Doctors should treat their patients like family
On July 20 The Beijing News printed a reader comment about the kind of medical service they received when they paid a visit to the ophthalmologist.
The reader complained that the traditional ideas for diagnosis had been replaced by slips of paper that told you go get tested by a machine.
One day after the letter appeared, the same paper ran another reader response: from a man whose wife had an urinary infection, and was told to have scans that an older doctor said were unnecessary.
Both readers reflected upon often youthful doctors who don’t ask many questions and does not really know how to diagnose.
The four aspects of diagnosis have all but been forgotten by doctors
by Xiong Baiyuan (熊柏渊), citizen.
At times when work is hectic and I’m tired, I get blood splotches on my lower eyeballs. Not long ago, a splotch of blood appeared on my right eye, giving me a headache on the right side of my head, so I went to a certain hospital and registered at the emergency ophthalmology department.
A youthful doctor listened to me talk and then used a slit lamp to check my eyes and also checked the intraocular pressure, and said that I was fine. I asked whether they wanted to look at the bottom of the eye, to make sure the problem wasn’t sparked by another problem at the back of the eye. After I voiced this the doctor told me get another registration number and to come back tomorrow. Checking the lower part of the eye is a most common practice in ophthalmology, so why would I need to come again? I reminded the doctor again: “Can’t the kid take a look at me?” The doctor quickly explained that he hadn’t brought any equipment. My God, the implement inside the intern’s pocket was exactly what he needed!
Afterward I went to a Grade Three hospital (the highest grade for publicly owned hospitals in Beijing), and after the rough examination of the ophthalmologist, I was declared again to be fine. Once again I told them that my eyes had caused my head to hurt, so the doctor suggested that I register for a number at the department of neurology.
The neurologist asked some light questions and then told me to go get a CT scan for my head. He didn’t ask about my medical history, or take my temperature, didn’t examine my neck and definitely did not check the soles of my feet， not to mention any other kind of examination of the nervous system. This is such slacking.
Skull CT scan and routine blood tests cost a lot of money. My result showed to be normal, but I still had a headache. Later, my mother, who used to work as a doctor, made a TCM remedy, and after three days my headache was gone.
From a young age I have been in and out of hospitals, and know that doctors need to make “four checks:” in TCM the four aspects for a diagnosis are looking, asking, listening and palpation (望, 闻, 问, 切) and in western medicine they are looking, feeling, knocking and listening (望, 扪, 叩, 听).
The methods for examination have become more advanced, but this doesn’t mean that the basic methods of examination should be eliminated. Hospital staff who overly rely upon high-tech equipment will only abuse clinical examinations, causing a huge wastage of medical resources and economical burdens for the ill. This also goes against the professional morality of medicine and its ethical standards.
Doctors have it too easy now
by Li Lala (李拉拉), citizen.
I share sentiments expressed in The Beijing News July 20 letter “The four aspects of diagnosis have all but been forgotten by doctors.”
Lately, my wife went to the hospital after getting an infection in her urinary system. The doctor on duty was a young doctor, and asked: “Symptoms?” My wife answered: “It hurts when I urinate.” Immediately following was a tearing sound and: “Go get a standard urine test!” I said, on the side: “She got this once before, last year, and urinated blood!” The doctor looked at me and then there was another tearing sound: “And get a B-mode ultrasound!” I asked again: “Do you think it’s only an infection or is it lithangiuria？“ This time the doctor didn’t even raise his head: “What use is it what I think? It only matters what the machine thinks!”
In the evening, I called my father (my father is a doctor), and told him what happened. He said: “It’s so easy being a doctor these days, all you need to do is write some slips for an examination. For something like your wife’s symptoms, in the past we’d ask first of all whether it was her first time experiencing pain, and then ask whether she is sleeping well? Whether she is tired at work? How much water is she drinking? Is she constipated? Also, you don’t need to get that B-mode ultrasound, if it really is lithangiuria then it’s going to hurt like hell!”
As you can see, doctors from the past and doctors now really aren’t the same.
In fact, using machines to help examine patients isn’t wrong: some symptoms cannot be correctly diagnosed just from experience. But, purely relying on machines means not only the “abuse of clinical examinations, causing a huge wastage of medical resources and economical burdens of the ill” but also no clues as to what illness patients have gotten and no clues as to what the illness means. The doctor really should say something, or ask something, so that the patient can go on to improve aspects of their lifestyle and the illness. All in all, machines can’t talk.
