It is difficult to register and queue for a long time, which is a common problem for the public to seek medical treatment. According to public information, in the evaluation of medical satisfaction in public hospitals, the overall satisfaction with the "waiting time in outpatient diagnosis and treatment" is low, focusing on the long waiting time for outpatient treatment, long waiting time for examination, and long waiting time for inspection and examination reports. On social platforms, the entry "queue for 2 hours, see a doctor for 2 minutes" also often arouses heated discussions among netizens.
On this topic, a reporter from the Southern Rural Daily recently interviewed several citizens and outpatient doctors from different cities. The root cause is still the asymmetry of doctor-patient information, the shortage of high-quality medical resources, and the long way to go in hierarchical diagnosis and treatment.
The number of outpatient clinics in tertiary hospitals is large, and queuing has become the norm.
Waiting for the call number and other reports, the outpatient queue has become the norm
Ms. Chen, a 25-year-old staff member, said that every time she waited for a long time to call for a gynecology visit, and she had to face patients who were constantly cutting in line for follow-up consultations, she was forced to wait for more than one hour.
"Some re-examination patients hold the list and block the door of the consultation room directly, regardless of whether there is someone behind them, and stand directly behind the patient who communicates with the doctor in the consultation room, and acquiesce that they are the next one. Ms. Chen said that the doctor did not prohibit this kind of behavior, and after the previous patients got up after the medical treatment, the returning patients rushed directly into the consultation room. "Although it is normal to come to the doctor after the examination, it does take up the time of the patients who are seen during the appointment time, and the time of all patients is forcibly extended. ”
Ms. Tian, a 28-year-old pregnant mother, said that she had been with a doctor since she was pregnant, but every time she drove from her home to the hospital, it took one hour to drive, and the most time-consuming thing was to wait for the report.
"I know that there are many people in the hospital and there are many gynecological examinations, but it is really unbearable for a pregnant woman to wait for each examination and wait for the report to be re-examined. Ms. Tian said that although she is accustomed to waiting for the examination report, it is a waste of time to come to the hospital so early to register and wait for several hours. If the process of medical visits and examinations can be optimized, it can make patients less strenuous.
Student C (pseudonym), a 20-year-old college student, shared his recent experience of waiting for a whole afternoon for a medical aesthetic project at the Dermatology Hospital of Southern Medical University. "I arrived at the hospital at 2 p.m., and the doctor suggested that I do a medical aesthetic project, and after paying the fee, it would take 4 hours to wait!" said student C, who learned from other patients who were waiting together that they had to queue up a long time in advance to do medical aesthetic projects, and if they needed to do a project temporarily, they had to come to the hospital at 7 a.m. to queue up.
The queuing site of the medical aesthetic project. Photo courtesy of the interviewee
"Why can't you spend money on projects according to the appointment time, so it's more convenient for people to make it easier? I finally find free time to see a doctor, and I have to sit in the hospital lobby and wait, I think this is very inefficient, and you still need to queue up for a doctor's appointment, so what's the point of making an appointment?" said student C.
Specialist No. 1 is hard to find, and it only takes 2 minutes to see a doctor
Appointments take a long time, and it takes time to make an appointment. Xiaomei (pseudonym), a 24-year-old staff member, has been suffering from acne for a long time and is a frequent visitor to the Third Affiliated Hospital of Sun Yat-sen University. Thinking that it was a matter of "face", she would guard the dermatologist and director every time. But the expert number is really difficult to grab, even if you squat at the first time of the number, you may not be able to successfully hang the number.
"Sometimes I forget to grab the number, and if I can't get it, I have to wait for another week, or I take leave to go to the hospital to ask the doctor for a plus number, but many doctors are unwilling to get a plus number. Xiaomei sighed, she couldn't grab the number, and sometimes the medicine couldn't be renewed in time. "It's not easy to register, and it takes a lot of time to queue up at every outpatient clinic. ”
In contrast to the long waiting time, many people pointed out that the time to actually see the doctor and talk about the condition was too short. Zheng, a 22-year-old college student, said that he came to Guangzhou from other places to study, and he often did not adapt to the change of seasons, and needed to be treated at the community health service station, but he didn't have time to ask a few more words every time, and the doctor had already prescribed the medicine.
