Posted by My American pediatrician friend went to China to visit, and he often saw that children with colds were to be treated with antibiotics and suspension liquids, but he didn't understand it very much.Because according to the textbook, the pre-cold is caused by a virus, and the main symptomatic treatment is to treat cough, runny nose, fever or headache.A small number of children entering the late stage of a cold, combined with bacterial infections, yellow sputum and fever, need antibiotic treatment, and children who cannot eat only need suspension liquid.
In the United States, medicine is separate.When you buy medicine, you buy it at a pharmacy, and the pharmacy is attached to some stores (such as Wal-Mart, CVS, Walgreen).Therefore, the doctor will not benefit him at all by prescribing more medicine, but he is responsible for taking the wrong medicine, so under normal circumstances, you will not take the medicine you don't need.
In the education of American doctors, two points are emphasized from beginning to end:Where to ask in advance is the easiest and cheapest.When prescribing the cheapest medicine, you should think of the cheapest test when you prescribe the checklist.It is the easiest and cheapest to do a physical examination of the patient by hand, and it must be done first at all times.Do the simplest and cheapest first, and then consider using the complex and most expensive.
I have a patient with breast nodules. She was in mainland China. When seeing a doctor, the doctor advised her to have an operation.She called me at that time.She was worried because a friend of fibroids recurred after the operation.It has been opened 3 times so far.Ask me what to do.Will it recur if I have the surgery myself?If you do not operate, you are afraid that it will get worse and increase your breast cancer risk.
I said that breast nodules are not as serious as fibroids.But I suggest that she first go find out if there are any Taiwanese breast creams in the mainland, and massage first.In the end, she bought it on Taobao, and the nodule disappeared after a month. Fortunately, there was no surgery.
After that, another friend of her fibroids used the breast cream and continued to massage for 6 months, and the fibroids gradually disappeared.Of course I am not saying that the operation is incorrect.However, the doctor should know the recurrence rate of surgery best. . . .
The highest principle of Western medicine is no harm (no additional harm caused by treatment).Therefore, American doctors will teach you health care methods.
For example, if you have joint pain, the doctor will ask you to exercise, your lobular hyperplasia and breast hyperplasia will teach you how to massage with breast cream. If you have bad teeth, he will teach you how to floss and rinse your mouth after meals.
In short, doctors always prioritize methods that do no harm.Instead of taking medicine to solve it, he hopes to make you change in your lifestyle.This kind of doctor-patient relationship is more comprehensive. He is responsible for your health, and medicine is just one part of it.Therefore, there are medical care, health care in English, among which care and protection, "care" is an important part.
But in China, there is a very strange phenomenon.A white friend of mine works in Beijing. He told me that he is often questioned by Chinese patients: Doctor, why don't you dispense me medicine?He said, I don't think you need to prescribe medicine in your case. . .Many patients in mainland China feel that the doctors did not prescribe medicines for them because they did not pay enough attention to their illnesses.This is a complete misunderstanding.
For American patients, you can ask doctors in Western California for the same medical question, or doctors in Eastern New York, or doctors in the city or doctors in the country.The answer is exactly the same.
In the United States, there is no need for patients to see a second doctor for the same disease. The paid medical insurance industry would consider this a waste.There is no "expert clinic" in the United States, because the level of attending physicians is the same, and the level of young and old is the same. (Young doctors’ knowledge will be newer.) There is no reason to pay more to see old doctors.
For example, American mothers take their children to see a doctor.
She came to the pediatrician first. This pediatrician is the first-line doctor in pediatrics.The pediatrician diagnosed a muscular (atrophy) weakness and referred to a neurologist.This is a second-line doctor, also called a specialist.The neurologist also diagnosed myasthenia.
The mother did not give up and would take the child to see a second neurologist.The second one said that the diagnosis and treatment of the first neurologist was completely correct, and you don’t need to come to me again.No need to find other doctors.
The punishment for misdiagnosis and mistreatment of doctors is a curse on American doctors.The elite doctors are well aware that their social status and financial income are hard-won, and they all cherish their professional reputation very much, work diligently and cautiously, otherwise, once an accident occurs, the social status is gone, the economic income is gone, and the future is gone. . .Moreover, it is illegal for doctors to take rebates in the United States, and their license will be revoked.
In other words, American doctors have a strong sense of responsibility.In the United States, occasional medical accidents are basically technical accidents, and liability accidents are rarely encountered.
The definition of misdiagnosis and mistreatment is that the following two situations must exist at the same time:One is that doctors have adopted methods other than textbooks, or unusual methods; the other is that this unusual method has produced undesirable consequences.
Because the process of judging misdiagnosis and mistreatment is a lawsuit, American doctors are afraid to avoid it, so everyone strictly abides by the textbook regulations and does not go beyond the thunder pool.On the other hand,Everyone will follow one or two textbooks and go to see a doctor, and the process will be very similar.
All important and changing medical documents in the world today are written in English.In the era of knowledge economy, the English ability of an intellectual in a non-English speaking country is a manifestation of national power.If you can't speak or listen to English with them, this world family will treat you as an outsider.One of my patients came back from Taiwan and brought the MRI report of the General Hospital of Taiwan's Armed Forces. It was written in English, and it was not translated specifically for patients like Beijing and Shanghai.
In Western countries, if a new medical technology is considered mature, from a national perspective, it must meet two conditions:
1. Train enough doctors to be able to operate the same technology to meet the needs of patients across the country;
2. Every patient who needs this technical help in any part of the country can get this help of the same quality.
If an advanced medical technology can only be used by some people (unless it is an organ transplant, the shortage of donors can only be used by some patients), then the government and all the people will yell together.
For example, the American health insurance company has set up three lines of defense in order to save money on MRI (one examination costs 1000 to 1500 US dollars).First, the doctor must write an application, and the medical insurance company will reject it. Second, it will cost the patient 80 US dollars to take an X-ray.If X-rays can solve the problem, there is no need for MRI; the third trick is the most effective, if the clinical judgment is that the neck, waist, shoulders and knees do not need to be operated immediately, the medical insurance company requires the doctor to treat it for one month.
Because most of the patients are not serious and will not come after one or two weeks of treatment, the medical insurance company saves the MRI money.A few years later, the American health insurance company reduced the cost of nuclear magnetic resonance from $1000 to $500.
I have been a research doctor in the United States for 18 years.In addition to observing the medical system in the United States, there are also opportunities to talk to doctors in Britain, Germany, Japan, Sweden, India, Pakistan, South Korea, Singapore, the Philippines, Taiwan and Hong Kong to learn about their medical conditions.I also talked with Bangladeshi and Malaysians.
The general concept is:
In the United States, the government focuses on the affairs of the poor.Theoretically speaking, in American society, no matter what kind of medical insurance (poor or rich) you use to see a doctor, the quality of medical services received by patients is the same.
To sum up, the money of the poor in the United States comes from:
1. National taxpayer's money
2. The medical and pharmaceutical industries directly served
3. Private donations
Seeing a doctor is the most important aspect of people's livelihood besides food and housing.Moreover, because seeing a doctor and seeking medical treatment involves family affection and the separation of relatives, poor handling can easily cause emotional and over-reaction of the person concerned, which will lead to social unrest.Having lived in the United States for many years, I admire the American medical system very much.In fact, behind these problems are extremely complex social issues, so I can only talk about my feelings.
