我們覆蓋的年齡段從0歲,從出生開始先天性的畸形一直到18歲,WHO規定兒童年齡界限在18歲以下都可以被歸為兒童,所以年齡段的跨越,無論從生理上還是心理上,病人的跨越幅度是非常顯著的。
比如說我團隊裏的5位(wei)年(nian)輕(qing)醫(yi)生(sheng),他(ta)們(men)有(you)的(de)非(fei)常(chang)和(he)藹(ai)可(ke)親(qin),有(you)的(de)非(fei)常(chang)酷(ku)很(hen)少(shao)說(shuo)話(hua)。年(nian)齡(ling)小(xiao)的(de)孩(hai)子(zi)就(jiu)非(fei)常(chang)喜(xi)歡(huan)和(he)藹(ai)可(ke)親(qin)的(de)醫(yi)生(sheng),而(er)十(shi)幾(ji)歲(sui)的(de)年(nian)輕(qing)女(nv)孩(hai)子(zi)就(jiu)很(hen)喜(xi)歡(huan)這(zhe)些(xie)很(hen)酷(ku)的(de)年(nian)輕(qing)醫(yi)生(sheng),他(ta)們(men)會(hui)有(you)不(bu)同(tong)的(de)風(feng)格(ge)。
huiguidaowomendeyiliaozhiliangkongzhidebenshen,wohaishitebiezantongliangweideguojiaoshoudeyijian,nibixuyaoyouyitaofeichangyangedekongzhizhiliangdebiaozhun,laibaozhengwomendemeiyigebingren,meiyigejibing,meiyitaishoushudoudedaogaozhiliangdefankui。
舉個簡單的例子。在我的手術室,我們打在X光guang片pian燈deng旁pang邊bian會hui有you一yi張zhang大da黑hei板ban,大da概gai接jie近jin一yi個ge平ping方fang米mi的de黑hei板ban,要yao求qiu他ta們men全quan部bu要yao用yong中zhong英ying文wen寫xie下xia,每mei個ge關guan節jie活huo動dong平ping麵mian的de活huo動dong度du,三san個ge自zi由you度du,六liu個ge活huo動dong方fang向xiang,要yao求qiu每mei個ge都dou要yao寫xie下xia來lai,肢zhi體ti的de長chang度du、旋轉屈伸的自由度寫下來,保證患者在手術當中能夠獲得同一水準的手術質量。
簡單總結一下,我們考慮到每個醫生的個性,他有不同的教育背景、風格和文化差異,但是在醫療照顧這方麵必須要有一套非常統一的嚴格標準。
李緒貴教授:要(yao)形(xing)成(cheng)同(tong)質(zhi)化(hua)的(de)手(shou)術(shu)和(he)照(zhao)護(hu),首(shou)先(xian)我(wo)們(men)必(bi)須(xu)要(yao)遵(zun)循(xun)共(gong)同(tong)的(de)診(zhen)療(liao)規(gui)範(fan)。像(xiang)我(wo)們(men)現(xian)在(zai)正(zheng)在(zai)推(tui)的(de)臨(lin)床(chuang)路(lu)徑(jing)等(deng)等(deng),一(yi)定(ding)要(yao)執(zhi)行(xing)統(tong)一(yi)的(de)標(biao)準(zhun),形(xing)成(cheng)標(biao)準(zhun)化(hua)的(de)診(zhen)療(liao)流(liu)程(cheng),我(wo)們(men)可(ke)以(yi)允(yun)許(xu)有(you)不(bu)同(tong)的(de)醫(yi)生(sheng),各(ge)有(you)各(ge)的(de)風(feng)格(ge)、tedian,zhehenzhengchang。danshiwomenshouxiandouyaozunxungongtongdebiaozhun,womenzaizunxunzhegebiaozhundeguochengdangzhong,yeyaotongguobuduandepeixunxuexilaidadaogongshi。meigerenbenshenhuigeyoutese,shoudaodewenhua、教育方麵的影響,每一個生物體各有各的特性,這不影響我們共同為病人執行統一規範標準。
3、骨科疾病的“預防、保守治療、手術治療、圍手術期康複、居家康複”的多學科協作如何實現?
Prof. Hildebrand:如(ru)果(guo)一(yi)個(ge)重(zhong)傷(shang)的(de)患(huan)者(zhe)來(lai)到(dao)我(wo)們(men)創(chuang)傷(shang)科(ke),來(lai)到(dao)我(wo)們(men)急(ji)診(zhen),我(wo)們(men)創(chuang)傷(shang)科(ke)的(de)同(tong)事(shi)必(bi)須(xu)先(xian)確(que)定(ding)他(ta)的(de)情(qing)況(kuang),然(ran)後(hou)跟(gen)其(qi)他(ta)的(de)科(ke)室(shi)協(xie)作(zuo),確(que)定(ding)他(ta)們(men)什(shen)麼(me)時(shi)候(hou)可(ke)以(yi)接(jie)收(shou)病(bing)人(ren),在(zai)這(zhe)之(zhi)前(qian)我(wo)們(men)應(ying)該(gai)做(zuo)什(shen)麼(me)工(gong)作(zuo),在(zai)患(huan)者(zhe)到(dao)達(da)醫(yi)院(yuan)之(zhi)前(qian),我(wo)們(men)就(jiu)已(yi)經(jing)做(zuo)好(hao)團(tuan)隊(dui)準(zhun)備(bei)。比(bi)如(ru)在(zai)治(zhi)療(liao)老(lao)年(nian)病(bing)人(ren)的(de)時(shi)候(hou),我(wo)們(men)也(ye)要(yao)跟(gen)內(nei)科(ke)的(de)醫(yi)生(sheng)一(yi)起(qi)工(gong)作(zuo),在(zai)患(huan)者(zhe)入(ru)院(yuan)之(zhi)前(qian),就(jiu)為(wei)患(huan)者(zhe)做(zuo)好(hao)準(zhun)備(bei)。