Zheng feels that doctors are becoming more and more casual in their treatment of patients, "Recently, the tonsils have been seriously inflamed, and even swallowing saliva is very painful, so the doctor simply prescribes granules and potions. I remember when I was a child, the doctor would take a flashlight to look at my nose and ask me to open my mouth to check my tonsils or use a stethoscope to check my condition. Shouldn't doctors be more concerned about the condition and ask more questions?"
"Queue for 2 hours and see a doctor for 2 minutes", many netizens shared their experience of seeing a doctor on popular social platforms, expressing their empathy. Netizen PU pointed out that it was okay to wait in line for a long time, and in the end, it was not more than two sentences to communicate with the doctor, and the doctor had already operated on the computer, and asked people to pay for the medicine. Netizen momo felt puzzled, the registration fee for the expert number that he finally hung up was several times more expensive than that of the ordinary number, but he still ended the treatment in a hurry, and he still didn't understand his condition.
Netizens complained about the long waiting time.
The doctor rotates continuously, and the patient can't finish reading
How did the doctors sitting in the consultation room view this problem? This reporter contacted several outpatient doctors from different departments of tertiary hospitals.
Dr. Huang of the obstetrics department said that some women often arrive at 8 o'clock in the morning, wait for the examination to come to see the report, wait for the medicine, it is more than 12 o'clock or even 1 o'clock, and sometimes there are still unfinished examinations, and they have to come again in the afternoon. "We doctors also understand that it is difficult to park in the hospital and the queue is slow, but we also work non-stop from the morning to the end of the patient's view, and each patient hopes that the patient in front of him will finish reading it quickly, and they also hope that the doctor will talk more about the situation with themselves, which is a contradiction. ”
As far as prenatal check-ups are concerned, the long-waiting link lies in color ultrasound. "In the past, it was a single line issued by all the doctors in the hospital, and if it was 11 o'clock in the morning, it might be in the afternoon, and at 4 or 5 o'clock in the afternoon, it might be in the next morning. Now it is getting better, and the mother and other patients are separated from the other patients to be examined by a professional doctor, and the queue time is relatively shorter. Dr. Huang said that a pregnant woman has to read the report to her again after the examination, and explain the time of the next prenatal check-up. Therefore, basically a pregnant woman sees at least two visits, which takes a long time, and the overall waiting time is long. "Most people see that the doctor has been busy, insist on reading all the numbers, even if the wait is long, they are still very patient, only a few people will loudly express dissatisfaction. ”
In response to the problem of long queuing time and short time to see a doctor, Dr. Wang of the Department of Dermatology summarized several reasons: First, medical resources are tight, and a doctor in the outpatient clinic has to see 50 patients in 4 hours from 8:00 a.m. to 12:00 p.m., and the average time is only a few minutes for each patient. However, some patients are more seriously ill and need to be examined more carefully, or they need temporary treatment, which will take more time. The outpatient doctors go out 5-6 days a week, 50 in the morning and 40 in the afternoon, the workload is very large, and the actual load is far overloaded, and most of the front-line medical staff are very tired.
Secondly, the problem set by the registration appointment system is to deal with such a large outpatient volume, and it takes more than a dozen numbers to be put in an hour, but in fact, the doctor can't finish it in this time, and it will inevitably drag out the time, resulting in a backlog of numbers, and it is impossible to call the number on time during the patient's appointment time. This problem is really difficult to solve, unless the number is limited.
In addition, some patients have a weak sense of time, especially during the time period from 8:00 to 9:00 in the outpatient clinic, and patients are often late. Most often, there is an appointment between 8:00 and 8:30, and there may only be one or two patients coming, and the rest are all piled up until 8:30, or even 9:00 at 9:00.
Dr. Wang also mentioned that in the outpatient clinic, he occasionally encountered some patients who were not registered, and rushed directly into the clinic to consult the condition, saying, "I am not here to prescribe medicine, but I want to ask if this disease can be cured." This situation often happens on weekends, and there are many patients in themselves, and then encountering a few such patients who cut in line for consultation, unreasonably occupy the time of doctors and patients, and the rhythm is completely disrupted.
