My American pediatrician friend visited China and often saw children with colds treated with antibiotics and suspensions. Because according to textbooks, pre-cold is caused by virus, mainly symptomatic treatment, cough, rhinorrhea, fever or headache. A small number of children enter the late cold, complicated with bacterial infection, yellow sputum fever only need antibiotics treatment, can not eat children only need suspension.
In the United States, medicine is separated. When you buy the medicine, you go to the pharmacy, and the pharmacy is attached to some stores (such as Wal-Mart, CVS, Walgreen). So, it's not good for him to prescribe more medicine for you. He's responsible for taking the wrong medicine, so normally you don't get the medicine you don't need.
In the education of American doctors, two things are emphasized all the time: the simplest and the cheapest. Write the cheapest medicine, and think of the same cheapest check-up when you write the checklist. Hand-to-hand physical examinations are the easiest and cheapest, and must be done first at any time. The simplest and cheapest to do first, not to consider using complex and the most expensive.
I had a patient, breast tubercle, and she was in mainland, and when she saw her, the doctor advised her to operate. At that time she called me and said. She was worried because she had a friend who had a fibroma surgery and had a relapse. It has been opened three times so far. Ask me what to do. If you do it yourself, you'll be back again. If you do not operate, you are afraid of becoming more and more serious, increasing the risk of breast cancer.
I say breast nodules are not as serious as fibroma. But I suggest she go first and find out if mainland sells TW's brushed chest cream, massage first. As a result, she bought it in Taobao, and after a month, the nodule disappeared, but she didn't have an operation.
Then her other friend of fibroma, with the chest cream, persisted with massage for six months, and the fibroma gradually subsided. Of course, I'm not saying the surgery is incorrect. However, the recurrence rate of surgery, doctors should be the most clear.
The supreme principle of Western medicine is that no harm (should not cause additional harm as a result of treatment. So, American doctors will teach you health care.
For example, your joint pain, the doctor will let you go to exercise, your lobule hyperplasia, breast hyperplasia will teach you how to cooperate with breast debridement cream massage, your teeth are not good, he taught you how to floss, how to gargle after meals, there are a lot of nutrients directly for the clinic, The doctor can prescribe directly to the patient.
In short, doctors always prefer unharmed methods. Instead of just taking medication, he wants to make you change in the way you live. The doctor-patient relationship is more comprehensive, he is responsible for your health, and medicine is just a part of it. So medical English has medical care, health care, in which care and protection, "care" is an important part.
But in China, there is a very strange phenomenon. One of my white friends, who works in Beijing, said to me that he was often questioned by Chinese patients: doctor, why don't you give me medicine? 'I don't think you need a prescription,'he said. Many of mainland's patients felt that doctors didn't prescribe them, or that they didn't pay enough attention to their illness. This is a complete mistake.
For American patients, you ask a doctor in western California, or a doctor in New York in the east, a doctor in the city or a doctor in the country, and the answer is exactly the same.
In the United States, patients don't have to go to a second fellow practitioner for their own illness, and the paid health insurance industry thinks it's a waste. There is no "specialist clinic" in the United States, either, because attending physicians are at the same level, as are young and elderly people. (young doctors' knowledge will be a little new.) There is no reason to go to the old doctor to pay more.
For example, American mothers take their children to a doctor.
She first came to the pediatrician, who was a first-line pediatrician. Pediatricians diagnosed myasthenia and referred it to a neurologist. This is a second-line doctor, also called a specialist. Neurologists also diagnosed myasthenia. They also told their mothers that the condition of the powerless children would get worse and worse, with wheelchairs at the age of 13 and death in their twenties. The current medicine is untreatable.
Mother does not give up, will take the child to see the second neurologist. The second said that the first neurologist's diagnosis and management were completely correct, and you didn't have to come back to me. And there's no need to find another doctor.
Mother believed the two doctors. Go back to the first neurologist. He arranged a follow-up, sent to a wheelchair at the age of 13, and was hospitalized until he died.
The punishment for misdiagnosis of a doctor is a hoop curse on the head of an American doctor. Doctors elite are well aware of their social status and economic income hard-won, are very valued their professional reputation, dedicated, cautious, otherwise once an accident, social status is gone, economic income is lost, the future is no longer. Moreover, it is illegal for doctors to take kickbacks in the United States, and their licences will be revoked.
In other words, American doctors have a strong sense of responsibility. In the United States, there are occasional medical accidents, basically technical accidents, rarely encountered responsible accidents.
The definition of misdiagnosis and mistreatment is that two cases must exist at the same time: one is that doctors adopt methods other than textbooks, or unusual methods, and the other is that this unusual method has bad consequences.
Because the process of misdiagnosed and misdiagnosed is a lawsuit, American doctors are afraid to avoid it, so everyone strictly adheres to textbook rules and does not overstep one step at a time. On the other hand, if you follow one or two textbooks and go to see a doctor, the process will be very similar.
All the important, changing medical literature in the world today is written in English. In the era of knowledge economic, the English competence of intellectuals in a non-English-speaking country is a manifestation of national strength. If you can't speak and listen to English with them, the world family will treat you as an outsider. One of my patients came back from TW and brought in the MRI report of the TW General military Institute, which was written in English, not specifically translated for patients like Beijing and Shanghai.
In western countries, if a new medical technology is considered mature, from a national perspective, it must have two conditions:
1. A sufficient number of doctors have been trained to operate the same technique to meet the needs of patients throughout the country;
2. Every patient in need of this technical help can get the same quality of help anywhere in the country.
If a state-of-the-art medical technology is available to only a few people (unless it's an organ transplant, a shortage of donors can only be used by some patients), then everyone from the government to the people will roar.
For example, Medicare has set up three lines of defense to save money on MRI ($1000 to $1500 a test). First, the doctor had to write an application, and the health insurance company tried to turn it down; second, the patient was asked to take an X-ray for only $80. If the X-ray can solve the problem, there is no MRI; the third trick, if the clinical diagnosis of neck, waist, shoulder and knee do not need immediate surgery, the medical insurance company needs a month's first treatment, if not easy to do the MRI.
Because most of the patients were not seriously ill, they stopped coming after a week or two of treatment, and Medicare saved the MRI money. A few years later, Medicare cut its MRI money from $1000 to $500.
I have been a research doctor in the United States for 18 years. In addition to observing the health care system in the United States, there are opportunities to talk to doctors in Britain, Germany, Japan, Sweden, India, Pakistan, South Korea, Singapore, the Philippines, TW and Hong Kong about their health care. I also spoke with the Bangladeshi and Malaysians.
The general concept is:
In the United States, the government focuses on the poor. In theory, in American society, no matter what kind of health insurance you use to see a doctor (poor or rich), the quality of medical care that patients receive is the same.
To sum up, the money of the poor in the United States comes from:
1. National taxpayer money.
2. Direct service of the medical community and the pharmaceutical industry
3. Non-governmental donations
Seeing a doctor is one of the most important things in people's livelihood besides food and shelter. And, because seeing a doctor involves the affection of relatives and the separation of relatives, it is easy to cause the emotional and overreaction of the parties concerned, so as to lead to social unrest. Living in the United States for many years, the United States medical system is very appreciative. In fact, behind these problems are very complex social problems, so I can only talk about my feelings.