在(zai)德(de)國(guo)我(wo)們(men)有(you)一(yi)個(ge)創(chuang)傷(shang)救(jiu)治(zhi)網(wang)絡(luo),整(zheng)個(ge)地(di)區(qu)的(de)醫(yi)院(yuan)都(dou)在(zai)這(zhe)個(ge)網(wang)絡(luo)當(dang)中(zhong),大(da)家(jia)能(neng)夠(gou)組(zu)織(zhi)在(zai)一(yi)起(qi)做(zuo)創(chuang)傷(shang)的(de)管(guan)理(li)。如(ru)果(guo)一(yi)個(ge)嚴(yan)重(zhong)創(chuang)傷(shang)的(de)患(huan)者(zhe)到(dao)了(le)一(yi)個(ge)無(wu)法(fa)治(zhi)療(liao)這(zhe)種(zhong)創(chuang)傷(shang)的(de)小(xiao)醫(yi)院(yuan),他(ta)會(hui)緊(jin)接(jie)著(zhe)被(bei)轉(zhuan)運(yun)到(dao)大(da)的(de)醫(yi)院(yuan),這(zhe)種(zhong)轉(zhuan)運(yun)在(zai)網(wang)絡(luo)和(he)架(jia)構(gou)之(zhi)下(xia)進(jin)行(xing)的(de),因(yin)為(wei)我(wo)們(men)都(dou)在(zai)這(zhe)個(ge)網(wang)絡(luo)當(dang)中(zhong),信(xin)息(xi)互(hu)通(tong),大(da)的(de)醫(yi)院(yuan)是(shi)無(wu)法(fa)拒(ju)絕(jue)接(jie)收(shou)這(zhe)些(xie)重(zhong)傷(shang)患(huan)者(zhe)的(de)。所(suo)以(yi)這(zhe)種(zhong)設(she)計(ji)是(shi)非(fei)常(chang)重(zhong)要(yao),把(ba)大(da)小(xiao)醫(yi)院(yuan)都(dou)放(fang)在(zai)係(xi)統(tong)裏(li)麵(mian)。當(dang)然(ran),患(huan)者(zhe)治(zhi)療(liao)之(zhi)後(hou),我(wo)們(men)也(ye)是(shi)通(tong)過(guo)這(zhe)個(ge)網(wang)絡(luo)進(jin)行(xing)緊(jin)密(mi)的(de)協(xie)作(zuo)。對(dui)於(yu)其(qi)他(ta)的(de)重(zhong)傷(shang)也(ye)是(shi)一(yi)樣(yang)的(de),這(zhe)樣(yang)才(cai)能(neng)給(gei)患(huan)者(zhe)最(zui)好(hao)的(de)治(zhi)療(liao)。
Prof. Mueller:當dang患huan者zhe來lai的de時shi候hou,有you時shi候hou他ta不bu隻zhi是shi有you骨gu科ke方fang麵mian的de疾ji病bing,可ke能neng還hai伴ban有you一yi些xie比bi較jiao嚴yan重zhong的de其qi他ta疾ji病bing,所suo以yi我wo們men必bi須xu跟gen其qi他ta學xue科ke協xie作zuo。在zai德de國guo,骨gu科ke在zai很hen長chang一yi段duan時shi間jian裏li做zuo了le很hen多duo保bao守shou治zhi療liao或huo者zhe手shou術shu治zhi療liao,同tong時shi還hai有you康kang複fu治zhi療liao。在zai我wo現xian在zai就jiu職zhi的de慕mu尼ni黑hei大da學xue肌ji肉rou骨gu骼ge中zhong心xin,我wo們men現xian在zai有you專zhuan門men的de創chuang傷shang外wai科ke醫yi生sheng,有you骨gu外wai科ke醫yi生sheng,也ye有you專zhuan門men理li療liao與yu康kang複fu的de醫yi生sheng,所suo以yi我wo們men組zu成cheng一yi個ge團tuan隊dui,這zhe個ge方fang法fa非fei常chang好hao,能neng夠gou盡jin力li給gei患huan者zhe提ti供gong最zui好hao的de治zhi療liao。但dan是shi我wo們men還hai需xu要yao其qi他ta學xue科ke加jia入ru,我wo們men有you一yi些xie跨kua學xue科ke的de中zhong心xin,比bi如ru運yun動dong醫yi學xue中zhong心xin。在zai這zhe個ge中zhong心xin,我wo們men跟gen其qi他ta學xue科ke的de醫yi生sheng為wei患huan者zhe製zhi定ding解jie決jue方fang案an。也ye就jiu是shi說shuo,有you的de時shi候hou我wo們men需xu要yao一yi個ge醫yi生sheng,做zuo組zu織zhi牽qian頭tou的de工gong作zuo,他ta負fu責ze整zheng個ge協xie作zuo。我wo們men這zhe方fang麵mian有you指zhi南nan,我wo們men有you越yue來lai越yue多duo的de這zhe些xie中zhong心xin,比bi如ru說shuo綜zong合he的de癌ai症zheng中zhong心xin,或huo者zhe是shi昏hun迷mi中zhong心xin等deng等deng,這zhe些xie都dou是shi我wo剛gang才cai提ti到dao的de跨kua學xue科ke中zhong心xin。很hen多duo患huan者zhe生sheng病bing之zhi後hou,其qi實shi他ta並bing不bu是shi一yi個ge學xue科ke的de疾ji病bing,它ta可ke能neng涉she及ji到dao其qi他ta方fang麵mian的de疾ji病bing,所suo以yi我wo們men需xu要yao更geng好hao的de協xie作zuo。
李旭教授:以我們自己目前的專業,我們治療的最多的病人為例,我們每年大概治療200個(ge)以(yi)上(shang)的(de)腦(nao)癱(tan)病(bing)人(ren)。腦(nao)癱(tan)的(de)病(bing)人(ren)在(zai)骨(gu)科(ke)的(de)治(zhi)療(liao)當(dang)中(zhong)是(shi)最(zui)具(ju)挑(tiao)戰(zhan)性(xing)的(de),可(ke)以(yi)說(shuo)是(shi)天(tian)花(hua)板(ban)一(yi)樣(yang)的(de)治(zhi)療(liao)。對(dui)於(yu)這(zhe)類(lei)病(bing)人(ren),手(shou)術(shu)隻(zhi)是(shi)其(qi)中(zhong)一(yi)部(bu)分(fen)。我(wo)們(men)經(jing)常(chang)講(jiang)一(yi)句(ju)話(hua)“三分手術,七分康複”,而他的康複甚至要貫穿他整個人生。手術隻是階段性的幹預,而對這類病人的綜合性幹預,除了手術醫生、小兒骨科醫生、康複技師,還包括兒科醫生、神經科醫生,包括護理、營養、心理、語言等等,幾乎所有的學科都需要納入其中,這是一個真正的MTD多學科評估和治療。
