Pediatricians revenue loss of less than half sibling level base rate 30% | _ Pediatrics news
Original title: pediatrician sibling average income less than half
Diagram Said shortage of pediatricians, but no one really large sample surveys.
March 4 and 7th National People′s Congress, the Chinese Academy of engineering, Director of the State Key Laboratory for respiratory disease in Guangzhou Zhong introduced during an interview with the South, led the Pediatric branch of Chinese Medical Association did a study showed that pediatricians turnover reached 11%.
South reporter an exclusive interview to the report drafting Pediatric branch of the Chinese Medical Association, Deputy Chairman of the Pediatric branch of Chinese Medical Association President, President of the Xinhua hospital affiliated to medical school of Shanghai Jiao Tong University Sun Kun. Sun Kun introduced the report last year, spontaneous led by the Pediatric branch of Chinese Medical Association, recently released an interim report.
14 provincial Pediatric Emergency Department
Up to 250 million passengers a year
Last year, the Chinese society of Pediatric branch and of the Pediatric branch of Chinese Medical Association started spontaneously Pediatric resources investigation in China, the Government does not invest. Sun Kun introduced the survey across the country′s 32 provinces 14,120 medical units at all levels (private hospital) more comprehensive pediatric resources investigation in China. Up to now, the complete 11,523 hospitals to complete the rate 82%. Now released an interim report is only the first-stage Pediatric related establishment surveys have been completed and two quality control data for statistical analysis of the 14 provinces.
At present, 14 pediatric medical institutions survey found that the overall situation in the province, Pediatrics is in big demand. Pediatric annual emergency room visits up 2.500 million passengers, and mainly focuses on General Hospital, 42%, grass-roots medical institutions 35%, MCH, 13% 1% of maternal and child health, children′s Hospital 9%.
Grass-roots hospital
Physician turnover rate of 30%
In the 14 provinces, has a full-time pediatrician 58582 people altogether, Super 40% per cent General Hospital pediatrician. Cultivation of Pediatricians must be resolved. Sun Kun introduced, no titles and titles of the primary physician is the major group of pediatricians, accounting for 46%, senior physician 20.9%, intermediate title physician 33.1%.
Based on an analysis of these data, said Sun Kun, the interim report is obtained, a number of conclusions.
First, the high turnover rate of nearly three years, 14 pediatricians, up to 11% in General, 6,531 pediatricians loss. Maximum percentage loss in primary hospitals, the loss rate of 32%.
Loss of the pediatrician had some characteristics. First, the doctor is the loss of these young doctors. Among young people less than 35 years, loss of more than 14 people out of every 100, and many smaller losses. Second, the undergraduate level paediatric high physician turnover and is inversely proportional to the wastage rate of doctors with grade level, titles, the lower the turnover rate is higher.
Pediatricians income levels
Significantly lower than clinical averages
Sun Kun introduced, according to the survey, pediatricians in general income levels significantly lower than clinical averages, general hospitals, maternal and child institutions and grass-roots medical institutions in paediatric clinical physician income is about the same level of 42%-51%. District pediatrician load is greater than that of medical institutions above the county level primary care doctors.
Sun Kun fully appreciates the difficulties of pediatricians. Department of Pediatrics called dumb, diagnosis is difficult. Adults, less weight, and fewer checks and routine physical examination, venous puncture sampling and imaging diagnosis and treatment of almost all projects such as time-consuming, checking is inefficient. Pediatricians than clinicians at the same level of income average of 1/2.
Countermeasure and suggestion
1 recovery paediatric admissions should be planning
At present States have started to restore Department of Pediatrics enrolled undergraduate medical. Sun Kun also served as Director of the Shanghai Jiao Tong University School of Medicine Department of Pediatrics. Sun Kun said, the school in the country in 2012 the first restoration of paediatric admissions.
"Despite the three-year planning to accompany and three years of specialist training plus College five years a total of 11 years, I retired before they could actually do the pediatrician, but for the future, it is worth doing. "Sun Kun fingers is not worried. But Sun Kun does not recommend that national did not rush headlong into mass action campaign planning and recruitment, or when excess Department of Pediatric training, these students due to the special courses cannot be transferred into the family doctor.
2 improving health-care inputs and treatment
The pediatrician "incremental" still takes a long time. So Sun Kun believes that needs to be done "stock" protection and optimization.
For a less stressful situation, Sun Kun recommends that the return value of pediatrician of Labor: on the premise of Medicare patients with inputs to ensure families were not to increase spending, raise the price of children′s clinic for 0-16 30%. Since the current public hospital compensation mechanism is not perfect, for Pediatric acute shortage of compensation, increased attention to public hospitals within the Pediatric Clinic price new and expanded. While seeking to pay special allowances to pediatricians.
