引入廉價而質優的亞洲醫生

December 6, 2010 at 11:46 pm | Posted in 醫療融資, health care | Leave a comment
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對香港《新報》評論之回應

香港醫學會十分關注《新報》於十二月三日所刊“新論”中對於我們的指責。此評論的最後一句提及,“假如港府可以打破香港醫學會的壟斷,引入廉價而質優的亞洲醫生(當然只限於公立醫院,私家醫院則不准),這才是最有效的解決香港醫療問題的政策。”我們認為,這一言論存在諸多事實錯誤。基於公眾利益的考慮,我們有必要進行澄清。

 

首先,香港醫學會是一個非政府組織,既無力管轄頒發執業牌照之事宜,也無權決定哪一國籍的醫生可以在香港執業。只有香港醫務委員會是獲得授權,可以依照《醫生註冊條例》頒發醫生執照的官方組織,且醫委會中百分之五十的成員是由任命產生。

 

香港一向給予行醫者最大程度的執業自由。香港早有既定機制容許外國畢業的醫生參加由香港醫務委員會定時舉辨的醫生執照試。經考試評核合格者可在本港公立醫院進行有薪實習,實習結束後若獲得公立醫院或任何私營機構的聘任,通常可獲准留港註冊執業。本港註册醫生若擁有外國核準的專科資格,可向香港醫學專科學院申請評定該資歷,達標者亦可向香港醫務委員會之教育及評審小組申請註冊成為專科醫生。

 

對於公立醫院稀缺的專科醫生,通常可獲一個有限度註冊,以便留港執業,這也包括現在急需的麻醉師。

 

如今,超過一千名畢業於香港以外地區的醫生已通過執照試,並在香港執業。香港醫學會有三名會董亦是於中國大陸畢業,而其中兩人現為公立醫院的高級醫生。

 

在試圖利用亞洲其他國家的醫療人手時,應考慮這一手段是否有悖道德?那些欠發達的亞洲國家投入數以百萬計的資金培養醫生,他們自己的國民不也應該擁有足夠的醫療人力資源嗎?

 

公立醫院若確實缺乏人手,這一問題便值得深入研究。為什麼有醫生在公立醫院完成培訓後,甚至還未完成時,就選擇離開?為什麼醫院管理局數年前向受訓醫生提供經濟獎勵,企圖誘使他們遠離公營部門?(我們的一個會董在辭職時獲發一百多萬元港幣)。在決定是否增加醫學生數量之前,我們是否應該先進行一次嚴格的人力資源調查?如果沒有足夠的職位去訓練醫生,憑什麼去增加其數量?

 

過去媒體所進行的民意調查顯示,民眾希望確保高質素的醫療人手。在缺乏嚴格的醫療知識評估機制下,允許外國畢業生來港行醫,不會對市民有任何益處,實際上,這將是危險的。

 

我們希望通過這一聲明使問題得到澄清。今後,在涉及香港醫學會的相關事務時,如若媒體在對事實不熟悉或沒有把握時能先與我們聯絡,我們將不勝感激。

 

李福基醫生

義務秘書

香港醫學會

二零一零年十二月六日

 

保險業界就醫療融資提新建議容許病人投保

April 23, 2010 at 2:09 am | Posted in health care | Leave a comment
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保險業界就醫療融資提新建議容許病人投保
政府與保險業界就醫療融資商討有新進展,保險業界提出多項建議,包括接受有疾病及先天性病人投保,但設三年索償等候期,投保人首年醫療開支不獲賠償,其後兩年分别獲一半及七成半賠償,到第四年開始才能獲全額賠償;同時容許投保人以原有條款及優惠,攜單轉換保險公司;若投保人無索償記錄,可獲退回部份保費。 食物及衛生局表示,會議有建議性,會詳細研究建議。安老事務委員會主席梁智鴻說,保險業界的建議對推動醫療融資有積極意義,但細節仍需微調,希望政府多作諮詢,製定能平衡各方利益的方案。

Nurse recruitment crisis warning

May 12, 2009 at 3:56 am | Posted in health care | Leave a comment

By Nick Triggle
Health reporter, BBC News

The NHS is facing a nursing recruitment crisis unless it does more to attract school leavers into the profession, union leaders say. The Royal College of Nursing says over the next decade 200,000 nurses will retire – a third of the total number. It said school leavers were snubbing nursing as a career, and called on ministers to run campaigns in schools to tackle the problem. The government admitted more should be done to promote nursing.

Previous research has shown that student applications by the under 20s are declining with nearly half of all nurse students now over 30, suggesting that more and more nurses are entering the profession after working as something else beforehand.

An RCN poll, published at its conference in Harrogate, of more than 8,600 seven to 17-year-olds showed nursing was the least preferred career in the public sector – behind police, teachers, doctors and fire-fighters.

Only one in 20 said their preferred career choice was to be a nurse.

Dirty job

The most common reasons for not wanting to be a nurse was a belief it was a dirty job or not liking blood.

Many said higher pay would make nursing more attractive – the average starting salary is still just over £20,000.

RCN general secretary Peter Carter said he wanted to see the government doing more to promote nursing as a career option in schools.

“It’s clear that the image of nursing does not reflect reality.

“Modern nursing is a dynamic career, providing an incredibly broad range of opportunities and a real chance to have an interesting, successful career that makes a real difference to other people’s lives.

“Often older recruits join the profession after becoming disillusioned with seemingly more popular careers and wish they had done so years earlier.

“We want more young people to join the profession and experience all it has to offer.”

Saffron Brown, a second-year nursing student at the University of Northumbria, who went into training straight after school, agreed.