youyuxianzaigefangmiandeshaizhashouduandefazhan,baokuoxinshengerjiuzhudengshouduandefazhan,womennenggouconghenxiaodenianlingjiufaxiannaotandebingren,womenxianzaikeyizailinchuangshangyudao1歲之前就來就診並且被明確診斷為腦癱的孩子,在1歲sui之zhi前qian這zhe個ge年nian齡ling本ben來lai他ta也ye不bu會hui走zou路lu,腦nao癱tan的de孩hai子zi他ta的de運yun動dong發fa育yu就jiu更geng加jia差cha了le,在zai這zhe個ge年nian齡ling能neng夠gou發fa現xian和he篩shai查zha出chu腦nao癱tan的de孩hai子zi是shi相xiang對dui比bi較jiao困kun難nan的de事shi情qing。如ru果guo這zhe些xie孩hai子zi沒mei有you被bei發fa現xian的de話hua,他ta們men到dao了le6-7歲這個年齡,以及10歲以後都將麵臨著非常大的手術幹預。所以如果我們能夠從很早期發現這些孩子的話,我們能夠及時的給他很多的康複,包括兒科、護理等等各方麵的幹預和指導,來幫助他以後能夠盡可能的避免手術風險。當然對這些孩子的隨訪一定是貫穿他整個的兒童期,從0歲一直到16歲或者18歲,對他的康複指導,多學科幹預,包括家庭,包括互聯網線上的指導,都應該始終貫穿其中。
李緒貴教授:其實在骨科疾病的診療過程,從院前到住院期間,甚至出院後,全程的診療活動中,我們醫院實行的是“醫護康一體化”的做法。我們醫院真正地把康複科跟骨科的各個專業,各個病區緊密結合。根據每一個病區的診療特色,讓康複科的醫生、康複治療師走進病區,然後通過“醫護康一體化”緊密合作的模式,完成對病人的診療。在這個過程當中,我們還結合快速康複的理念ERAS理念。我們甚至探索怎樣把中國特色、中西結合的特色與ERAS相(xiang)結(jie)合(he)。對(dui)於(yu)出(chu)院(yuan)以(yi)後(hou)病(bing)人(ren)的(de)隨(sui)訪(fang),我(wo)們(men)醫(yi)院(yuan)也(ye)有(you)專(zhuan)門(men)的(de)隨(sui)訪(fang)團(tuan)隊(dui)。通(tong)過(guo)隨(sui)訪(fang),我(wo)們(men)收(shou)集(ji)病(bing)人(ren)的(de)療(liao)效(xiao)甚(shen)至(zhi)各(ge)方(fang)麵(mian)的(de)滿(man)意(yi)度(du),改(gai)善(shan)我(wo)們(men)對(dui)疾(ji)病(bing)的(de)診(zhen)療(liao)。
4、對於運動損傷的患者,應設置獨立的運動損傷亞專科,還是應該分流到按解剖學分科的亞專科?
Prof. Hildebrand:deguomeiyigejiepouxuedezhuankedouhuifenchengbutongdeyazhuanke,erqiezhezhiguanzhongyao。zheyangdehuacainenggeihuanzhetigongzuijiadefuwu,zhenduitadetebieqingkuang,ruguoshiyigenianqingyundongyuanshoushang,takenengzaiyundongdeshihouhuaiguanjieguzhele,huozheshizubuguzhe,zheyangdehua,yinggaishiyouzuihaodezhuankeyisheng,yaomeshiyundongyixuekedeyisheng,yaomeshizuhuaiwaikedeyishenglaigeitazuoshoushu,zhequjueyujutideanpai,danshiwomenyexuyaoyundongsunshangdequankeyisheng。xiangxiangyixia,ruguohuanzheshouzhongshanglaidaoyiyuan,tadeguguguzhele,ranhoukanzhendezhuanjiashuowoshifuzejianguanjiede,wobuzhidaozenmezhiliaogugudewenti。
zaiwomenzhuanke,meiyigezhuyuanyishenghemenzhenyishengdoubixuyaoyouyixieyundongsunshangquankebeijingzhishi,cainengzhidaozaitebiezhongyaodejizhenxia,ruheduizhengzhiliao。zaijizhendeshihouwomenyehuiyouyazhuankeyisheng,danshiyanzhongshoushangdehuanzhe,womenbixuyaoyouyundongsunshangquankedezhichi,tebieshizaiwanshangdeshihou,yinweizhuankeyishengnageshihoumeishangban,suoyimenzhenyishengjiubixuyaolejie。
Prof. Mueller:yundongyuanshoushanglaidaoyiyuandeshihou,taxuyaozuijiadezhiliao,xuyaozhuankeyishengdezhiliao,danshiguanjiedezhiliao,birushuoxiangzuhuaidezhuankeyishenggeitajinxingzhiliao,danshihaiyouduiyuyundongyuan,tahaiyouyixieteshudeyinsuyaokaolv,birufuyongxingfenjidengdeng。yundongyuanyexiwangnenggoujinkuaidihuidaojingjichangshang。biruzhegeyundongyuanyouruanguquesundewenti,jinconggukeyishengdejiaodulaishuowokeyigeitashishi“微骨折”手shou術shu,但dan這zhe可ke能neng需xu要yao至zhi少shao半ban年nian到dao一yi年nian的de時shi間jian才cai能neng夠gou重zhong返fan賽sai場chang。