3 physicians turned to pediatricians should have access
Restoring paediatric admissions have a matter after the pediatrician is recovering Pediatrics directory of career development prospects, particularly in recovery within the framework of the National Science Foundation Research Fund Pediatric single row (1998 abolished), of adults because children are not reduced.
"Pediatric practitioner examinations Pediatric single row, rather than fail in addition Pediatrics or were misunderstood pediatricians are failing. "Sun Kun said the physician isn′t transferred to Pediatrics, physician transfer trade associations must be responsible for training, examination and admission.
Visit
Shenzhen children′s Hospital: fever emergency room wait team
"Line 5 hours after registration, missing doctor. "The day before the South reporter visited the Shenzhen children′s Hospital, from daytime to night fever parents anxiously waiting in line to see a doctor, even children with fever above 39 c to register for emergency treatment, was also told to take first blood," because of the emergency, with 42 people waiting in line. ”
Shortage of pediatricians, is very prominent in the Shenzhen children′s Hospital from 2011 to 2015, there are 36 doctors and 139 of the hospital nurses to resign. Shen Yang Chuanzhong, Director of the maternal and child health hospital neonatal section introduction, State regulations, doctors an hour about 6 patients, but pediatricians are often an hour to ten or twenty evening emergency pediatrician a night after hundreds of children.
At 18 o′clock the day before yesterday, the South reporter came to Shenzhen children′s Hospital saw Hall on the first floor of the reservation ticket, registered at the crowded, four Windows full of all parents and children standing in line, almost every window has a long line of more than 10 people. Is also located in the first floor of the emergency room waiting area, waiting area for almost 50 seats have been filled with people.
Ten parents in the South reporter asked at random, were rushed to the hospital immediately because the child had a high fever, but I didn′t know came to the hospital, they face another long wait. Emergency triage of emergency department waiting area, which has been surrounded by a group of parents, people keep asking "when will it be my turn to look at the child? "The nurse said it could not answer the correct time, she arranged for the sick child to register as soon as possible, blood pressure.
South reporter to the duty officer of the emergency triage of inquiries line, get the reply is, "emergency, with 42 people waiting in line, most conservative take 2 hours of waiting time." Reporters then went to the emergency room on the first floor, also stood in the aisle waiting for parent and child, the baby is crying and high fever.
