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美国医生该对中国医生说什么?-3 2013-05-21 10:53:35

此行第二项任务是在边远山区举行村医培训,益发使人对国内情况感慨万千。

一位美国UC的心脏医生远赴中国,在云南农村筛查先心病已经7年。5年前听说他的故事我觉得这是一位活生生的白求恩,立刻参与协助。云南农村高血压发病率出奇的高,而高血压的诊断治疗相对容易便宜,实际上却几乎无人问津,直到出现后期并发症。每个村寨都有村医,而且如今村医不再赤脚,都有学历工资,还有政府颁发的村医执照。

我认为缺乏防治是因为对高血压认识不足,另外就是文化传统,有“病”才看医生,而高血压早期无症状。据此,我在美國申请了专门基金外加自己出钱,将白求恩的事业扩大到成人,举办村医培训。培训目的简单明确,高血压是病,应该治,容易治,早治可以免发并发症。

我以为这是项造福人类的大好事,而且目标不高,应该从此彻底改变边远山区医疗状态的一个重要部分。在基金申请上,我心情激动的列出潜在的意义,除了治疗高血压,我们将可能:1)通过民间努力补充政府诸事无遗管理模式中不可避免的疏漏;2)将村医发展使其起到美国初级全科医生(Primary Care)的作用;3)逐渐推广预防性治疗。说到激动处不免引经据典,曰,“上工治未病”。

多次努力,在国内却争取不到任何实质性帮助。朋友同事病人只愿意私人给我赠送现款,不愿捐助,没有任何一家国内企业机构实质性赞助。5年下来,没有过任何一位国内同事与我同行。这次培训,协助的只是新加坡和美国教会在云南慈善的几位。

举办培训班,所有费用必须我出,除了教学场地,还得提供学员食宿,竟然还要补助全县300名村医两天缺勤工资。原准备举办三期的款项一次用尽,除了心疼扔钱,求着教人的状态说明人家学生根本不想学。

也许人家都早已会治高血压?完全不是。村医们从不敢自己给病人开药,病人吃着什么就继续什么,没吃药的就接着不吃。

可叹开幕式上,县与州卫生局领导都来了,大谈,政府拨款逐年成倍增长,要与世界健康医疗水平接轨。

培训按照日程教纲结束,我心中却是五味杂陈,原子弹炸跳蚤般甚至几分失落。本应该觉得干了件有用的实事,却实在吃不准。

与本题关联的是,为什么美国医生可以远赴云南农村却难得国内援手?为什么很多人参观白求恩故居却没有人想试试做白求恩做的事?如果连高血压都不敢治,医生执照有什么用?那里的村民真需要医疗的时候该怎么办,能怎么办?

他们会杀医生吗?这样的医生该杀吗?

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作者:姜尼 留言时间:2013-05-22 16:50:49
小樵, 不知何故,把你的园子弄乱了,你自己清理一下吧。对不住了。
回复 | 0
作者:小樵 留言时间:2013-05-22 12:31:23
您是位中国的美国医生?
回复 | 0
作者:姜尼 留言时间:2013-05-22 11:48:24
不想贴了,没什么意思。连伟大的美国总统裤链都关不住,何况大夫。有人的地方就有问题,这是人的本性。还是想想美国医生到底应该对中国医生说点什么吧,既然处在“更有水平”的地位,那就把这讲清楚。
回复 | 0
作者:姜尼 留言时间:2013-05-22 11:40:09
不想贴了,没什么意思。连伟大的美国总统裤链都关不住,何况大夫。有人的地方就有问题,这是人的本性。还是想想美国医生到底应该对中国医生说点什么吧,既然处在“更有水平”的地位,那就把这讲清楚。
回复 | 0
作者:姜尼 留言时间:2013-05-22 11:39:07
不想贴了,没什么意思。连伟大的美国总统裤链都关不住,何况大夫。有人的地方就有问题,这是人的本性。还是想想美国医生到底应该对中国医生说点什么吧,既然处在“更有水平”的地位,那就把这讲清楚。
回复 | 0
作者:姜尼 留言时间:2013-05-22 11:38:20
不想贴了,没什么意思。连伟大的美国总统裤链都关不住,何况大夫。有人的地方就有问题,这是人的本性。还是想想美国医生到底应该对中国医生说点什么吧,既然处在“更有水平”的地位,那就把这讲清楚。
回复 | 0
作者:姜尼 留言时间:2013-05-22 11:37:18
不想贴了,没什么意思。连伟大的美国总统裤链都关不住,何况大夫。有人的地方就有问题,这是人的本性。还是想想美国医生到底应该对中国医生说点什么吧,既然处在“更有水平”的地位,那就把这讲清楚。
回复 | 0
作者:小樵 留言时间:2013-05-22 10:47:28
Gosnell, who is NOT a board-certified obstetrician or gynecologist

何止不能代表,他原本不是美国医生
回复 | 0
作者:姜尼 留言时间:2013-05-22 10:03:06
http://www.omaha.com/article/20130406/NEWS/704069933