Dr. Xing of the Department of Endocrinology pointed out that the chronic disease clinic mainly sees diabetes and hypertension, and many of them are long-term follow-up and relatively elderly people. Since the hospital launched the computer appointment system, some elderly people do not know how to register online, or are used to registering at the window on the same day, and can only be queued after the appointment number at a fixed time period. Many of them come to the hospital at 7 o'clock to register, and they will have to wait for a long time. It would be nice if there was a family member to help make an appointment.
"As doctors, we have to juggle both the ward and the outpatient clinic, and we have 1-2 rounds of visits per week. Although the clinic starts at 8:30, when the ward inspection is completed and the ward work is completed, sometimes it is already around 9 o'clock when I go to the outpatient clinic. There are usually dozens of patients in the morning, and at the beginning of the month, patients are concentrated in follow-up visits and prescriptions, and almost 50 numbers are seen. On average, a person only has two or three minutes, and we can only finish the treatment of a patient in a hurry, and we can't talk more. Dr. Xing said that fortunately, many of them are old patients who are familiar with the condition, and ask about the recent blood sugar control, whether they are uncomfortable, and if they do not need to adjust their medication, they can generally be seen in two or three minutes.
Countermeasures: Optimize the outpatient process and advocate rational medical treatment
From the doctor's point of view, many doctors believe that difficult registration, long queues, and short consultation time are difficult problems to solve in the short term, and they need to understand each other more and jointly maintain a good outpatient order.
In the outpatient waiting area of the hospital, patients are waiting to be called.
Dr. Chen pointed out that the main reason for "queuing for 2 hours and seeing a doctor for 2 minutes" is that the country's medical resources are relatively insufficient. After the implementation of time-based appointments, the queue situation in the outpatient clinic has improved, but the consultation process and time for patients with complex conditions will inevitably be longer. Some patients are not familiar with the process, or have been waiting for a long time, and they are in a bad mood and run to the consultation room to make noise, and the doctor also needs time to calm down.
Dr. Xing said that at present, it is still difficult for community and town health centers to fully undertake the management of chronic diseases, and a lot of work is concentrated in tertiary hospitals, and doctors are running wards and outpatient clinics at both ends, which is very stressful. "After a long period of contact, many old patients are also very understanding of us. Although the patient sometimes complains after waiting for a long time, we also complain to him, saying, 'You see, I haven't rested, I haven't drunk water, and I don't dare to go to the toilet.' Don't worry, I'm sure I'll see you all before I leave. Sometimes it just takes a little more communication and mutual understanding. ”
Dr. Wang of the Department of Dermatology believes that in order to solve the difficulty of outpatient registration and the long wait, it is necessary to expand the capacity of medical services from the government and hospital levels. On the other hand, patients should improve their sense of time and see the doctor on time during the appointment time. Hospitals can also consider shortening the time period for registration appointments, such as 15 minutes, so that patients can make appointments more accurate and rationally triage, which can also relieve the pressure of outpatient clinics to a certain extent.
In order to optimize the design of the outpatient process and shorten the stay time of patients in the outpatient clinic, the National Health Commission and the State Administration of Traditional Chinese Medicine issued the "Theme Activity Plan for Improving Medical Experience and Enhancing Patient Experience (2023-2025)", which proposes specific measures. The third is to provide a variety of payment channels, and explore the implementation of "diagnosis and treatment before payment" and "one visit and one payment" under the premise of ensuring the safety of funds.
In addition to strengthening outpatient management and optimizing the process mechanism in hospitals, experts also called on patients to seek medical treatment rationally, and there is no need to "push" large hospitals for minor illnesses and pains.
With the advancement of Guangdong's construction of a top-notch medical and health service system, focusing on strengthening the foundation and accelerating the construction of a new pattern of orderly medical treatment and diagnosis and treatment, more and more high-quality medical resources in large cities and hospitals have sunk to the grassroots level and come to the "doorstep" of the masses. It is understood that at present, the hospitalization rate in the province's cities and counties remains at about 95% and 85%, which means that more people can see a good doctor without leaving the city or county.
【Reporter】Jiang Ling, intern Shi Yinyin
Source: Southern Rural Daily