In Office, No. 03, a lady surnamed high with 2-year-olds are seeing a doctor in her arms. High requirements of the proposed arrangements for hospitalization, doctors answer residential places had run out for the day, have to stay in hospital until tomorrow now, "fever to hospital with more than 100 more every day, and are in the hospital, beds are also not enough, Ah! ”
Responsible editor: Zhao Jiaming SN146
Article keywords: Pediatrics
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儿科医师收入不及同级水平一半 基层流失率三成|儿科_新闻资讯
原标题：儿科医师收入不及同级平均水平一半
图示 都说儿科医生紧缺，不过没有人真正做过大样本的调查。
3月4日和7日，全国人大代表、中国工程院院士、广州呼吸疾病国家重点实验室主任钟南山在接受南都记者采访时介绍，中华医学会儿科分会牵头做的一项研究表明，儿科医生流失率达到了11%。
南都记者独家采访到了报告起草者、中华医学会儿科分会副主任委员、中国医师协会儿科分会会长、上海交通大学医学院附属新华医院院长孙锟。孙锟介绍，这份报告历时一年，由中华医学会儿科分会自发牵头开展，近日出炉了中期报告。
14省儿科门急诊
达每年2.5亿人次
去年，中华医学会儿科分会及中国医师协会儿科分会自发启动开展的中国儿科资源调查，政府没有投入经费。孙锟介绍，本次调查为覆盖全国32个省份的14120家各级医疗单位（含民营医院）的比较全面的中国儿科资源的调查。截至目前，完成11523家医院，完成率82%。目前出炉了中期报告仅采用第一阶段儿科相关机构调查已经完成并经过两次质控的14个省份的数据进行统计分析。
目前，14省的儿科医疗机构调查总体情况发现，儿科的需求很大。儿科年门急诊量可达2 .5亿人次，且主要集中在综合性医院，占42%，基层医疗机构占35%，妇幼保健院占13%，妇幼保健所占1%，儿童专科医院9%。
基层医院儿科
医师流失率超三成
在这14个省，一共有专职儿科医师总计58582人，综合医院儿科医生占比超四成。儿科医生的培育亟待解决。孙锟介绍，无职称和初级职称的医师是儿科医师的主要群体，占总体的46%，而高级职称医师占20.9%，中级职称医师占33.1%。
根据对这些一手数据的分析，孙锟表示，中期报告初步得出了一些结论。
首先，近三年14省儿科医师流失率高，可达总体的11%，6531名儿科医师流失。基层医院流失百分比最大，流失率达32%。
这些儿科医生流失出现了一些特点。第一，这些流失的医生大多都是年轻的医生。在小于35岁的青年医生中，每100人中会有超过14人流失，并且年龄越小流失人数越多。第二，本科以下层次儿科医师流失率较高；而且医师的流失率与职称高低成反比，职称越低，流失率越高。
儿科医师收入水平
显著低于临床平均水平
孙锟介绍，根据调查显示，总体的儿科医师收入水平显著低于临床平均水平，综合性医院、妇幼机构和基层医疗机构的儿科医生的收入大约是同级别临床医师的42%—51%。区县级以上医疗机构儿科医师负荷明显大于基层医师。
孙锟非常明白儿科医生面临的困境。儿科被称为哑科，诊疗难度大。相对成人而言，用药量少，检查也少，并且常规体检、静脉穿刺取样、影像检查等几乎所有的诊疗项目费时耗力，检查效率低下。儿科医师收入不及同级别临床医师平均水平的1/2。
对策与建议
1 恢复儿科招生应有规划
目前国家已经启动恢复儿科系招收本科医生。孙锟同时还担任上海交大医学院儿科学系的主任。孙锟说，该校2012年在全国最先恢复儿科方向招生。
“尽管由于三年规陪及三年专科医师培养加上本科五年共11年，等我退休了他们还没真正做儿科医生，但是为了未来，值得去做。”孙锟掐指一算，不免担忧。不过孙锟并不建议全国一哄而起大规模运动式地没有规划地招生，否则，到时候出现儿科系培养过剩，这些学生由于课程设置特殊性无法转岗做成人科医生。
2 提高医保投入和诊疗费用
儿科医生“增量”的到来还需要很长时间。所以孙锟认为，先要做好“存量”的保护与优化。
针对钱少压力大的现状，孙锟建议回归儿科医生劳动应有的价值：在医保投入保证患者家属不增加支出的前提下，采取提高0-16岁儿童诊疗价格30%。因为目前公立医院补偿机制不完善，给儿科的补偿严重不足，因此诊疗价格的提高有利于公立医院重视内部儿科新建和扩大。同时争取给予儿科医生特殊津贴。
3 内科医生转行当儿科医生应有准入制
在恢复儿科招生后还有一件事关儿科医生事业发展前景的是恢复儿科目录，尤其是在国家自然科学基金等科研基金的架构中恢复儿科单列（1998年起取消的），因为儿童不是缩小的成人。
“儿科执业医师考试儿科单列，而不是考不及格加考儿科，否则给人误解儿科医生都是不及格生。”孙锟表示，内科医生转岗到儿科不是不可以，但是内科医生的转岗必须由行业协会负责培训，考试并准入。
走访
深圳儿童医院：发高烧看急诊也要排长队
“挂号后排队5个小时，还没看上医生。”前日南都记者走访深圳市儿童医院，发现从白天到深夜都是发烧孩子的家长在焦急地排队等待看医生，甚至有发高烧39℃以上的孩子想要挂急诊，也被告知需要先量血压，“因为前面急诊号已经有42人在排队。”
儿科医生紧缺，在深圳市儿童医院表现得十分突出，2011年到2015年，该院共有36名医师及139名护士辞职。而深圳市妇幼保健院新生儿科主任杨传忠介绍，国家规定，医生一个小时大概看6个病人，但儿科医生往往一个小时要看一二十个；晚上急诊，儿科医生一晚上要看上百个孩子。
前日18时，南都记者来到了深圳市儿童医院，只见一楼大厅的预约取号、挂号处人头攒动，四个窗口前满满当当的都是排队的家长和孩子，每个窗口前几乎都有十几人的长队。而同样位于一楼的急诊候诊区，等候区域将近50个座位已经坐满了人。
南都记者随机询问的近十位家长，都是因为孩子高烧立刻赶往医院的，但没想到来到医院后，他们面对的是另一场漫长的等待。急诊候诊区的急诊预检分诊台，已经被一群家长团团围住，不断有人询问“什么时候能轮到我的孩子看病？”值班护士表示无法回答准确的时间，她只能尽快为生病的孩子们安排挂号、量血压。
南都记者向急诊预检分诊台的值班人员询问排队情况，得到的回复是，“急诊号已经有42人在排队，最保守也要2小时的等候时间”。记者随后来到一楼的急诊室，走道里同样站着等待的家长和孩子，且有高烧的婴儿正在放声大哭。
在03号诊室中，一位姓高的女士怀里抱着2岁的孩子正在就诊。高女士提出安排住院的要求时，医生答复当天的住院名额已经用完，要住院也得等到明天，“现在每天发高烧来医院的孩子有100多个，都住院的话，病床也不够用啊！”
责任编辑：赵家明 SN146
文章关键词： 儿科
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