我坚信这些人不能代表美国医生
回复 | 0
作者:姜尼 留言时间:2013-05-22 09:52:11
本不想说,还是贴一段儿吧!

http://www.cnn.com/2013/05/13/justice/pennsylvania-abortion-doctor-trial


Doctor found guilty of first-degree murder in Philadelphia abortion case
From Sarah Hoye and Sunny Hostin, CNN
updated 10:26 AM EDT, Tue May 14, 2013
Watch this video
Gosnell trial: Can't unsee those photos
STORY HIGHLIGHTS

Defense attorney: "The jury spoke and we respect the jury's verdict"
Dr. Kermit Gosnell is convicted of three counts of first-degree murder
A jury also finds him guilty of involuntary manslaughter
The first-degree murder conviction means Gosnell could face the death penalty

Philadelphia (CNN) -- A Philadelphia abortion provider who killed babies by cutting their spinal cords with scissors was found guilty of first-degree murder on Monday.

The conviction on three counts of first-degree murder means Dr. Kermit Gosnell, 72, could be sentenced to death.

Assistant District Attorney Joanne Pescatore sobbed after the verdict in the high-profile case was announced. Gosnell appeared shocked. He let out a sigh and shook his head back and forth.

Defense attorney Jack McMahon told CNN it's too soon to tell whether he will appeal the conviction.
Abortion provider found guilty of murder
Prosecutor was sobbing during verdict
Residents of Gosnell's neighborhood talk
Abortion doctor's response to verdict

"We were disappointed. We put on a vigorous defense. We think it went well for us in the courtroom," he said. "But the jury spoke, and we respect the jury's verdict."

Gosnell also was accused in the death of Karnamaya Mongar, 41, who died of an anesthetic overdose during a second-trimester abortion at his West Philadelphia clinic. In that case, the jury found him guilty of involuntary manslaughter.

Gosnell, who is not a board-certified obstetrician or gynecologist, was also found guilty of 21 counts of abortion of the unborn, 24 weeks or older.

In Pennsylvania, abortions past 24 weeks are illegal unless the health of the mother is at stake.

Abortion doctor case triggers painful memories for ex-patient

The case next moves to the penalty phase, when jurors will weigh whether to give Gosnell a death sentence. It's possible the doctor will testify, said William Brennan, an attorney who represented Gosnell earlier in the case.

"I would think there would be a lot of mitigation in this case and I think probably, and this is a guess, but probably at that time the jury would hear from Dr. Gosnell," he said.

Earlier Monday, the jury, after deliberating for two weeks, said it was hung on two counts, and the judge instructed them to continue trying to reach a verdict on them.

Judge Jeffrey P. Minehart also told jurors that their progress showed they were "considering the evidence seriously."

Gosnell's co-defendant, Eileen O'Neill, 56, was found guilty of conspiracy to operate a corrupt organization and two counts of theft by deception for operating without a license to practice medicine. O'Neill, a medical school graduate, was not charged with performing illegal abortions.

Both pleaded not guilty.

Eight people involved in Gosnell's clinic, called the Women's Medical Society, have pleaded guilty to various charges, including four to murder.

The grand jury report from 2011 says the "people who ran this sham medical practice included no doctors other than Gosnell himself, and not even a single nurse," yet they still made diagnoses, performed procedures and administered drugs.

McMahon, in an impassioned, 2½-hour closing argument, said that none of the infants was killed; rather, he said, they were already dead as a result of Gosnell administering the drug Digoxin, which can cause abortion.

Gosnell also was accused of reusing unsanitary instruments; performing procedures in filthy rooms, including some in which litter boxes and animals allegedly were present at the time; and allowing unlicensed employees -- including a teenage high school student -- to perform operations and administer anesthesia.

The remains of aborted fetuses were stored in water jugs, pet food containers and a freezer at the clinic, the city's chief medical examiner Sam Gulino testified.

Former employee Kareema Cross said Gosnell regularly performed illegal late-term abortions that he routinely recorded as "24.5 weeks."

McMahon, who called no witnesses, accused prosecutors of "the most extraordinary hype and exaggeration in the history of the criminal justice system," even adding that they are "elitist" and "racist."

Gosnell has been accused by authorities of preying on low-income, minority women. McMahon argued that Gosnell offered access to health care for people who were poor and without health insurance.

During his closing remarks, Philadelphia Assistant District Attorney Edward Cameron turned to Gosnell and yelled, "Are you human?"

Gosnell smirked at Cameron without speaking. Cameron then continued, declaring, "It's time for us to extinguish the fire he created."

The doctor was first charged in January 2011.

The case has drawn national attention and sharp criticism from anti-abortion activists.

But that doesn't mean it sets a precedent, CNN legal analyst Paul Callan said.

