The current "test before treatment" is only an emergency measure, and is not suitable for universal promotion.
Data map: Patients queuing at the hospital**. Photo: Xinhua News Agency.
Text |Luo Zhihua.
Just want to take an X-ray in the hospital, but also have to go through the **, initial diagnosis and other processes. A few days ago, Mr. Zhou, a citizen of Chongqing, shared his medical experience on social platforms, which caused a lot of resonance.
According to the worker**, Mr. Zhou recently felt some discomfort in his chest cavity, and a doctor friend made a simple diagnosis for him and suggested that he go to the hospital for X-rays. After arriving at the hospital, Mr. Zhou was told that he had to register the internal medicine outpatient number and get the examination form issued by the doctor before he could pay for the examination. It took Mr. Zhou more than two hours to complete the process, but the actual inspection time was less than 5 minutes. Moreover, after listening to his description, the doctor only prescribed an X-ray examination.
Many patients have had this experience. So, if the patient's request is only for examination, can the ** consultation process be avoided?In this regard, many netizens "posted" their own examination experience, saying that they should improve efficiency and implement "inspection before treatment" to save effort and money for patients. Some medical workers also said that patients may not be able to accurately judge the examination items they want to do, and they can better examine the symptoms by seeing a doctor first.
It has to be said that the current "first examination before treatment" has attracted widespread attention, which is related to the concentrated outbreak of respiratory infections in many places some time ago. In the face of this concentrated infection, in order to dredge the diagnosis and treatment process, hospitals in many places have adopted the optimization measure of "first inspection and then treatment". As this has a significant effect in triaging patients and shortening waiting times, many people believe that the promotion of "test before treatment" should be considered in a wider range of areas.
It is understandable that patients want to reduce the obstruction of medical treatment, but it should also be noted that the current "test before treatment" initiative for respiratory infection detection in many places is special. That is to say, the purpose of the detection of respiratory tract infection is relatively single and has a relatively strong uniformity. However, this does not apply to many diseases with complex causes.
For example, patients suffer from many types of diseases, involving not only the respiratory system, but also the digestive system, circulatory system, etc., and there is no identity between examination and diagnosis and treatment, and there is no similar item that can be combined, so it is difficult to implement "examination before treatment".
In the past, some hospitals explored and promoted "first examination before treatment", and some hospitals tried to open laboratory clinics, but no matter which model it is, "first examination and then treatment" can only do the tests that patients must do, such as measuring blood sugar in diabetic patients and electrocardiogram (ECG) in patients with heart disease.
Some people in the industry believe that examination items such as gastroscopy, X-ray, B-ultrasound, blood and urine tests can be carried out "first inspection and then medicine". But most health care providers disagree with this view because the examination is part of the care. This is like the doctor before the medicine, the medicine for the doctor, to ensure that the diagnosis and treatment order is the same. Invasive examinations such as gastroscopy and X-rays should be done in strict accordance with the indications, and diagnosis and treatment should not be bypassed.
It has been proven that promoting "test before treatment" without specific conditions can lead to waste and increase trouble. For example, it is usually not wrong to give an ECG to a person with heart disease, but a conventional ECG may not meet the needs of care, and when the condition is complicated, the doctor may have to redo a polyECG or Holter ECG. Another example is the same blood test, if it is not diagnosed by a doctor, it may lead to the lack of the most critical item of the test content, and the blood has to be drawn again.
Therefore, when there are a large number of patients with similar conditions, and these patients need the same examination, "test before treatment" can be used as an emergency measure. In ordinary diagnosis and treatment, there may also be some room for exploration. For example, we can learn from the emergency classification model launched in many places, when a large number of patients appear in a short period of time, add a "first examination before treatment" level in the classification, so as to arrange some patients to do the tests that really need to be done first. However, this can only be used as an emergency measure under specific conditions, and is not suitable as a universal measure.
In short, under certain conditions, "first examination and then treatment" can indeed optimize the diagnosis and treatment process, but it must also be carried out in an orderly manner by medical staff, rather than by the patients themselves, so as to save effort and money for patients while ensuring the safety of medical treatment.
Written by Luo Zhihua (medical worker).
Edited by Liu Tianhong.
Proofread by Diyan Chen.