Recently, the medical profession has made such a sound:In order to be promoted, hospitals tend to give priority to first-line medical care against epidemic diseases, but this team is too large. Therefore, without first-line medical care for various reasons, promotion is basically hopeless and in the foreseeable future.
Everyone’s spit is concentrated in two aspects:
First, there are differences on the definition of front-line personnel.Some people did not enter the isolation ward, but they also treated patients in clinical departments, and lacked protective clothing and other equipment. At the worst of the epidemic, their danger was not lower than that of the isolation ward, so they trembled and took the initiative to isolate their families, but they were not included in the first-line file. In fact, the isolation ward was even considered as the safest department in the hospital at a certain time, and the protector won the world.
Second, there are many medical staff in hospitals all over the country actively signing up for the first line, and the reserve echelon is large enough.However, China’s anti-epidemic effect was so high that many medical workers did not wait for the opportunity to go to the front line, and the epidemic ended. The results show that tens of thousands of medical staff in Fangcang Hospital have zero infection and are relatively safe, and the aid workers in Hubei have received not bad rewards both mentally and materially, and now they enjoy preferential treatment in promotion, further crowding out the opportunities of non-frontline personnel.Not only a little worried, is it really reasonable to give priority to the promotion of doctors in the front line of anti-epidemic?
And recently"Abolish the deputy chief physician and chief physician, and abolish the doctor promotion system!"The voice is high.
Xu Yonggang, a magic dentist, thinks:
The evaluation mechanism for promotion to full and deputy titles has always been only scientific research, papers and patents as important indicators, and at the same time, it has created the largest academic misconduct groups and individuals in the world and the most intensive academic industry chain.
It can’t be said that all patents of medical research papers are false, and there are outstanding people in any industry who lead the development of medicine, but there are too few. The vast majority of medical scientific research, whether self-written or plagiarized, takes promotion as the original intention. From project establishment to research, it has neither clinical practical significance nor promotion prospect, but basically it will produce "achievements" and eventually be labeled as "domestic leading level" or "domestic advanced level", which also gives medical staff a relatively objective understanding of the domestic level of China medicine, and medical staff are tacitly aware of this.
This year, the promotion evaluation mechanism of many hospitals has been changed, which has reduced the proportion of scientific research papers in principle, and increased clinical medical records, personal performance, social evaluation, patient satisfaction and so on under the premise of giving priority to the first line of anti-epidemic, which has strong flexibility in the implementation process due to the lack of focus and quantitative indicators.
Starting from the essence of medical treatment,The most reliable evaluation should be patient satisfaction, which can truly reflect the doctor’s skill and service level, but because this index is more difficult to quantify,The space for fraud can even exceed that of scientific research papers, so it can’t be referenced in the evaluation, which is a serious injury.
Both the old standards and the new evaluation standards have disadvantages objectively, and this promotion system has done great harm to the medical industry.
First, it destroyed the relationship between cadres and the masses.The leaders of all hospitals have repeatedly optimized the evaluation criteria in order to be fair and just as far as possible, but they still can’t satisfy all the medical staff, and the spearhead and pressure are pushed to the leadership and personnel departments.
Second, destroy the relationship between colleagues.In order to compete for the quota, all means are used, and the surface is calm, but in fact it is undercurrent.
Third, destroy the relationship between superiors and subordinates.The director of the department has to make a difficult balance between adjusting the work of the promoted person and maintaining the operation of the department, which is easy to lose sight of one thing and lead to a stiff relationship.
This system affects not only the interests of doctors, but also the interests of patients.If doctors can’t concentrate on treating diseases and saving lives, but they spend their time catering to policies, practicing fraud and speculating, cheating on each other and so on, it will mean disaster for patients.
The basis of the promotion of professional titles is to control the proportion of posts.
However, controlling the proportion of posts cannot maintain the old, middle-aged and young structure of hospitals and the construction of talent echelon! The common dilemma of hospitals is:More and more senior doctors are getting together and retiring slowly, and fewer and fewer new recruits are leaving, resulting in high resignation rate, resulting in tension in senior positions.The solution should be to introduce more new people to expand the denominator, not to reduce the numerator.
Since there are so many disadvantages, why must we control our posts? There seems to be only one answer left,Control wage file. Every time you add one more post, you will increase your expenditure, and you will get a higher salary after retirement.
howeverObviously, the salary of medical staff should not be controlled.And this year’s medical reform and rectification, especially the space for medical equipment rebates has basically been eliminated.
In fact, many doctors are looking forward to this day. Everyone hopes to have a reasonable sunshine income and use wages to reflect the value of labor. After the epidemic, most hospitals have reduced their financial performance and their income is directly based on wages. However, wages have not been raised accordingly.
Under such circumstances, it is necessary to raise wages reasonably.
It is the most realistic, feasible and least costly scheme to abolish the senior post system and automatically raise the salary scale according to the qualifications of medical staff. On the one hand, it can stabilize the medical team and mood, on the other hand, it can let young doctors see the prospects, reduce turnover and establish a lasting sense of professional belonging.
