Wang Chen is the Vice President of the Chinese Academy of Engineering and the President of Peking Union Medical College of the Chinese Academy of Medical Sciences. As an expert in respiratory and critical care medicine, Wang Chen has stepped forward in major public health events many times.
In 2003, Wang Chen served as the chief expert of the Beijing "SARS" prevention and control expert group;
In 2009, influenza A (H1N1) was circulating, and Wang Chen was the leader of the national medical expert group;
In 2020, when the new crown epidemic broke out in Wuhan, Wang Chen's proposal to establish a "square cabin hospital" was adopted and implemented, quickly turning the tide of the anti-epidemic war, known as "a key move at a critical moment".
In view of the current epidemic situation and more topics in Chinese medicine, Wang Chen accepted an exclusive interview with Dong Qian, a reporter of the "Face to Face" column.
It's hard to have a "soothsayer" in really precise time right now.
Reporter: Chinese mainland there have been indigenous cases caused by imported cases of the Olmi kerong variant, as a doctor who has been deeply involved in the prevention and control of the virus, when the virus mutates from generation to generation, what do you pay close attention to?
Wang Chen: A very critical issue is to pay attention to the mutation of the virus and the stability after the mutation is generated. This virus is a very smart virus, we say it is a "perfect level virus", it knows how to survive and adapt to itself, its survival and adaptation must be increased transmission, reduced pathogenicity, survival in the body for a longer time, this is the direction of its evolution. Because there are too many variables in all aspects and uncontrollable, the direction of virus development has countless possibilities, it is difficult to predict, and it is difficult to have a "prophet" in really accurate time.
Reporter: We've been living with COVID-19 for two years, how far do we understand it?
Wang Chen: It is still in progress, because a new pathogen has emerged, and the understanding of it often requires a relatively long-term process, especially if it is in mutation and evolution, the law of this virus is not mastered now, and it has not yet formed a relatively stable state.
Reporter: Two years have not been stable?
Wang Chen: Actually, two years, for a new host to adapt is not too long a time. Last April in Wuhan, people began to talk about the post-epidemic era, I said not the post-epidemic era, we are still in the epidemic era, I said don't think we have won, we just lack imagination about this virus.
Public health cannot be "niche"
In the 66 days of fighting the epidemic in Wuhan, Wang Chen witnessed the impact of the outbreak on the medical system and had a deeper thinking about the shortcomings of China's public health system. On July 16, 2020, the "School of Group Medicine and Public Health" of Peking Union Medical College was officially launched. Wang Chen hopes that this college, which was born in the midst of the epidemic, can realize the transformation of doctors from focusing on individuals to focusing on groups, from focusing on the present to paying attention to the long-term and even future generations, and promoting the transformation of the concept of "taking treatment as the center" to "taking the people's health as the center".
Wang Chen: In the past, the focus of medicine was clinical medicine, that is, on patients, that is, clinical care for patients, but through this epidemic, we found that medicine should focus on groups. The doctor must not only see the health interests of the critically ill patient lying on the bed, but also help him, but also take into account his family, the social environment in which he lives, his country and nation, which is what doctors and the medical community should consider.
Wang Chen believes that in the case of the long-term separation and development of clinical medicine from preventive medicine and public health, group medicine may become a new paradigm and new orientation of medical development, so that people no longer talk about "prevention" and "treatment", but naturally classify the responsibility for the population as part of medicine and part of the work of clinicians.
Wang Chen: Public health is often one-sidedly understood in our country, as if this is a CDC thing, and it has little to do with other people, absolutely not. Public health, like medicine, enhances and maintains health from the six aspects of disease prevention, diagnosis, control, diagnosis and treatment, rehabilitation, plus health promotion. At present, the concept of some people, especially some of us in the medical community, still makes public health niche and limited.
Reporter: Do you still think so after the epidemic?
Wang Chen: I hope to change, but change is still not enough.
Reporter: How urgent is this issue?
Wang Chen: It is extremely urgent, and if this concept does not change, it will be difficult to truly establish a modern public health system in accordance with the requirements of the state.
Reporter: If this system is still fragmented, and we are in the midst of another epidemic, what will be our reaction?
Wang Chen: I have to say that we are afraid that we will have to repeat the difficult situation that we have had. But if it is opened, it will be completely different.
To improve the public health system, we must strengthen investment
At the two sessions, Wang Chen repeatedly submitted proposals proposing the establishment of a national medical and health science fund, thereby increasing support for medical and health science and technology innovation. Wang Chen believes that in order to improve the public health system, the state must strengthen investment.
