Editor’s Note:
British painter Luke Fildes can be called a classic painting of medical humanities < < Doctor > >, His creation was inspired by a tragic life experience. At that time, Luke’s son was seriously ill, and he invited Murray, a famous doctor, to treat him. During the communication, Murray’s medical skills and moral realm gave Luke a lot of insights. Although his son eventually died due to the deterioration of his illness, Luke understood from it that the mission of medicine is not only to rescue the patient’s condition, but also to observe and care for the patient’s pain. It is a “flexible science”.
Judging from the medical background, environment and technology at that time, it cannot be compared with modern medicine, but the attitude and dedication of doctors and the dependence and trust of patients on doctors are also incomparable to modern medicine.
With the rapid development of medicine today, people have gradually lost their reverence and respect for doctors. Everyone thinks that what is free is the best, but what is free is probably the most undeserved. They have always wanted to write such an article. I didn’t expect to see an article with similar views. I will pass it on to you first.
In my opinion, doctors should not unconditionally provide free services to patients, Although this depicts the doctor’s angel image, But there are also many ineffective demands. The effectiveness of free consultation is very limited. The [opportunity cost] (time and energy) invested by doctors, Could have created greater social value, This also includes helping patients in more need to solve more serious and urgent problems. Therefore, this free transaction has led to the loss of social resources. It is a huge loss to both patients and medical staff, and it has been inefficient from the beginning. The same is true of the policies in the medical field. It cannot give any reform that affirms the full value of medical care, nor can it improve the current serious shortage and contradiction. (Editor: < < Southern Weekend > > Reporter Yuan Duanduan)
For several years, I have received free consultation from patients and visitors every day and night. I think I am helping patients, but in fact, this seemingly [altruistic] behavior has deeply hurt the society. Let’s put aside the limitations of online consultation. As a half-year-old economics major, let’s first look at whether this [altruistic] behavior has created its due value for the society.
During my years of free counseling, The workload has soared. Apart from phone calls and meetings, Apart from being questioned by relatives and friends for daily meetings, Apart from all the questions after chatting up the driver and the teacher when taking a taxi, until January 2016, I will receive an average of 23 written inquiries every day. That is to say, if each consultation takes me 10 minutes, I will spend more than three hours answering these questions every day, and my ongoing work, entertainment, rest and study will have to be interrupted.
A week ago, I made a little game: I set the starting price for consultation at 30 yuan (psychological consultation 80 yuan). Since a week ago, the number of consultations has dropped sharply to 3 per day. Then the problem came. Originally there should be 23 questions per day. Where have the other 20 questions gone?
Let’s elaborate on a simple economic principle: the price that visitors are willing to pay for a consultation is called [willingness to pay]. That is to say, of the 23 questions I received every day in the past, only 3 had a willingness to pay above 30 yuan.
The amazing truth is that there are still 20 questions, more precisely, my answers to these 20 questions, which are not worth 30 yuan RMB to visitors. Is this the concept of what? In the eyes of 20 people every day: [It doesn’t matter, I would rather take the 30 yuan to buy a spicy chicken burger set meal, go to the barbershop on the street to wash, cut and blow, and buy some lottery tickets … in short, the question of asking this product is not so important compared with these]. So I suddenly found out that the problem I spent a lot of time and energy solving was just someone else’s [casual question].
Economic analysis is often more and more rational, more and more sharp and more and more mean. But curiosity about the truth forced me to put aside my BLX and continue to think: Why do visitors chase after me to ask these [casual] questions? The answer is simple: [Because you are free] [Because we have a good relationship].
As a result, many people are willing to interrupt my life and consume my time and energy to solve their or their family’s [less important problems]? The crueler reality is that although these questions and answers are not even worth 30 yuan, they are willing to consume our feelings. In their hearts, my labor and our feelings are not worth this [small question less than 30 yuan].
I am chilled to find that every day my energy is trying to solve the problems raised by these people who think my work is not important and our feelings are not important, which are not too important to them. Moreover, such people have more and more such problems day by day.
Yes, just like Britain, where the government pays all the expenses after the health care reform, the number of patients has suddenly doubled several times and the supply of drugs is in short supply. Is it because people are more likely to get sick? No. The core principle of economics is called [people respond to incentives]. If you have to understand it as [people love petty gain], it’s up to you.
Free has greatly promoted the growth of demand and stimulated many ineffective demands: many people [suddenly] want to go to the hospital to find a doctor, while some patients who need recent surgery have been placed one year later; Many medicines are stored in the drawers of some families until they expire, while many people do not get life-saving medicines. These [free troubles] are all what the author has seen and heard in Britain, and have been argued and criticized by many economists: resources are not properly allocated, and those who really need them do not get the help they deserve.
