This article was written by Origami
Don't want 198, don't want 88, just 1 yuan, you can hang the number of national experts and provincial experts?
Recently, the Second Hospital of Jida University has launched a "teaching clinic" for only 1 yuan, with a limit of 3 in one morning. When patients see a doctor, they are mainly faced with the students of the expert team, but in the end, the experts are the gatekeepers.
According to the staff of Jilin University, the teaching clinic was very popular as soon as it was implemented, and it was basically difficult to find the number one, and there were even local Internet celebrities who made an appointment to make a short video on Douyin (which was rejected and did not make the trip).
Looking at other provinces and cities, this kind of novel and special outpatient clinic has sprung up like mushrooms after a rain, and has gradually become a must-have new outpatient clinic for the top three.
Teaching clinic, is it really fragrant?
Teaching clinics, Concord has millions of flowers
Teaching outpatient clinic is a special form of medical outpatient clinic, which is different from traditional outpatient teaching and general outpatient clinic. In the teaching outpatient clinic, the inpatient doctor leads the reception process, while the instructor above the deputy chief physician is responsible for guidance and decision-making. This model allows young doctors to practice under the supervision of senior physicians while providing services to patients.
According to the Chinese Journal of Internal Medicine, the first hospital to open a teaching outpatient clinic is Peking Union Medical College Hospital, and in 2017, the Department of Internal Medicine of Peking Union Medical College Hospital returned to its previous tradition and developed a resident teaching outpatient clinic.
But for a long time, the popularity of teaching clinics was not high. What really found the teaching clinic was really fragrant was many dental hospitals. Three years ago, we wrote a small sample survey report on the opening of teaching clinics in West China Stomatological Hospital. It was found that for the Department of Stomatology, the teaching clinic seemed to be "tailor-made". (Click to view the previous content: 3 yuan can see a doctor in West China?) This wave of big threeers can't learn)
In the dental departments of many hospitals, it has become a tacit agreement that "spending hundreds of dollars to hang up the number of the specialist department, but in the end it is operated by students".
Teaching clinics can solve some of the nominal problems. The hospital has made a prior agreement with the patient by increasing the amount and reducing the price, and the patient can choose and trade in advance. High-level hospitals provide medical resources, but also allow their students to gain a lot of practical skills, reducing the risk of doctor-patient disputes.
In May 2023, the National Department of Medical Administration issued the "Theme Activity Plan for Improving the Feeling of Medical Treatment and Enhancing the Patient Experience (2023-2025)", which stated that medical institutions are encouraged to open new outpatient clinics such as anesthesia, pain, and health management to provide more abundant outpatient diagnosis and treatment services.
The State encourages the development of innovative outpatient models
Source: Health Commission website
With the right time and place, a large number of tertiary hospitals have opened teaching outpatient clinics one after another.
"Students sit in the clinic, teachers sit in the hospital" is gradually becoming the standard configuration of teaching outpatient clinics in many tertiary hospitals. Some hospitals also offer free registration or only charge for general outpatient visits, and even get on-site appointments for expert outpatient clinics, or preferential plus rights for the next visit.
Eat more than one fish: go to the teaching clinic and open the director's blind box
The Second Hospital of Jida is not the first to open a teaching clinic, and it will not be the last.
We have discussed the practical application of teaching clinics, and one of the most worrying points is the attitude of patients towards teaching clinics. (Click to view the previous content: 3 yuan can see a doctor in West China?) This wave of big threeers can't learn)
Whether it is in a conventional hospital or a teaching hospital, in fact, most patients have ambiguous attitudes towards clinical teaching in hospitals. Some patients think that they come to the hospital to simply "solve the problem" - they have to become a teaching material in the midst of illness, which is not acceptable to everyone. And that's perfectly reasonable.
However, with the popularization and increase of teaching clinics, and after several years of cognitive precipitation and the spread and fermentation of the Internet, patients' attitudes towards teaching clinics have begun to be stripped from the seriousness of hospitals and re-decomposed into a new cognition.