對dui於yu專zhuan業ye運yun動dong員yuan來lai說shuo,讓rang他ta半ban年nian到dao一yi年nian不bu參can加jia比bi賽sai競jing技ji,那na幾ji乎hu是shi不bu可ke能neng的de事shi情qing。因yin此ci我wo們men的de骨gu科ke專zhuan家jia必bi須xu要yao有you專zhuan科ke的de醫yi生sheng,同tong時shi也ye要yao有you了le解jie運yun動dong專zhuan科ke知zhi識shi的de醫yi生sheng,讓rang他ta們men一yi起qi來lai攜xie手shou處chu理li從cong診zhen斷duan到dao康kang複fu的de整zheng個ge流liu程cheng。比bi如ru說shuo,像xiang腫zhong瘤liu科ke的de病bing人ren合he並bing肩jian關guan節jie疾ji病bing時shi,他ta們men在zai先xian做zuo完wan腫zhong瘤liu手shou術shu之zhi後hou再zai做zuo骨gu科ke的de手shou術shu。對dui於yu運yun動dong醫yi學xue科ke來lai說shuo,就jiu需xu要yao這zhe種zhong跨kua學xue科ke的de合he作zuo。
李旭教授:可ke能neng在zai不bu同tong的de學xue科ke,不bu同tong的de醫yi院yuan,不bu同tong的de國guo家jia,不bu同tong的de文wen化hua背bei景jing下xia,可ke能neng都dou很hen難nan一yi概gai而er論lun。我wo們men國guo內nei很hen多duo醫yi院yuan的de運yun動dong醫yi學xue科ke醫yi生sheng,比bi較jiao擅shan長chang做zuo膝xi關guan節jie或huo者zhe是shi髖kuan關guan節jie,或huo者zhe是shi肩jian關guan節jie,這zhe些xie相xiang對dui大da關guan節jie的de鏡jing下xia治zhi療liao。但dan是shi如ru果guo一yi個ge足zu踝huai運yun動dong損sun傷shang的de病bing人ren找zhao到dao他ta,他ta可ke能neng會hui覺jiao得de超chao越yue了le他ta的de專zhuan業ye治zhi療liao的de範fan圍wei,或huo者zhe是shi超chao越yue他ta的de能neng力li。這zhe種zhong病bing人ren到dao創chuang傷shang骨gu科ke或huo者zhe到dao足zu踝huai外wai科ke,可ke能neng會hui得de到dao更geng適shi當dang的de治zhi療liao。雖sui然ran他ta同tong樣yang也ye是shi運yun動dong損sun傷shang的de病bing人ren。對dui於yu軟ruan骨gu損sun傷shang的de病bing人ren,假jia如ru是shi微wei骨gu折zhe的de病bing人ren,到dao創chuang傷shang外wai科ke還hai是shi到dao運yun動dong醫yi學xue科ke?我wo覺jiao得de這zhe些xie都dou是shi很hen現xian實shi的de問wen題ti。無wu論lun怎zen麼me樣yang,如ru何he讓rang學xue科ke設she置zhi更geng加jia優you化hua,一yi定ding是shi出chu於yu一yi個ge最zui基ji本ben的de前qian提ti和he目mu標biao,就jiu是shi如ru何he讓rang病bing人ren得de到dao最zui優you質zhi的de、zuigaobiaozhunhuadezhiliao,zheyidingshiwomendemubiao,wulunzhegexuekeshiruheshezhi,zuizhongdemubiaoyidingshiyizhide。suoyichongfenjiehegejiayiyuandebeijing,jiehewomendelinchuangshuizhunhuozhelinchuangshanchang。
wotebiexiangshuodeshi,zaiwozijisuojingliguozhemeduonian,gongliyiyuanyehao,siliyiyuanyehao,wozhidaowomenhenduoyiyuan,tebieshigukebijiaopangdadeyiyuan,shiyouduogexuekeshezhideyiyuan,pubiancunzaiqiangbingrendewenti。jiugangcaidelizi,yigezuhuaisunshangdebingrenjiujingyinggaidaoyundongyixueke,haishidaozuhuaiwaike,haishidaochuangshangguke,shenzhiyoudeyiyuanhaiyoujizhen、創chuang傷shang中zhong心xin,四si個ge科ke都dou可ke以yi搶qiang這zhe個ge病bing人ren,誰shui動dong作zuo快kuai,誰shui手shou快kuai,誰shui就jiu搶qiang到dao。在zai利li益yi的de驅qu使shi下xia,很hen多duo醫yi院yuan都dou存cun在zai這zhe樣yang的de問wen題ti。所suo以yi最zui關guan鍵jian的de還hai是shi如ru何he評ping估gu醫yi生sheng、科室的業績,臨床的工作指標。而最後,大家不隻考慮從利益上如何讓自己獲益,這給醫院的管理者提出了很大的難題。
李緒貴教授:這個問題就像我們國家一句老話“術業有專攻”。suoyiduiyundongsunshangshouxianyaojianyigedadezhuanke,zhiyouzhuanzhuyuzheyikuaideyishengcainengjiejuezhegewenti。zhiyugezhongbutongleixingdeyundongsunshang,womenjiuyaogenjujutidejiepoubuweilaizuojinyibudexifen。bifangshuotongyangshiyundongsunshang,nishiyigeputongrenqundeyundongsunshang,haishizhuanyeyundongyuandesunshang,womendouyaoqufenduidai。woxiangtebieqiangtiaoyidian,yishengzhijianyaotongguoduofenxiangduojiaoliu,napashiyundongsunshangdejibingyekenengxuyaogukeqitazhuanye,shenzhigukeyiwaidezhuanyegongtongcanyu,zhejiushiduoxuekexiezuo。wojiaodezhiyouzaihuaizhegongtongdemubiao,weilegenghaodejiejuejibing,rangbingrennenggengkuaigenghaodehuifu,bixugongtongxiezuo。
