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the director complained: the total performance of the pediatric department last month was only a few thousand yuan.

how to divide the more than ten people in the department?

if the pediatrician hadn't revealed his true feelings, we would have never known that the pediatrician's life was so difficult.

on september 24, the director of the radiology department of a hospital in chongqing posted an article online describing the current situation facing the pediatric department in his hospital. he pointed out: "the pediatric department of our hospital is basically useless, and the total performance of the general practice last month was only a few thousand yuan. how can this be divided among the more than ten people in the general practice?fortunately, the leadership agreed with the department director and asked the finance department to advance part of the salary so that everyone could make ends meet. now the director of pediatrics is worried about everyone's jobs all day long. "

"thinking back to those years, the pediatrics department was very popular, adding beds, recruiting people, and recruiting department directors. pediatrics was once the star department of the hospital, but in just a few years, it has declined to this extent! now, both pediatrics and obstetrics and gynecology have become brothers in difficulty.it has also become a burden in the courtyard. it is a pity to abandon it. you are not allowed to abandon it. if you keep it, it will not be of much use.. i wonder which department the next such department will be. is it possible that it is the radiology department? it feels like our ultrasound department has begun to show signs of success. "

what i'm most afraid of is seeing complaints like this, because when i open the comment section, it's zatui's complaints.

in this regard, the deputy director of a hospital in huanggang, hubei province said: "your hospital's pediatric performance is low, but it still exists.the pediatric department of our hospital is no longer available, and the maternal and pediatric resources in the county have been directly merged.in the future, all maternal and child diseases will go to the maternal and child health hospital, and other hospitals will not offer pediatrics. "

a pediatrician from a maternal and child hospital in hebei also said: "the maternal and child health hospital in our county was taken over by the city's maternal and child health hospital, and a new group was established. the pediatric performance in the past two months has also been dismal, and the competent authorities need to introduce new performance the evaluation method gives us a salary cut. i have summarized the reasons for the sharp decline in our pediatric performance.due to the school holidays in july and august, some children return to their hometowns, some go out to play, and some go to beijing with their parents for the summer vacation, so the number of pediatric consultations in the county has dropped.。”

"school is now open. in the future, autumn and winter will come, and the flu will come back. needless to say, the number of pediatric patients will definitely increase. today's pediatrics is either too bleak or too busy all year round. even if it is busy, the performance will not be much better, because the number of pediatric hospitalizations is there are fewer operations and less surgery. the day before yesterday, i treated a child and took x-rays and five kinds of medicine for less than 100 yuan. how can you say that the performance of pediatrics is so good? "

there are many voices complaining about suffering, but there are also some encouraging words. a pediatrician in guangxi said: "brothers and sisters, who put us at the bottom of the contempt chain in the department? if we persist, we will only suffer in the past few years." , the sanming model will be launched soon. once it is promoted across the country, we will all be able to eat from a big pot. even if we enjoy the average salary of a doctor, it will be much better than living half-dead now. if we persist, the good days of pediatrics will come soon. "

after obstetrics, rescuing children has become a hot topic

too little performance, attrition of medical staff, and declining number of medical visits.

many pediatric departments have been closed or integrated this year

still rememberduan taothe director previously issued the strongest voice of "rescuing the obstetrics department", but now a doctor related to pediatrics said"difficult to achieve performance" "need to advance salary", it’s really heartbreaking.

in fact, in the past year, many paediatrics departments have been closed or integrated due to low department performance and declining patient visits.

at the beginning of this year, there were media reports thathebei children's hospital of integrated traditional chinese and western medicinepublished on the official public account "closing notice", the hospital was completely closed on december 19 last year. the hospital's premises are operated by the newly established hebei mayo cardiovascular disease hospital, and the new hospital officially opened on december 20 last year.

it is understood that hebei children’s hospital of integrated traditional chinese and western medicine officially opened on december 8, 2018.it is a tertiary children's specialty hospital, this is also the first children’s hospital in hebei province featuring integrated traditional chinese and western medicine diagnosis and treatment. according to time calculation, hebei children’s hospital with integrated traditional chinese and western medicine has just been in operation for 5 years.

why is a good children's hospital closing? the announcement stated that the reason for the closure was “according to the development status of the hospital in recent years, combined with social development factors such as the declining birth rate year by year, hebei children's hospital of integrated traditional chinese and western medicine decided after careful research". although the children's hospital was closed, fortunately the original pediatric department was retained and moved to the new hospital for integration. at least the pediatric resources were not wasted.

in march this year,xi'an yanta tianyou children's hospitala "bankruptcy and reorganization case" was issued,the announcement stated that the hospital has been ruled to enter bankruptcy reorganization., and openly recruit investors from the public.

this modern second-level children's specialty hospital established in 2006 is affiliated to shaanxi tianyou children's medical management group co., ltd., which also operates a number of children's hospitals. in july 2022, some media reported that the hospital owed employees wages for seven months, which had not been resolved for a long time. poor management became the main reason for its bankruptcy and reorganization.

in july, according to media reports, some medical staff in the pediatric department of an affiliated hospital in zhengzhou, henan, were about to resign. the reason was that the department’s performance was only 1,700 yuan per month, and the performance in some months was even less than 1,000 yuan.

doctors at the hospital said: "the children were hospitalized for seven or eight days, but after reimbursement, the cost of the entire treatment process may only cost five or six hundred yuan. what is even more frustrating is that some parents will also pay a few yuan for the registration fee. we argued endlessly,pediatrics is so cheap! if the hospital cannot solve our survival problem, we will have no choice but to leave in the end.”

