军队中小医院实行主诊医师负责制的困难与对策

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主诊医师制度即“Attending”制,是目前国外医院广为应用的一种医疗服务管理模式,所谓“Attending”负责制,是由一名Attendin(g具有副主任医师以上资格)、一名Fello(w主治医师以上)和一名Residen(t住院医师以上)组成的一个医疗小组,全权负责到院病人的门诊、住院、手术、会诊、出院后随访等一系列医疗服务工作,并对所负责的病人的医疗服务质量把关。作为一种新的医疗服务模式,主诊医师负责制的特点在于强化了服务的流程与医生的责任意识,它的优势在于:将管理单元进行细分,管理组织更加扁平化,减轻科主任的负担;更加扁平化的组织结构促使组织人员的竞争意识和服务意识不断增强,组织人员的利益与价值可以真正得到体现,组织内冒尖的人才也会容易脱颖而出,不同的意见与思想能够加强碰撞;同时竞争意识与服务意识的增强也会有力地改善医患关系,有效实现以病人为中心的服务宗旨。然而作为一项国外成熟的医院管理模式,其成功实施建基于相关配套的医师资格考试制度、各级医师的严格授权制度和住院医师培训制度等等,对于国内的医院来说,引入主诊医师负责制必然会遭遇实践多年的“三级查房制”的惯性影响。传统的“三级医师查房制”也有其客观的优势,在既有的医疗服务管理体系中发挥着应有的作用,因而如果引入主诊医师负责制,医院管理者应该厘清两者各自的优劣势,明白自己在现有的阶段想要解决什么问题,如何解决,所有的这一切都要有通盘的计划,这样才不至于造成《军队中小医院实行主诊医师负责制的困难与对策》中所说的新式服务管理模式引发“族群撕裂”。 The attending physician system is the “Attending” system, which is a widely used medical service management model in foreign hospitals. The so-called “Attending” accountability system consists of one Attendin (g is qualified as a deputy chief physician), one Fello (w attending physician or above) and a Residen (above teh resident) medical team responsible for the outpatient service, hospitalization, surgery, consultation, post-discharge follow-up and a series of medical services, and is responsible for The quality of medical care of patients checks. As a new medical service model, the CPO system is characterized by enhanced service flow and doctor’s sense of responsibility. Its advantages include: the management unit is subdivided, the management organization is more flattened, and the director of the department is relieved Burden; a more flat organizational structure to promote organizational awareness of competition and sense of service continue to increase, the interests of organizations and the value can be truly reflected in the organization will emerge from the tip of talent will be able to stand out, different views and ideas to strengthen the collision; At the same time, the awareness of competition and the enhancement of service awareness will also greatly improve the relationship between doctors and patients and effectively realize the patient-centered service. However, as a mature foreign hospital management model, its successful implementation is based on the related qualification examination system, the strict authorization system for all levels of physicians and the resident training system, etc. For the domestic hospitals, the introduction of the attending physician Responsibility system will inevitably encounter years of practice, “three rounds of inspection system,” the inertia. The traditional “three-level physicians rounds room system” also has its objective advantages, in the existing medical service management system to play its due role, so if the introduction of the physician-in-charge system, hospital managers should clarify the two Advantages and disadvantages, understand what they want to solve in the existing stage, how to solve all of this all have a comprehensive plan, so as not to cause “military small and medium hospitals to implement the responsibility of the attending physician’s difficulty and countermeasure” In the new model of service management triggered “ethnic rift.”
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