Links and Sources
It only matters what the machine thinks: getting diagnosed in a Chinese hospital
On July 20 The Beijing News printed a reader comment about the kind of medical service they received when they paid a visit to the ophthalmologist.
The reader complained that the traditional ideas for diagnosis had been replaced by slips of paper that told you go get tested by a machine.
One day after the letter appeared, the same paper ran another reader response: from a man whose wife had an urinary infection, and was told to have scans that an older doctor said were unnecessary.
Both readers reflected upon often youthful doctors who don’t ask many questions and does not really know how to diagnose.
The four aspects of diagnosis have all but been forgotten by doctors
by Xiong Baiyuan (熊柏渊), citizen.
At times when work is hectic and I’m tired, I get blood splotches on my lower eyeballs. Not long ago, a splotch of blood appeared on my right eye, giving me a headache on the right side of my head, so I went to a certain hospital and registered at the emergency ophthalmology department.
A youthful doctor listened to me talk and then used a slit lamp to check my eyes and also checked the intraocular pressure, and said that I was fine. I asked whether they wanted to look at the bottom of the eye, to make sure the problem wasn’t sparked by another problem at the back of the eye. After I voiced this the doctor told me get another registration number and to come back tomorrow. Checking the lower part of the eye is a most common practice in ophthalmology, so why would I need to come again? I reminded the doctor again: “Can’t the kid take a look at me?” The doctor quickly explained that he hadn’t brought any equipment. My God, the implement inside the intern’s pocket was exactly what he needed!
Afterward I went to a Grade Three hospital (the highest grade for publicly owned hospitals in Beijing), and after the rough examination of the ophthalmologist, I was declared again to be fine. Once again I told them that my eyes had caused my head to hurt, so the doctor suggested that I register for a number at the department of neurology.
The neurologist asked some light questions and then told me to go get a CT scan for my head. He didn’t ask about my medical history, or take my temperature, didn’t examine my neck and definitely did not check the soles of my feet， not to mention any other kind of examination of the nervous system. This is such slacking.
Skull CT scan and routine blood tests cost a lot of money. My result showed to be normal, but I still had a headache. Later, my mother, who used to work as a doctor, made a TCM remedy, and after three days my headache was gone.
From a young age I have been in and out of hospitals, and know that doctors need to make “four checks:” in TCM the four aspects for a diagnosis are looking, asking, listening and palpation (望, 闻, 问, 切) and in western medicine they are looking, feeling, knocking and listening (望, 扪, 叩, 听).
The methods for examination have become more advanced, but this doesn’t mean that the basic methods of examination should be eliminated. Hospital staff who overly rely upon high-tech equipment will only abuse clinical examinations, causing a huge wastage of medical resources and economical burdens for the ill. This also goes against the professional morality of medicine and its ethical standards.
Doctors have it too easy now
by Li Lala (李拉拉), citizen.
I share sentiments expressed in The Beijing News July 20 letter “The four aspects of diagnosis have all but been forgotten by doctors.”
Lately, my wife went to the hospital after getting an infection in her urinary system. The doctor on duty was a young doctor, and asked: “Symptoms?” My wife answered: “It hurts when I urinate.” Immediately following was a tearing sound and: “Go get a standard urine test!” I said, on the side: “She got this once before, last year, and urinated blood!” The doctor looked at me and then there was another tearing sound: “And get a B-mode ultrasound!” I asked again: “Do you think it’s only an infection or is it lithangiuria？“ This time the doctor didn’t even raise his head: “What use is it what I think? It only matters what the machine thinks!”
In the evening, I called my father (my father is a doctor), and told him what happened. He said: “It’s so easy being a doctor these days, all you need to do is write some slips for an examination. For something like your wife’s symptoms, in the past we’d ask first of all whether it was her first time experiencing pain, and then ask whether she is sleeping well? Whether she is tired at work? How much water is she drinking? Is she constipated? Also, you don’t need to get that B-mode ultrasound, if it really is lithangiuria then it’s going to hurt like hell!”
As you can see, doctors from the past and doctors now really aren’t the same.
In fact, using machines to help examine patients isn’t wrong: some symptoms cannot be correctly diagnosed just from experience. But, purely relying on machines means not only the “abuse of clinical examinations, causing a huge wastage of medical resources and economical burdens of the ill” but also no clues as to what illness patients have gotten and no clues as to what the illness means. The doctor really should say something, or ask something, so that the patient can go on to improve aspects of their lifestyle and the illness. All in all, machines can’t talk.