Wang Chen: In 2019, the World Bank announced the health investment of various countries, according to the World Bank's calculations, our national investment is 5.4% of GDP, of which the government investment is 2.9%. On the world average, health investment accounts for 9.9% of GDP, of which government investment accounts for 5.9%. So 9.9% to 5.9%, 5.4% to 2.9%, do you know whether our country is investing enough or not? Investment in health can not be regarded as a kind of consumption, the development direction of our entire medical and health undertakings must be to improve the quality of medical care, maintain the people's prevention, diagnosis, control, treatment, rehabilitation and health promotion as the main line, rather than just worrying about some so-called cost control related issues, especially for a person who has been malnourished, you also take dieting as a prescription, you think that he dropped a few bread crumbs is to cause local waste, which will cause obstacles to our future development, will cause us to make mistakes in judgment, The wrong direction, by the time you perceive it we are already behind again.
Creation of a 4+4 medical education model
In January 2018, Wang Chen began to serve as the president of the Chinese Academy of Medical Sciences and Peking Union Medical College. Half a year later, Union Medical College established the "4+4" medical education model, which is in line with international advanced medical education and opened a pilot class in advance. The first "4" in 4+ 4 is in the undergraduate education stage, students can be distributed in each school to study their own majors, such as literature, biology, philosophy, law, etc., these from different majors and in the university to produce medical aspirations, in the undergraduate education stage to complete a certain biology, organic chemistry and other pre-medical courses, and after passing the medical school entrance examination, and then receive 4 years of clinical medical professional training, graduation can obtain a doctor of medicine. Wang Chen hopes that the "4+4" system can cultivate top doctors with multidisciplinary integration.
Wang Chen: The knowledge system of medical students themselves is relatively simple, and the professors of medical schools are mainly biology, and they have both medical knowledge and medical systems. Each of us students has a very different way of thinking, and the students will pay great attention to the mechanism of life sciences; those who study law will think about how to better protect the interests of both doctors and patients when facing the doctor-patient relationship or participating in the formulation of the physician law and the health law in the future.
Reporter: Do you want to train a good doctor, or do you want to train a good scholar in medicine?
Wang Chen: Both, doctors themselves are scholars.
Doctors want to get rid of "private" and "virtual"
In 2021, on the occasion of the 100th anniversary of the completion of Concordia Medical College, Wang Chen repeatedly admonished at the graduation ceremony of this batch of students that Concord people must have the spirit of "serving the public under the heavens" and "serving the people", and must eliminate the two kinds of character of "private" and "virtual".
Wang Chen: I didn't want to talk about it, but later, at the end, I thought that they were also the so-called last lesson, and at this time, I should put a little bit of the most critical words in my heart, the words that need to be the same as parents telling their children, and they should be said, which are these two words. I tell my students that you must avoid being such a person in the future. Because if the private word is shown, it is utilitarian to think about the problem immediately, and he thinks that everything is good for me, will I offend people with this thing, what can I get from this thing? How can I "do more with less", he calculated this.
Reporter: Doctors are also people, why can't we think like this?
Wang Chen: His duties are related, the selfish movement of the heart becomes successful, the medical behavior becomes successful and profitable, and when it is really expressed, the behavior is a false word. Imaginary words show that they are performative to do things, not to pursue what they do. Doctors must be realistic, writing prescriptions, medications, surgeries, and verbal conversations with patients in the most practical actions.
"Quacks are more harmful than no healers"
As a doctor and a medical educator, Wang Chen emphasizes that medicine is "multi-learning", an academic and technical system that combines natural sciences, social sciences and humanities. The pursuit of man's ultimate interests is the purpose of medicine, so medicine is still "anthropology".
Wang Chen: Concordia's school motto is to respect science and humanity, and Concordia's school spirit I think should be compassionate, focused, and introspective.
Reporter: How do you understand these three words?
Wang Chen: Compassion is the heart of benevolence, when he sees the weak and sees those who need help, the doctor should take care of this person with compassion; concentration, the doctor's consultation, care, must not have distracting thoughts, must focus on the patient without distraction, in order to cure him; introspection, as Mr. Zhang Xiaoqian said, such as approaching the abyss, like walking on thin ice, the older the doctor, the more senior the doctor knows how to be afraid, the more he knows that he may make mistakes at any time. Medicine is one of the most infallible professions, and the infallibility of medicine is aviation-grade, even beyond aviation-grade. The harm of quack medicine is worse than no medicine, so we must always maintain a state of self-examination, do not be self-righteous, do not inflate, and do not make mistakes.