Prof. Stinus:在zai實shi際ji工gong作zuo當dang中zhong,我wo們men確que實shi需xu要yao對dui一yi些xie運yun動dong的de特te別bie方fang麵mian有you了le解jie,對dui心xin理li的de問wen題ti和he興xing奮fen劑ji的de問wen題ti都dou要yao有you所suo了le解jie。因yin此ci要yao有you一yi個ge很hen好hao的de協xie作zuo網wang絡luo。我wo經jing常chang會hui把ba運yun動dong員yuan分fen配pei到dao亞ya專zhuan科ke,如ru果guo是shi有you嚴yan重zhong創chuang傷shang的de話hua,如ru果guo是shi殘can運yun會hui的de運yun動dong員yuan,我wo可ke能neng會hui做zuo骨gu科ke創chuang傷shang的de評ping估gu來lai解jie決jue這zhe個ge問wen題ti。在zai德de國guo這zhe些xie亞ya專zhuan科ke的de團tuan隊dui是shi非fei常chang重zhong要yao的de,對dui於yu運yun動dong創chuang傷shang來lai說shuo,我wo一yi般ban會hui叫jiao他ta們men去qu看kan亞ya專zhuan科ke。
彭女士:我wo覺jiao得de骨gu科ke一yi定ding要yao從cong解jie剖pou學xue來lai分fen類lei,比bi如ru說shuo像xiang運yun動dong醫yi學xue,現xian在zai我wo們men國guo家jia的de運yun動dong醫yi學xue主zhu要yao做zuo關guan節jie鏡jing,以yi為wei會hui做zuo關guan節jie鏡jing就jiu是shi運yun動dong醫yi學xue,其qi實shi是shi錯cuo的de。運yun動dong醫yi學xue應ying該gai按an解jie剖pou部bu位wei,比bi如ru說shuo世shi界jie微wei創chuang脊ji柱zhu大da師shiMayer,他不僅僅是脊柱醫生,其實他是著名的運動醫學專家。比如說脊柱損傷肯定要去脊柱科,肩、膝、kuansunshangkendingyaobayundongsunshangfendaozhexieke,zuhuaisunshangkendingshiquzuhuaike,erbushishuozhuanmenchengliyigeyundongyixuekelaizhiliao,meiyouyigerennengbasuoyoudebuweijiejue。ruguozhitingliuzaiguanjiejing,jianguanjiejinghexiguanjiejing,nabujiaoyundongyixue。
5、現階段骨科是否有必要引進手術機器人、人工智能輔助診斷、3d 打印個性化醫療等設備和技術?
Prof. Hildebrand:我的答案是肯定的。一個非常好的設備,比如說術中 3D影(ying)像(xiang)導(dao)航(hang)。手(shou)術(shu)機(ji)器(qi)人(ren)未(wei)來(lai)會(hui)變(bian)得(de)更(geng)加(jia)的(de)重(zhong)要(yao),我(wo)覺(jiao)得(de)很(hen)多(duo)同(tong)行(xing)肯(ken)定(ding)都(dou)同(tong)意(yi),你(ni)們(men)現(xian)在(zai)已(yi)經(jing)用(yong)到(dao)很(hen)多(duo)手(shou)術(shu)機(ji)器(qi)人(ren)了(le),比(bi)如(ru)一(yi)些(xie)脊(ji)柱(zhu)損(sun)傷(shang)的(de)手(shou)術(shu)。講(jiang)到(dao)大(da)數(shu)據(ju)的(de)重(zhong)要(yao)性(xing),我(wo)們(men)需(xu)要(yao)技(ji)術(shu)來(lai)幫(bang)我(wo)們(men)處(chu)理(li)數(shu)據(ju),所(suo)以(yi)AI就能派上用場。我們骨科的手術已經用了很多3D打印技術,比如骨缺損、定製植入物,我們也是用3D打印的方法。Mueller教jiao授shou在zai第di一yi個ge問wen題ti也ye提ti到dao。毋wu庸yong置zhi疑yi,在zai德de國guo我wo們men必bi須xu要yao有you一yi些xie專zhuan業ye的de科ke研yan部bu門men領ling導dao人ren,他ta們men要yao做zuo出chu決jue定ding,就jiu是shi我wo們men到dao底di要yao用yong什shen麼me樣yang的de好hao的de技ji術shu來lai幫bang助zhu,而er不bu是shi用yong不bu用yong的de問wen題ti。而er且qie我wo們men也ye要yao有you實shi驗yan室shi,實shi驗yan室shi和he研yan發fa應ying該gai用yong什shen麼me新xin技ji術shu,我wo們men都dou必bi須xu要yao深shen入ru討tao論lun。而er且qie可ke能neng必bi要yao的de話hua,我wo們men還hai需xu要yao很hen多duo的de工gong程cheng師shi,但dan是shi工gong程cheng師shi具ju體ti怎zen麼me操cao作zuo,需xu要yao我wo們men給gei他ta醫yi療liao信xin息xi,然ran後hou工gong程cheng師shi幫bang助zhu我wo們men解jie決jue技ji術shu難nan題ti,滿man足zu我wo們men的de需xu求qiu,達da到dao我wo們men的de目mu的de,更geng好hao的de治zhi療liao患huan者zhe。