Back to my little game: How did 30 yuan’s pricing come about?
This is my measure of the cost of each consultation, It also means: in my heart, this squeezed 10 minutes, more than 3 hours a day [other values created by instinct for society], is called [opportunity cost] in economics. Perhaps I instinctively appease a mother who is deeply saddened by the loss of her child so that she can sleep without panic. Perhaps I instinctively translate an abstract of a paper to help a doctor graduate smoothly. Perhaps I instinctively go to the nursing home for a three-hour free clinic. Instinct to learn more advanced ideas and apply them to work for the benefit of patients; Instinctively walking and chatting with my family made me and them feel warm and happy.
Yes, three hours a day, I instinctively contribute more to the world, But I spend them on solving these innocuous problems. What is more abominable is that, In fact, it was my [free] that created these problems and stimulated ineffective demand. I caused so many [problems that I didn’t have], and I was dragged into the pit, forgetting that there were more things I should do outside the pit. Only then did I realize that for several years I have exhausted myself every day and the possibility of creating more value for society.
Of course, I am talking about the 20 people who disappear every day. I think you who would like to see the article here will definitely not be the [20] questioner. So next time you ask questions, dear, can you ask those questions that are worthy of 30 yuan (80 yuan) consultation fees?
So I made a decision: all free consultation is over.
Network consultation has many limitations, It is easy to cause delay and missed diagnosis. At the same time, there are also huge legal and policy risks. At present, all domestic health laws restrict: Doctor-patient behavior must not be carried out in non-hospital places. In other words, As long as it is not in the hospital, it takes minutes for doctors to deviate from the rules, be revoked their licenses or even step into the court. Therefore, I encourage all visitors to visit the hospital and interview in the consultation room. If you are really afraid of the hospital, you are also welcome to consult online, but before consulting, please read the statement of responsibilities and rights carefully. Would you also like to pay voluntarily? Of course, if you are in financial difficulties, please tell me boldly that I will exempt you from the bill. I believe many doctors will exempt you from the bill.
I was a patient, He was also a patient’s family member, I know very well that the process of seeing a doctor is extremely tortuous. I once took my family to see a doctor. In the hospital where he stayed, There were 11 queues, Average 17 minutes each time, Four times in the wrong line, Make the wrong order, Return the order, reopen the order, The balance is insufficient, Inquiries failed, Was pointed out in the wrong way, The computer broke down once each, was booked and the toll office yelled twice, was cut in line 9 times, was urged 3 times by the patients in the back, witnessed the patients quarreled with the staff 2 times (once he fell something and almost started fighting), in the process, he was constantly hit by passers-by in a hurry, and his ears were full of noisy noise or crying. At that time, I was extremely agitated and wanted to scold when I saw people and kick when I saw the door.
Therefore, I especially understand the eagerness and anxiety of every patient and family member, and every fear and sorrow eager to be comforted. However, I still want to say cruelly: please don’t let me do any form of guidance, queue jumping, plus sign, and don’t let me arrange doctors, hospitalization or surgery.
The reason is simple: Hospitals are full of excess demand and too few resources. An overload of paramedics. Every doctor, Especially young doctors, are never stopping to solve one problem after another. There are no holidays and weekends, I didn’t sleep for several nights on duty, Exhaustion of life at work, With a meager salary, Bearing criticism and questioning, even personal safety. In such an atmosphere, we have accumulated special friendship between colleagues and teachers and students for many years. We understand each other’s difficulties and do not want to increase the burden on each other. This hard-won feeling needs careful care and cannot stand your several ordeals or break your promise. I hope you understand me.
My mother joked, “Do you have no money to spend on writing so many things for 30 dollars?” Delete it! Don’t be ashamed! [I said wrong, I want all medical staff’s labor to be respected; In order that no matter what kind of occupation’s knowledge and skills will be valued. In order that every act of goodwill really creates its due value for the society. I apologize to my family and friends for the three hours that have disappeared every day in the past few years, because they should have been with them. I also apologize to the world, because it should have created more three hours for the world.
Author’s brief introduction:
Huambo, Graduate Student of Sports Medicine and Osteology, National Psychological Counselor, British Hospital of Neurology and Neurosurgery, Royal National Orthopaedic Hospital, Clinical Attachment, Oberlinhaus Orthopaedic Hospital, Germany Fellowship.