深化医改必须走出唯临床怪圈.PDFVIP

Negative Vol.6 No.5 2015 DOI:10.13276/j.issn.1674-8913.2015.05.004 深化医改必须走出“唯临床”怪圈 吴秋芳 （湖北省监利县第二人民医院，湖北 监利 433325） Deepening medical reform must be free from the eccentric view that only clinic comes first WU Qiu-Fang Second People’s Hospital of Jianli County, Jianli 433325, China Abstract The hospital administration mode that only clinic comes first has been the big barrier to the new round 【 】 of medical reform. The adverse effects have been showed in the following five aspects: ① it encourages the evil trend of over-treatment in clinic; ② it speeds up the excessive hospital expansion for rapidly gathering medical resources; ③ it makes doctors exhausted for work overload; ④ it weakens doctors’ faith of pursuing excellence; ⑤ it spawns academic misconducts. To break away from the “only clinic” view, we must make an effort in the following four points: ① guide doctors’ rational medical behaviors from the perspective of philosophy; ② renew the thoughts of health care investment in a pragmatic way; ③ improve the three-grade hospital network and shift the emphasis of health care service on the basic hospitals of the network; ④ strengthen the laws and rules to control and prevent excessive medical treatment. Keywords clinical management mode; only clinic comes first; harm; medical reform 【 】 【摘 要】 “唯临床”的医院管理模式己经成为了新一轮医改的拦路虎，主要表现为：①助长过度医疗之风；② 为争夺资源促使医院快速扩张 ；③因“过劳”拖跨医生身体；④淡化医生追求卓越的信念；⑤“唯临床”也是学 术不端的推手。只有在以下方面下功夫，才能走出“唯临床”怪圈：①从哲学层面倡导医生理性行医；② 从务实 角度更新卫生事业投入思路；③健全三级医疗网络，把医疗服务的重心沉在网底 ；④完善法律法规，筑牢管控过 度医疗的防火墙。 【关键词】 临床管理模式；唯临床；危害；医改 【中图号】R-197 【文献标识码】 A 我国自2009年吹响第二波医改的号角以来，医改