according to the "2021 china health statistics yearbook", the number of pediatric outpatient visits in my country's general hospitals in 2020 was 230 million.a decrease of 16.7% compared to 2019, in the following years, the number of pediatric outpatient clinics in general hospitals continued to decline.

what is more strange is that,while the number of pediatric outpatient clinics in general hospitals across the country has declined overall, the number of pediatric outpatient clinics in top tertiary hospitals in various provinces and cities has increased year after year., which results in "tired to death, starved to death"some tertiary-level pediatric departments work all year round without any free time. during the autumn and winter flu seasons, they are full every day. more general hospital pediatric departments are deserted, and no children even go to see a doctor.

under this circumstance, public hospitals have government support and can maintain the status quo no matter how bad the situation is, but private hospitals will not fare well. in particular, before the epidemic, private hospitals were vigorously run and many children's specialized hospitals were opened. when the tide receded, the fertility rate dropped, the subsidy policy disappeared, and performance could not be earned. the end result of these private children's hospitals was closure.

a deputy director of pediatrics at a tertiary university in sichuan said: "paediatrics in public hospitals is not easy, let alone private hospitals.a lot of private children's hospitals and clinics have closed down in chengdu this year. it is really difficult to make a profit simply by doing pediatric business. children's illnesses are different from those of adults. they are generally not serious and require observation before treatment. it is difficult to survive in the regular disease business. several directors and i are thinking,can we develop into the fields of child health care and children's specialties, such as optometry, children's spinal health, children's oral cavity, children's height development, children's skin and other diseases?in order to broaden the sources of profit, today’s parents are very concerned about the growth and development of their children.everyone likes to take growth hormone, this aspect of business is very profitable. "

pediatrics in a tertiary university: there are many children in our department, but the performance is still pitiful.

i’m busy and tired and have no way out. i just want sanming’s medical reform to come soon.

it is understandable if small hospitals and private hospitals are facing pediatric difficulties.but what’s the matter with the top tertiary hospital, which is full of children all day long, complaining about the “difficulty of living in pediatrics”?

a pediatric internist at a tertiary-level affiliated hospital in jiangsu complained: “pediatrics is difficult, there are many children in our department.i was busy all day long, and when i paid my salary, i saw that my performance was 3,000.compared with others in oncology and surgery, the performance is several times worse. it's really a waste of time. i regret choosing pediatrics. there is no way out. alas, who told me that my score in the postgraduate entrance examination was too low and i was transferred to pediatrics? i deserve it..."

a doctor from the department of surgery of a tertiary maternal and child health hospital in shandong said: "in november, december, january, and other special months in our two campuses,the total number of pediatric outpatient and emergency visits in a day can exceed 10,000, and the highest record has exceeded 15,000. medical staff are treating patients 24 hours a day, but some patients still have to wait for a while before they can be seen.”

"it stands to reason,the number of patients admitted is overwhelming, so the performance of the department should be good.no, compared to surgery and internal medicine, we are at the bottom. because although there are many patients, without surgery, no value can be created, and prescribing medicine is extremely cheap. if this continues, then this life will be over, and there will be no hope.i only hope that the arrival of the sanming model can help us in pediatrics to provide common prosperity and transfer payments among all departments in the hospital. then our pediatrics will definitely be more motivated than now.”

according to relevant data, among the departments in china’s public tertiary hospitals, the radiotherapy department has the highest cost-return rate, which is 20%.the cost-return rate for pediatrics is -14%, the income of the department cannot make ends meet, and the income of pediatricians is naturally low.

why is this happening?

on the one hand, public hospitals are responsible for their own profits and losses, and doctors' income comes from two parts: basic salary and performance salary. in the performance appraisal of pediatricians, the number of patient visits accounts for 55% of the total number of appraisal items.a decrease in the number of patients will directly lead to a decrease in performance.

on the other hand, in addition to the number of patients, treatment fees and examination fees are also an important part of the department's income. however, when prescribing medicines for children, they must be converted in proportion to the condition of the children, and the dosage is significantly lower than that for adults. in addition, since the organ systems of the children are still in the developmental stage, it is difficult to determine the indications for surgery, so we adhere to the idea of ​​not having surgery if it can be done without surgery.the number of third- and fourth-level surgeries performed in the pediatric department is relatively small, and its performance is really not comparable to that of adult departments.

let’s take a look at the positioning of pediatrics. public hospitals must reflect public welfare,pediatrics in public hospitals should pay more attention to social benefits, while economic benefits are secondary., because the operation of public hospitals mainly relies on their own revenue generation, but the economic benefits of pediatrics are low, so the hospital needs to continue to "transfuse blood and subsidize money." even though the social benefits of pediatrics are high, due to poor economic benefits, in the eyes of hospital leaders, pediatrics is an unearned job. happy department.

performance is too low and not valued,moreover, the society’s compensation mechanism for pediatrics is not perfect, and it is often difficult to pay pediatricians’ salaries on time and in quantity., this affects the motivation of pediatricians, and it is not surprising that we hear them complaining often.

at present, some pediatricians are very much looking forward to the arrival of the sanming medical reform. they believe that after the implementation of the sanming model, the government will be able to provide for pediatricians, and at least they will be able to receive a basic salary on a monthly basis. let us wait and see whether this is really what the pediatricians think.

written by | alaska treasure

editor | alaska treasure