Then, once you get rid of the pressure of promotion, will it make doctors lose their goals, muddle along their qualifications, lack the motivation of scientific research and innovation and be mediocre?
He believes that not only will it not, but it will make it easier for outstanding talents to produce results, becauseScientific research that does not aim at promotion will be more pure, scientific research projects will be sharply reduced to fine, but investment will be saved, and the survival of the fittest will play the self-purification function of the industry.
If the rules are abolished and the promotion system is abolished, it is conservatively predicted that more than 95% of medical research, papers and patents in China will disappear completely, which will inevitably lead to the instantaneous collapse of that huge industrial chain, and the interest chain involved is complicated, and the vested interests have the right to make rules, which is a game in another dimension.
People in the medical profession express their views:
@ Chunqiu:Although this proposal is good, it is not realistic. If we just cancel the deputy director and the chief physician. Then it is not good for most departments and doctors. You can modify the evaluation and assessment system. However, without such classification, just one night shift and duty will affect the normal operation of a department. Personally, I think our current assessment system has not adapted to the development of the hospital now, nor can it reflect the ability and dedication of doctors. We all say that a department depends on the efforts of the whole team. However, it cannot be denied that sometimes having a master in a department will improve the influence of the department, but the income and honor won by a master in technology are not the most.
@ Cloud light and wind light:Resolutely supporting the cancellation of the so-called evaluation of sub-high and regular high professional titles is meaningless, but it wastes doctors’ time to concentrate on their work. Some people are busy with the promotion of professional titles every year, some are busy with hospital interpersonal relationships, and some are busy writing so-called papers that are not practical, which wastes manpower and material resources and has no meaning at all. I hope to cancel it as soon as possible so that doctors can do their work wholeheartedly.
@NATURE：If there is no benchmark to eat from the same pot, who will do scientific research? Anyone can learn clinical skills in three months, and it is really difficult to do scientific research without getting started for three years. If you don’t ask for it, then no one will do scientific research, and the country’s scientific and technological development will soon go backwards. The disadvantages of big pot rice appeared decades ago. Needless to say, all walks of life must be divided into levels in order to develop healthily. As for the evaluation of professional titles, SCI is still the most fair evaluation index at present, and people have to have pressure to have the motivation to go up. However, in view of the serious fraud at present, the effective way is to strictly investigate and control, and not to engage in administrative management, but to be an expert. The implementation of the representative system is to try to avoid making up the numbers with low scores, recommend those who make good ones and make high ones, and gradually improve the current disadvantages.
@ Dr. Huang Dentistry:This is just like the college entrance examination. Although people say that the college entrance examination is unfair every year, there is a college entrance examination every year because it is the best platform under the current conditions. The current rating method is the same. As long as you can find a more reasonable and beneficial evaluation method, you can definitely replace it. The key is that there is no …
@ Chen Gongjian:In fact, as a doctor, the most important responsibility is to cure diseases, so all medical-related evaluations should be based on the efficiency of treatment! The cure rate was the core of the medical system in Song Dynasty. In modern society, the main body of evaluating the therapeutic effectiveness of diseases is physical and chemical indicators, in fact, the improvement ratio of patients’ subjective symptoms should also be added. In addition, the incidence of related diseases, long-term recurrence rate, etc. should be weighted in proportion. But in this way, how many medical staff who are now in high positions can still have the face to continue saying: I am a doctor? ! As for other derivative fields such as papers, it is enough to set attractive special awards.
@ 中中中:Most of those who say that they want to abolish it are blind to the eye. People in any industry should be graded to distinguish the good from the bad. The professional title evaluation system formed over the years has contributed a lot to distinguishing talents, and has also formed many recognized talent evaluation standards, such as academic qualifications "Promotion with relevant educational experience", such as working years "Promotion with sufficient work experience", such as inter-provincial evaluation "Try to eliminate human feelings evaluation". For example, the professional business exam "Must be qualified for professional knowledge and clinical skills".
@ 味味:The wage system in China is too complicated, which is neither scientific nor reasonable. The salary items are full and the salary amount is very skinny. It is better to learn from the west and implement the annual salary system! The unfair distribution of bonuses and coefficients has been eliminated. I have been an attending physician for 20 years, and I don’t feel too excited to be promoted to higher vocational colleges. Apart from not publishing papers in journals, I have also written papers that have not been published. Although I have received many invitations to write and send, I have not stepped out of this step. I wrote a lot of popular science articles, and I also sent some in WeChat official account, with a total reading of tens of thousands. I think that if the paper is too utilitarian just for the title, it is better to write some popular science articles. In fact, many promotions are just for that benefit, to get more money, and there is only a hollow reputation. Maybe I won’t be promoted to higher vocational education before I retire, but I don’t regret it, just a little regret. At the thought of the patient’s trust and satisfaction, I still feel a lot of comfort and satisfaction when I see the red banner.
What do you think of "abolishing the deputy chief physician and the chief physician, and abolishing the doctor promotion system!" What about the advice?