“Too many people think nursing is about working in hospital, but it is much more diverse than that. There are all sorts of jobs in the community you can do.”

Health minister Ann Keen admitted there was more that could be done over recruitment.

The Department of Health has recently set up a commission to look into the future of the profession. Part of the remit is recruitment.

Ms Keen said: “Having started my career as a nurse, I have seen first hand just how rewarding a career it can be.

“The range of opportunities available to qualified nursing staff is among the broadest of any profession.”

Options beyond statins

November 17, 2008 at 2:15 pm | Posted in health care, medicine | Leave a comment
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http://www.boston.com/news/health/articles/2008/11/17/options_beyond_statins/

There is, they said, sound evidence that exercise and a healthy diet can lower levels of inflammation as measured by the high-sensitivity C-reactive protein test, known as hs-CRP. But – and this is where it gets a bit tricky – it has yet to be proved beyond a doubt that patients who reduce their inflammation levels through lifestyle changes have fewer cardiovascular emergencies.

Still, when Dr. Paul Ridker tells patients they have scored dangerously high on the test he created, this is his recommendation:

“The first, second, third, and fourth intervention for anyone with elevated hs-CRP is get to the gym, lose a few pounds, throw away the cigarettes, and start thinking about a healthier diet,” Ridker said. “That remains overwhelmingly the most important intervention for lowering cardiovascular risk.”

Just how important? A 2006 study by University of Massachusetts Medical School researchers showed people with fiber-laden diets were 63 percent less likely to have inflammation problems than people whose diets were low in fiber. An Italian study had similar findings, saying patients who consumed lots of whole grains, fruits, vegetables, and nuts significantly reduced their inflammation readings.

Dr. Ira S. Ockene, a preventive cardiology specialist at UMass and an author of the fiber study, said 30 grams of fiber is considered the benchmark for a healthy diet. You can get as much as one-third of that, he said, by eating a hearty bowl of pea soup.

“And if you want to lower your CRP and you have a big gut,” he said, “the best thing to do is to exercise and lose weight. When you lose weight, a whole bunch of good things happen.”

While researchers long recognized that physical activity reduces risk of heart attacks and strokes, the underlying reasons were not always so clear. A Brigham study last year yielded important clues, finding that lower inflammation levels matter most.

It doesn’t take a lot of exercise, Ridker said: A half-hour a day of aerobic exercise will do.

“I take a fair number of patients who travel quite a bit, and I tell them, ‘It’s as important to put your sneakers in your briefcase as it is your laptop,’ ” Ridker said.

It makes a world of sense that exercise and diet should contribute to reducing inflammation and, by extension, heart attacks and stroke, said Dr. Michael Lauer, of the National Heart, Lung, and Blood Institute.

“But I have to be honest,” Lauer said, “this is a hypothesis at this time – and a very good hypothesis – but I don’t think it’s a proven one.” And it won’t be, he said, until a study demonstrates for sure that an inflammation-reducing lifestyle changes result in fewer heart attacks and strokes.

At Cleveland Clinic, doctors don’t just preach about exercise and diet; they take patients on outings to restaurants to reinforce good habits. Patients are asked to be honest about whether they’re likely to heed the advice to eat well and exercise.

For some patients, “pills are an answer, but it’s not all of the answer,” Cho said. “I tell my patients all the time that pills are supplements, not substitutes, for a healthy lifestyle.”

Said the Doctor to the Cancer Patient: Hit the Gym

August 14, 2008 at 7:40 am | Posted in health care, medicine | Leave a comment

Sponsored by Memorial Sloan-Kettering Cancer Center, this class for cancer patients has been around for some time, mostly in a league by itself. But in recent years, following studies that found exercise to be beneficial in combating the effects of cancer, the class has gained some company.

Gyms and fitness centers have begun stepping in to meet a small but growing demand for programs designed to not only hasten recovery but to address the fatigue of chemotherapy, the swelling of lymphedema and the loss of muscle tone.

疾病治疗重心“前移” “防病”重于“治病”

March 4, 2008 at 1:02 pm | Posted in china, health care | Leave a comment
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医改方案不必“太完美” 政府投入重在基层

针对议论颇多的改革方案内容,曾经参加过国家医改方案讨论的钟南山希望最终的医改方案不必“太完美”,而是要有所侧重。

“现阶段医改重点应该放在两个方面,一是公共卫生体系,疾病的预防和传染病防治等应该是完全公益性的,如果把它变成市场化就会大大削弱预防为主的意义;二是政府要加大投入支持基层社区和乡镇医疗机构建设,满足基层群众的看病需求。”他说。

钟南山还希望通过媒体继续呼吁全民要提高“疾病预防”意识,“当前国际医疗模式正在将治疗重心向‘提前预防’前移,过去重要的是对疾病的诊断和治疗,现在更重要的是对疾病的预防和早诊早治,增强疾病预防意识将是解决看病难和看病贵问题的一个‘有效途径’”。 据了解,美国从1963年到1993年的30年间,心肌梗死的病死率下降了59%,取得惊人成绩。钟南山说,美国这种病死率的大幅下降并不仅是来自于先进的医疗技术,最主要是通过全民教育、生活方式和饮食习惯的转变实现的。

“小病早治花钱不多,但解决大问题;如果到了晚期即便花很多钱,也解决不了大问题。” 钟南山强调,目前老百姓在很多疾病上没有相关预防的知识,亟待加强全民教育。医务人员也要承担责任,主动传播预防知识。作为中华医学会理事长,他今年计划设立一个奖项,奖励为普及医学知识做出突出贡献的医务人员,鼓励他们向百姓普及预防知识,使“预防为主”深入人心。

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