On the short video platform, there is a saying that is very hot, that is, "instead of trying hard to grab the expert director's number, it is better to lie down and go to the general outpatient clinic". If you see a minor illness, the main treatment of a tertiary hospital can also be treated; If it is a serious illness, the attending person is likely to shake people and shake some mysterious bosses to take action.
"Go to the teaching clinic and open the director's blind box." This kind of experience is similar to meeting a sweeping monk when he first entered the Shaolin Temple, and is often spread and shared on various short video platforms.
The establishment of the teaching clinic is a new type of guaranteed blind box for patients who are now high-intensity surfers. After all, the attending doctor may still be lazy and not draw cards from the pool of experts, but the teaching clinic is officially designated as having a "guaranteed SSR".
Source: Screenshot of social platforms
A blogger who posted a popular plog of the teaching clinic said that the teaching clinic is a rare fantastic adventure on the Internet, and "I even received a thank you from the publicity department of the hospital."
Eat more than one fish, and the hospital will "win hemp" again.
Delicate but inedible flowers, it takes time to feed back into the clinic
So, do the doctors who really need to teach outpatient problem-solving win?
Medicine, a highly practical discipline, must be passed on through clinical teaching. For doctors who are not yet in charge of their own work, the teaching clinic is undoubtedly an excellent opportunity for outpatient training.
However, in terms of the current situation, the teaching clinic is more like a delicate and beautiful orchid for clinical education, rather than a big potato that can be eaten and filled.
First of all, the number of teaching clinics is really small.
No matter which tertiary hospital it is, the number of teaching outpatient clinics has not been expanded. Tang Feng (pseudonym), a doctor at a tertiary hospital in Zhejiang, said that for them, the teaching clinic is not like a normal exercise, but more like an elusive exam. After teaching the outpatient clinic, the director's comments will be recorded accordingly, but each director's diagnosis and treatment ideas are different, and they may just have a comprehension before they end."
Secondly, the teaching clinic is not suitable for all departments at present.
Wang Erli (pseudonym), an administrator of a tertiary hospital in Guangzhou, once conducted research in a tertiary hospital that was a small fire for teaching outpatient clinics. The other party believes that the consultation time of teaching outpatient clinics is generally longer and more detailed, and patients and doctors need a certain amount of patience and empathy, so general practice outpatient clinics and some pediatric outpatient clinics are a better experimental site.
Yu Simiao (pseudonym), chief physician of the obstetrics and gynecology department of a tertiary hospital in Jiangsu, also gave the same view. Yu Simiao's hospital first discussed opening a part of the teaching clinic in the gynecology department, and she had a strong objection, "The number of gynecology outpatient clinics is very large, and the teaching is basically completed in practice, I don't think there is a need to spend so much manpower and material resources to build a new so-called outpatient clinic, but waste time."
In addition, compared with normal outpatient clinics, patients' expectations of teaching outpatient clinics are disappointed, which in turn affects their trust in clinical practice.
On social media, some patients posted "lightning protection stickers" for teaching outpatient clinics, because their actual experience may be that regular doctors or young doctors are leading the diagnosis and treatment throughout the whole process, and the participation of the big names in the real expectations is not so deep, "or even disappears directly."
According to Wang Erli's analysis, there are two possible reasons for this situation, one is that the teaching clinic is not a stable consultation mode at present, "whether we should pay attention to teaching or diagnosis, there is no clear understanding at present." Another reason is that patients' perception of teaching clinics is affected by publicity, "Many patients are attracted by the publicity model of spending a small amount of money to find a director. There are some more extreme patients who come in and say, I just want the director to speak, and the young people don't talk."
Resources:
1、https://rs.yiigle.com/cmaid/1022016
2、https://www.gov.cn/zhengce/zhengceku/202305/content_6883385.htm