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National basic public health services, basic medical care, new rural cooperative medical care, etc. have been carried out for many years, has become the norm, but the author will also hear the grass-roots public health service personnel, including village doctors reflect the situation of overwork.
we calm down and think, where is the root cause of village medical tiredness? Why is there always work, but there is always work to be done? First, the gradual standardization of medical insurance, village doctors feel the pressure of the last two years, medical insurance work more and more strict, more and more standardized.
The village health room, which had been used to relying on medical insurance policy to eat, felt unprecedented pressure, not only to regulate the current clinical diagnosis and treatment behavior, but also to correct the previous unreasonable phenomenon, so that village doctors such as thin ice, income plummeted.
, the population base is high, "rate" difficult to complete public health services are resident residents in the jurisdiction, but many service indicators are based on the number of household registration in the jurisdiction to approve.
in the residents of the great mobility of today, villagers outside to buy a house to live is not uncommon, more migrant workers.
the majority of rural residents are less than 50 per cent or less of the household population.
Some "rates" in public health service projects make it very difficult for village doctors to complete, this accounting method needs to be improved, it is suggested that some places should be more in the advanced areas, "rate" should be formulated according to the number of resident population in the bailiwick as the base, so that more scientific and reasonable.
3, holidays rest into a luxury village doctor practice place in the countryside, the villagers do not have the city people that kind of commute concept, want to come when they come, feel uncomfortable to find a doctor, this is also undeniable.
Real life is: the village doctor is eating patients, village doctors have to put down chopsticks to see a doctor;
day to continue to see a doctor, follow-up, complete the tasks arranged by superiors, rest at night is not good, continue to work during the day, over time, the older village doctor will feel the body can not stand, but there is no good way.
Some health hospital public health service personnel will call at any time to data, say work, WeChat group from time to time will receive new tasks, emergency notifications, some not very urgent things but require immediate completion, but also included in the performance appraisal.
people do not have a computer or network at home, or related data is not around, but also have to return to the unit to complete.
Grass-roots public defenders do not have holidays, even afraid of holidays, because often encountered "Friday notice, Monday to results" "pre-festival arrangement arrangements, post-festival supervision and assessment" and other phenomena, the family reunion, reduce physical and mental pressure of the holidays, village doctors received is indeed "use the holiday residents to return home a favorable time to carry out residents file updates, slow disease follow-up" notice, holidays so that the grass-roots public defenders busier than usual, more tired, more pressure.
, the grass-roots public security people meeting busy village doctors to attend regular meetings every month, this is indisputable.
but this project opened, that section opened, add up to a little more.
National work start-up meeting, important work promotion meeting, old work look back, public health arrangements deployment training meeting, some can be sent through the mailbox, study at home, but because of the need for superior supervision check-in, photos, had to unified requirements for village doctors to the hospital or county to go to a meeting, one after another, half a day or even a day time is gone.
the past few years has been reducing the burden on the grass-roots level, but the real implementation of the area is still few, village doctors do not feel less burden.
, APP, WeChat group, mobile phone side of the task of many departments in order to improve work efficiency, the introduction of some APP, in order to investigate public health residents awareness rate, mass satisfaction and so on.
In order to promote the APP and pay attention to the public number, the county to the township, the village under the indicators, in the village living in the old people and children, it is difficult to complete will be in accordance with the requirements of the operation, and finally become the village doctor in the operation.
village doctors in the health education group to guide the villagers to download, install, pay attention to, associate, register, but many villagers do not cooperate with the degree, in a few days will be unloaded or taken off.
there are several working groups on Every public defender and village doctor's WeChat, and from time to time they have to reply to "receive" or forward notifications, which have become part of their lives.
, the writing of paperwork difficult village doctors everything to write plans, public health services many items, each project to write a work plan or implementation plan.
and some places also require the writing of monthly plans, weekly plans, daily plans, but often the grass-roots plans can not catch up with the changes of superiors.
Material instruments are a form of reflection of work, but some leaders are used to using documents to implement documents, the same material repeatedly to, year after year, but also format norms, the number of words can not be less, not a secret origin of the village doctor a little hard.
7, a variety of reports, toss back and forth each item to report, but also monthly, quarterly, annual, at any time, in the information system function is becoming more and more perfect today, do not know why the monthly report, the system will not automatically count the quarterly report and annual report.
Some units often send notice in the morning, the afternoon will be handed in, or even immediately send notice, immediately want data, different departments, often want the same material, similar forms, the same content of the material, forms, back and forth, several times to fill in, convenient for themselves, trouble the grass-roots.
8, only ask the plan, water through the field some superiors of the draft for comments, only "ask the plan" not "na plan", seems to have a lot of tricks, but failed to "let the grass-roots implementers who have a voice to say their bitterness";
nine, quarterly supervision, annual assessment, to meet the assessment busy ledger every to the end of the season, the end of the year, the supervision and inspection, special assessment came.
to the grass-roots living more, the above notice down, you have to prepare information according to the assessment criteria.
items included in the assessment list of higher-level departments should find ways to improve the information.
some assessment form on the assessment content, grass-roots professionals, village doctors can not even understand, consulting related personnel can not say a sample, but is to carry out the assessment.
this makes it difficult for village doctors to cook without rice."
there are some previously unscheduled work, year-end but to assess, village doctors in order to "not lose points", had to rack their brains to complete.
sometimes there is a "ride assessment" phenomenon, greatly increasing the burden of public security personnel, frustrated their enthusiasm for work.
, guidance shallow accountability deep, the grass-roots response to the heart more tired inspection assessment of the original intention is to promote the public health services to do real, do fine, in order to improve the quality of service, stimulate the grass-roots service personnel's enthusiasm for service.
However, some local departments, but when faced with the task of work, through the list, programmes, rules and other means of all decomposition to the lower levels, the task of the work refined to "have the minutes of the meeting" "check-in" "have the work photos" and so on, but also take the "responsibility letter" "in-system notification" and other measures of accountability punishment, moving to subsidize the distribution of things, linked to the distribution of funds, so that the grass-roots service personnel physically and mentally exhausted.
village doctors have high occupational risk and responsibility, but the income is not very high.
At the same time, we will also face the real problems of family members' children going to school and employment, the health status of the elderly, but also participate in the village's red and white happy events, census and other social affairs, more importantly, bear the whole life cycle of the village residents, all-round health management, a heavy burden on the shoulders, how can not be tired? Therefore, our management, top-level designers should be located in the village doctor's mind, more understanding of the grass-roots level, more help, more humane design, to fully consider the grass-roots reality and the operability of the village doctor, to the district resident population as the base of reasonable quantification of the project task indicators, moderate research and development, promotion of closely related app, really reduce the burden of village doctors, maintain the physical and mental health of village doctors.
only when the village doctor is healthy can we have more energy and more time to implement the policy of benefiting the people, do a good job of serving the people, and do a good job in the health management of the villagers in the district all-round, full life cycle and full age.