Prof. Mueller:25年前當我還是年輕醫生的時候,第一台骨科機器人誕生,當時我們就開始用來做關節置換手術,到了3-5年nian後hou,我wo們men回hui首shou看kan當dang時shi的de機ji器qi人ren真zhen的de不bu好hao用yong,因yin為wei他ta是shi來lai自zi工gong業ye的de機ji器qi人ren。機ji器qi工gong程cheng師shi在zai設she計ji的de時shi候hou,完wan全quan沒mei有you骨gu科ke醫yi學xue的de經jing驗yan,他ta們men也ye犯fan了le一yi些xie錯cuo誤wu。主zhu要yao問wen題ti是shi,當dang時shi的de機ji器qi人ren穿chuan過guo了le軟ruan組zu織zhi,把ba整zheng個ge軟ruan組zu織zhi都dou損sun傷shang,然ran後hou就jiu那na款kuan機ji器qi人ren就jiu被bei禁jin用yong了le。但dan現xian在zai不bu一yi樣yang,我wo們men現xian在zai有you新xin的de骨gu科ke手shou術shu機ji器qi人ren來lai做zuo關guan節jie置zhi換huan手shou術shu。從cong數shu據ju來lai看kan,機ji器qi人ren毫hao無wu優you勢shi,但dan它ta初chu始shi階jie段duan,所suo以yi我wo們men必bi須xu要yao接jie受shou創chuang新xin,然ran後hou要yao有you這zhe種zhong新xin的de技ji術shu,但dan是shi我wo們men對dui此ci也ye要yao持chi謹jin慎shen的de態tai度du,它ta不bu是shi用yong來lai做zuo市shi場chang營ying銷xiao的de,它ta是shi用yong在zai大da學xue醫yi院yuan裏li麵mian的de,還hai要yao找zhao出chu它ta的de優you缺que點dian。
我(wo)們(men)還(hai)記(ji)得(de)那(na)個(ge)機(ji)器(qi)人(ren)特(te)別(bie)昂(ang)貴(gui),當(dang)時(shi)也(ye)沒(mei)有(you)拿(na)到(dao)任(ren)何(he)補(bu)助(zhu)。所(suo)以(yi)我(wo)們(men)必(bi)須(xu)要(yao)持(chi)著(zhe)嚴(yan)謹(jin)的(de)態(tai)度(du)來(lai)選(xuan)擇(ze)好(hao)用(yong)的(de)機(ji)器(qi)人(ren),畢(bi)竟(jing)它(ta)也(ye)是(shi)花(hua)很(hen)多(duo)錢(qian),我(wo)們(men)預(yu)算(suan)也(ye)是(shi)有(you)限(xian)的(de),但(dan)是(shi)既(ji)然(ran)新(xin)的(de)技(ji)術(shu)來(lai)了(le),我(wo)們(men)就(jiu)要(yao)將(jiang)它(ta)和(he)新(xin)的(de)數(shu)據(ju)融(rong)合(he),做(zuo)一(yi)些(xie)改(gai)革(ge)創(chuang)新(xin)。其(qi)實(shi)我(wo)自(zi)己(ji)也(ye)用(yong),而(er)且(qie)我(wo)也(ye)很(hen)喜(xi)歡(huan)用(yong),但(dan)是(shi)必(bi)須(xu)持(chi)一(yi)個(ge)非(fei)常(chang)謹(jin)慎(shen)和(he)嚴(yan)肅(su)的(de)態(tai)度(du),要(yao)結(jie)合(he)數(shu)據(ju)以(yi)批(pi)判(pan)性(xing)的(de)態(tai)度(du)來(lai)看(kan)待(dai)這(zhe)種(zhong)技(ji)術(shu)。
李旭教授:我們醫院沒有手術機器人,也沒有人工智能輔助診斷,但是我們有3Ddayinshiyanshi。woxiangjiandandetanyixiawoduishoushujiqirenherengongzhinengfuzhuzhenduandekanfa,wulunshishoushujiqirenhaishirengongzhineng,zuoweiyizhongxindejishu,qishiwomendouyinggaibakonghaotadeshiyingzheng,yijiyangepinggutadezhiliaobiaozhunhezhiliaozhiliang,bingbushishuoxindejishujiuyidingshianquande,meiyourenheyizhongjishudoushijueduianquande。shanggexingqi,Leidinger教授來到我的醫院訪問,他就談到了我們做肢體延長手術,在西方國家最近的20年nian當dang中zhong出chu現xian可ke以yi體ti外wai控kong製zhi的de可ke以yi延yan長chang的de髓sui內nei釘ding,而er在zai中zhong國guo我wo們men目mu前qian做zuo肢zhi體ti延yan長chang手shou術shu都dou還hai是shi使shi用yong體ti外wai的de外wai固gu定ding支zhi架jia,會hui有you很hen多duo的de並bing發fa症zheng。但dan是shi即ji便bian是shi體ti外wai體ti控kong製zhi的de體ti內nei延yan長chang的de髓sui內nei釘ding,貌mao似si非fei常chang安an全quan,Leidinger教授都談到其實這些產品都有高達30%的de並bing發fa症zheng問wen題ti。甚shen至zhi有you的de產chan品pin已yi經jing被bei測ce試shi了le。任ren何he一yi種zhong新xin的de技ji術shu,我wo們men去qu麵mian對dui和he使shi用yong它ta,都dou應ying該gai掌zhang握wo好hao適shi應ying症zheng,及ji嚴yan格ge評ping估gu它ta的de治zhi療liao質zhi量liang。在zai中zhong國guo很hen多duo醫yi院yuan會hui有you這zhe樣yang的de趨qu勢shi,似si乎hu新xin的de技ji術shu就jiu意yi味wei著zhe高gao大da上shang,意yi味wei這zhe個ge醫yi院yuan就jiu似si乎hu邁mai上shang了le一yi個ge新xin的de台tai階jie,其qi實shi我wo覺jiao得de應ying該gai特te別bie審shen慎shen地di對dui待dai這zhe個ge事shi情qing。
2023 SEOS
人才培養環節

大會主持:Prof. Boriani、廖遠朋教授、林海濱教授
討論嘉賓:Prof. Stief、 Dr. Leidinger、Prof. Stukenborg-Colsman
1、如何給年輕醫生更多技能實操機會?如何處理年輕醫生犯的錯誤?