"The testimony in this case was so graphic and so horrific. It was described literally as a house of horrors taking place in this Philadelphia clinic," Callan said. "So I think that most objective observers will say that ultimately this will be an isolated case, hopefully, and that it's simply a case where prosecutors had to act. It had nothing to do with being pro- or anti-abortion."

After Monday's verdict, the leader of one anti-abortion group said justice had been served.

"Even as we celebrate this verdict, we honor and mourn as well those among our nation's weakest children who did not receive 'their day in court' -- and we must remember that Gosnell is not an outlier within the abortion industry," Lila Rose, president of Live Action, said in a written statement. "We cannot allow these 'guilty' verdicts, welcome as they are, to make us complacent when it comes to the continuing abuses happening even now in abortion facilities throughout our nation."

More restrictions on abortions will lead to more cases like the Women's Medical Society, not fewer, abortion rights advocates argue.

"We thought we had said goodbye to back-alley abortionists," said Jessica Arons, head of the Women's Health and Rights Program at the Center for American Progress.

"Legal access to abortion helps counteract "predators" who "prey on vulnerable women," Arons said.

"It's not that we need more laws or stricter laws," she said. "Pennsylvania just didn't do its job in enforcing the laws against him earlier."

CNN's Catherine E. Shoichet, Josh Levs, David Ariosto, Jason Hanna and Dana Ford
回复 | 0
作者:姜尼 留言时间:2013-05-22 07:18:33
华欢笑,中国医生法制不行,道德不行,医德不行,专业技术不行,我看找人直接把中国大夫都拿刀捅死算了。你倒是言辞表达的清清楚楚,怎么这么叫人听着不舒服。实事求是一点儿好不好,中国医生那么大一个群体难道都是一群窝囊废?
回复 | 0
作者:华欢笑 留言时间:2013-05-21 21:44:25
读了你的几篇短文,有些莫名其妙的感觉,没有读出你的真正意思,美国医生到底应该对中国医生说什么?

说一点自己不成熟的感觉;首先从法制上讲,美国医生与中国医生根本没有任何可比性,他们所受到的法律教育也不在一个层面上。美国医生从申请入读医学院开始,医学院四年,临床实习,无时无刻都在受到医学法律的约束,他们必须遵守法律,必须遵守道德,必须遵守医德;其次是专业知识;先不说中国学生从高中直接考医学院,中国医学院的学生是百分之百毕业;而美国是读完本科才可以考医学院;(除去本医连读),美国医学院的淘汰率很高,尤其是第一年;一科不及格,一学期重读; 美国医生课程的难度高,训练强度大,这些中国医生都没办法相比。

中国医生无论从法制方面,道德方面,医德方面,专业技术,都不可能与美国医生相比。

美国医生能对中国医生说什么呢?中国现有的社会体制,中国现有的法制,中国根深蒂固的风俗文化,养育了中国化的医生。
回复 | 0
作者:小樵 留言时间:2013-05-21 18:53:42
谢谢,不是卖关子,真是还说不畅来。前边说职业荣誉责任,这次说庸医可以误人,可都觉得没触及本质
回复 | 0
作者:無知者,無畏 留言时间:2013-05-21 18:41:05
内地的医患关系恶劣,的确不是一两天的事情,短时间也不会有真正的改善。最恶劣的,是他们对待生命的看法,屁民的生命其实也没有人紧张,他自己也不紧张,他们有很多比健康优先级别更高的事情,你去紧张他的健康,他反而觉得你多事。

举一个例子,去年我去中国省亲,有一个远亲病得不轻,我建议他去看医生,并且出车帮他拉去医院,帮他垫支医药费,你猜他怎么说?他说你有钱给我治病,不如拿钱给我供孙子读书,钱花在孙子身上有盼望,我是老朽,挨一天算一天,而他紧张的是后人的前途。

中国内地穷人需要用钱的地方太多了,而健康和医疗的优先级别并不高,一个字,“难”。
回复 | 0
作者:姜尼 留言时间:2013-05-21 18:38:12
小樵,

横跨中西的医学经历很难得,既是美国医学教授有话对中国医生讲,那就请直言不讳,直触根本。讲出的话有人捧,有人砸都很正常。都跟你三集了,还不知道你到底想说什么。
回复 | 0
作者:小樵 留言时间:2013-05-21 18:24:51
我也是在勉为其难,觉得该说点什么又不知从何说起,只能一点点理清,争取弄出些头绪
回复 | 0
作者:lone-shepherd 留言时间:2013-05-21 17:36:49
小谯医生,
你的这个系列从一开始我就看了,却不知如何留言。
病人对医生护士的暴虐行为必须谴责,对救治他们的人不问青红皂白地施暴是暴民行为。
另一个现实是,一般民众对医生印象不佳:原因一半是民众、一半是医生。国内的医生缺乏西方的医德教育;即使有在国内的大环境下也不能保证医德。实际情况是医生收红包、开药拿回扣、医院要求医生对病人进行不必要的昂贵检查是很常见的。
不过牧人相信小谯医生正在做的一定会有成效的。
回复 | 0
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