Prof. Stief:我wo的de想xiang法fa是shi,盡jin早zao讓rang年nian輕qing醫yi生sheng承cheng擔dan責ze任ren。我wo們men的de年nian輕qing醫yi生sheng在zai整zheng個ge手shou術shu當dang中zhong全quan程cheng跟gen隨sui,我wo們men手shou把ba手shou教jiao他ta們men,即ji使shi是shi很hen複fu雜za的de手shou術shu也ye讓rang他ta們men參can與yu其qi中zhong。即ji使shi是shi三san個ge小xiao時shi的de手shou術shu,我wo們men也ye會hui有you幾ji分fen鍾zhong的de時shi間jian讓rang他ta們men練lian手shou,做zuo一yi些xie具ju體ti的de操cao作zuo。我wo們men有you模mo擬ni手shou術shu,還hai有you一yi些xie其qi他ta的de設she施shi來lai幫bang他ta們men提ti升sheng和he練lian習xi。現xian在zai的de問wen題ti就jiu是shi,在zai每mei天tian的de工gong作zuo和he照zhao顧gu患huan者zhe的de過guo程cheng當dang中zhong,需xu要yao一yi個ge開kai放fang的de氛fen圍wei。出chu錯cuo是shi非fei常chang糟zao糕gao的de,但dan是shi我wo們men必bi須xu要yao公gong開kai討tao論lun,需xu要yao足zu夠gou的de反fan饋kui或huo者zhe是shi答da案an。並bing不bu是shi出chu了le錯cuo誤wu後hou讓rang某mou個ge特te定ding醫yi生sheng承cheng擔dan責ze任ren,而er是shi從cong這zhe個ge錯cuo誤wu當dang中zhong,讓rang所suo有you的de科ke室shi成cheng員yuan都dou能neng夠gou從cong中zhong學xue到dao東dong西xi。
廖遠朋教授:對醫生來說實操能力非常重要。我覺得中國的醫生其實不缺乏實操的機會。這個問題應該是”如何給年輕醫生提供高質量的實操機會”。實(shi)際(ji)上(shang)很(hen)多(duo)醫(yi)生(sheng)都(dou)在(zai)重(zhong)複(fu)一(yi)些(xie)低(di)水(shui)平(ping)的(de)實(shi)操(cao)。有(you)沒(mei)有(you)給(gei)他(ta)們(men)一(yi)些(xie)更(geng)好(hao)的(de)機(ji)會(hui),讓(rang)他(ta)們(men)從(cong)事(shi)高(gao)質(zhi)量(liang)或(huo)者(zhe)高(gao)水(shui)平(ping)的(de)操(cao)作(zuo)能(neng)力(li)的(de)培(pei)養(yang),這(zhe)可(ke)能(neng)是(shi)醫(yi)院(yuan)麵(mian)臨(lin)的(de)問(wen)題(ti)。我(wo)們(men)中(zhong)國(guo)有(you)句(ju)話(hua)叫(jiao)做(zuo)“有為才有位”。
換個角度來講,我覺得“有位才有為”yeshishuodetongde。nibugeitazeren,bugeitazheyangdeweizhi,natakenengyemeiyounenglihuozhemeiyoujihuijinxinggaoshuipingdecaozuolianxi。zhegeyegenkeshidefazhanyouguanxi。ruguoyigekezhurenlaoshibasuoyoudegaozhiliangcaozuodouwozaizijishoushang,bufanggeinianqingyisheng,nazhegekeshimeiyoufazhan。yinciruheyouyigehaodejinshengtujing,yigehaodekeshiguihua,wojiaodezhegecaishijiejuegaozhiliangshicaodebanfa。
另(ling)外(wai),每(mei)個(ge)醫(yi)生(sheng)都(dou)會(hui)錯(cuo)誤(wu),我(wo)們(men)醫(yi)生(sheng)都(dou)是(shi)從(cong)錯(cuo)誤(wu)當(dang)中(zhong)學(xue)習(xi)出(chu)來(lai)的(de)。醫(yi)院(yuan)肯(ken)定(ding)會(hui)有(you)一(yi)些(xie)容(rong)錯(cuo)機(ji)製(zhi)。年(nian)輕(qing)醫(yi)生(sheng)不(bu)能(neng)出(chu)了(le)問(wen)題(ti)就(jiu)扔(reng)給(gei)醫(yi)院(yuan),就(jiu)不(bu)管(guan)了(le)。要(yao)從(cong)錯(cuo)誤(wu)當(dang)中(zhong)學(xue)到(dao)了(le)什(shen)麼(me),有(you)什(shen)麼(me)經(jing)驗(yan)教(jiao)訓(xun),這(zhe)個(ge)我(wo)覺(jiao)得(de)更(geng)需(xu)要(yao)製(zhi)度(du)去(qu)體(ti)現(xian)。
林海斌教授:zhongsuozhouzhi,shoushushiwomenwaikeyishengchengchangdejishi。tongshiyeshihengliangwaikeyishengnengliheshuipingdebiaochi。zailinchuangshijianzhong,chulebenkejiaoxueyiwai,haiyoushuoshijiaoxue、博士教育,更需要上級醫生的“傳幫帶”。我覺得這個非常重要。
dier,wojiaodeyixiangbudaodeshiwushinanmiande,danshiwojiaodeyishengshibuyinggaifancuowude。weishenmezheyangjiangne?yinweiyishengzhegezhiyegenqitazhiyebuyiyang。qiguan、肢zhi體ti造zao成cheng了le嚴yan重zhong的de損sun害hai之zhi後hou,沒mei有you辦ban法fa替ti代dai的de,不bu是shi像xiang工gong程cheng師shi買mai個ge零ling件jian過guo來lai替ti代dai一yi下xia,人ren是shi沒mei辦ban法fa買mai的de。因yin此ci我wo個ge人ren的de觀guan點dian,我wo是shi不bu允yun許xu年nian輕qing醫yi生sheng犯fan錯cuo誤wu。不bu能neng一yi次ci犯fan錯cuo誤wu,兩liang次ci再zai犯fan,我wo覺jiao得de你ni肯ken定ding就jiu不bu適shi合he當dang外wai科ke醫yi生sheng。可ke能neng更geng不bu適shi合he當dang醫yi生sheng了le。
Dr. Leidinger:培訓、jiaoyuheshicaodeguochengfeichangzhongyao,womenzaideguoyouhenhaodejizhi。womenkeyibashoushudeguochengfenchengjibufen,nidezhushouzuoyixiejiandandebufen,zhudaodeyishizuoyixiebijiaonandebufen,lunliuwanchengshoushubuzhou,rangtamenyuelaiyueduodequchengdanzeren,yexuyinianzhihou,tajiukeyizaizhuzhiyishijianduxiaduliwanchengzhenggeshoushule。womendajiadouyinggairangnianqingyishengzuohaozhunbei。zaishoushuzhiqianhetamentaolunshoushubuzhou,hezhushouyiqilaizhunbei,zheyangzhushoutanengzuohaozhunbei,keyiyuxianjianzhayixiashoushuqiangegebuzhoushifouzhunbeiwanshan,tahuizhidaoyingdangyaoxuanshenmeyangdezhiruwu,huozheshiyounaxietidaizhiliaofangan。bangzhunianqingyishengzaishoushuqianzhunbeihaoshoushudebuzhou,zheshiyizhonghenhaodepeixunbanfa。
2、如何保持團隊的積極性?
Prof. Stief:zhegewentishiruheliuzhurencai,yaoliuzhurencaidehua,xuyaogentakaizhanduonianhezuo,zuizhongyaodeyidianjiushizunzhong,wozunzhongwodetongshi,zunzhongwodetongren,zunzhongshishuangxiangde。dier,chulezunzhonghaiyouzhongcheng。woduituanduizhongcheng,yexiwangtamentongyangduidaiwo。tuanduineibujianlixianghuzunzhonghexinren。disan,rangtamenchengdanzeren,ranhoujianzhayixiatamenshifouyouzheyangdezerengan,shifounenggouwanchengrenwu。disi,womenxiwangtamennenggoubuduandigaishan,qingchuyulanershengyulan,chaoyuewomen,nianqingdeyishengyingdangbiwogengyouxiu,birushuowunianzhihouchaoyuewo。
廖遠朋教授:對dui於yu保bao持chi團tuan隊dui的de積ji極ji性xing,每mei個ge人ren可ke能neng都dou有you自zi己ji的de觀guan點dian想xiang法fa。如ru果guo從cong一yi個ge醫yi院yuan管guan理li者zhe的de角jiao度du來lai講jiang,我wo個ge人ren覺jiao得de有you幾ji個ge關guan鍵jian詞ci。第di一yi,我wo覺jiao得de是shi信xin任ren。你ni要yao保bao持chi團tuan隊dui的de積ji極ji性xing,作zuo為wei管guan理li者zhe來lai說shuo,你ni要yao給gei他ta足zu夠gou的de信xin任ren。第di二er,就jiu是shi授shou權quan,你ni光guang相xiang信xin他ta不bu行xing,你ni還hai得de給gei他ta相xiang應ying的de權quan力li,讓rang他ta有you動dong力li去qu保bao持chi團tuan隊dui的de積ji極ji性xing。第di三san,就jiu是shi要yao設she置zhi,要yao從cong管guan理li者zhe的de角jiao度du,從cong醫yi院yuan的de層ceng麵mian設she立li恰qia當dang的de目mu標biao,以yi目mu標biao為wei導dao向xiang,讓rang他ta既ji能neng夠gou摸mo得de到dao,但dan是shi又you必bi須xu要yao跳tiao得de起qi來lai,他ta跳tiao起qi摸mo高gao才cai能neng摸mo得de到dao,這zhe樣yang能neng保bao持chi團tuan隊dui的de精jing神shen。第di四si,就jiu是shi恰qia當dang的de獎jiang懲cheng製zhi度du,設she立li恰qia當dang的de獎jiang和he懲cheng的de製zhi度du,來lai維wei係xi團tuan隊dui的de激ji情qing。最zui後hou,作zuo為wei醫yi院yuan的de管guan理li者zhe,還hai要yao挑tiao選xuan組zu建jian團tuan隊dui的de成cheng員yuan,尤you其qi是shi領ling袖xiu和he領ling導dao。
Prof. Stukenborg-Colsman:meigeyiyuandetuanduidouyouyidingdecengjiguanxi。zaideguo,womenxiwangjinkenengdebianpinghua,zheyangdehuazaituanduidangzhonghuigenggongping,womenxuyaoyoutuanduijingshen,tuanduidemeigechengyuandouxuyaoyizhongzijihenzhongyaodeganjiao。congjilidejiaodulaikan,womendaxueyiyuanyouyanjiuxiangmu,rangtamenyuelaiyueduodecanyudaozhexieyanjiuxiangmudangzhong,bangzhutamengerenchengchang,suizhelinchuangshuipingdetigao,chengweiyigegenghaodeyanjiuzhe,zuihaonenggougeitamenyixiedongli。wodechuzhongshisuoyoudetuanduichengyuanzuizhongdounengyousuochengchang。
林海斌教授:我wo認ren為wei人ren才cai是shi整zheng個ge醫yi院yuan發fa展zhan的de核he心xin資zi源yuan,也ye是shi第di一yi生sheng產chan力li。人ren才cai團tuan隊dui的de成cheng立li是shi推tui動dong學xue科ke建jian設she的de重zhong要yao支zhi撐cheng,是shi前qian進jin的de動dong力li。我wo覺jiao得de團tuan隊dui的de積ji極ji性xing跟gen學xue科ke帶dai頭tou人ren非fei常chang重zhong要yao,學xue科ke帶dai頭tou人ren要yao非fei常chang的de大da度du,而er且qie學xue科ke帶dai頭tou人ren要yao有you“傳幫帶”的精神,每個團隊成員都是核心人物。
Dr. Leidinger:chulezunzhonghezerenhezhongchengzhiwai,haiyoukezhurendezeren,tayingdangyishenzuoze,wodangshijiufeichangchongbaiwomendezhuzhiyisheng,worenweijinshijinriyeyiyang,yexubuxiangguoqudenamechangjian,danshixianzaihaishizhongyaode,jiushiniduizijisuozuodeshiqingchongmanjiqing,zaijiaoxuedeguochengdangzhong,haiyouduiyuyixuedezhiliang,zhiliaodezhiliang,zheyingdangshiyigekezhurendezeren。zaibuchongyidian,jiushituanduijianshedenuli,xianzaizhongyaoxingyeyuelaiyueda。chulegongzuozhiwai,dajiahaikeyiyiqicanjiajuhui,yiqichifan,buguanhebuhejiu,doushiyinggaichangjianmiande。duiyurencaidegerenfazhanlaishuo,nikeyirangtamenchuguocanjiayixiefangxuexiangmu。buguanshiguoneidehaishiguojidexiangmupeixun,zhexiedoushibiyaode。
未完待續……
第四屆中歐醫院管理學科建設人才培養全球論壇將於2024年10月在如夢如幻的中國蘇州盛大開幕。良辰美景奈何天,青山白水,後會有期。仁醫醫療就是兩個對等的靈魂。從無到有、從小到大、養大成人、健康成長。我們從脊柱外科到骨科再到醫院全部科室。我們鎖定目標、放眼全球、滿眼帶光、內外兼修、感召一切……
