要做一名合格的医生

我做临床工作近六十年,对怎么做个合格的医生略有体会,写出来供大家参考。医学是一门实践性很强的自然科学,因为它的服务对象是人,所以也是一门人文科学。一名合格的医生原则上讲应是医德高、医术精的医生。一、具体在医德医风上的几个方面1.要重视仪表和谈吐:一名合格医生应该     

如何成为一名好的临床医生

根据从医经历,从“树立理想、掌握技能、甘愿奉献与团队协作”四个方面来阐述如何成为一名优秀的临床医生。强调:①病史、体检及检验的重要性;②要善于总结反思与创新;③治人与治病同等重要。     

做一名医术精湛、医道高超的医生

用通俗语言讲 ,一名医术精湛的医生就是一名有本领的医生 ;一名医道高超的医生就是一名完美的医生。本领无止境 ,完美无绝对。笔者认为一名能解决当时当地本科疾病 ,达到众人认可或更高水平的医生 ,应该可算是一名有本领的医生 ;而一名既有本领 ,又有良好行为的医生 ,应该可算是一名完美的医生。这样的医生 ,我们是应该、而且是能够做到的。笔者意图在此和同道们、尤其和年轻的同道们 ,一起研讨如何来成为这样的医生。一名有本领的医生应该具备哪些条件 ?笔者认为基本条件为 :有学问 ,有经验 ,有能力。一、有学问有学问的医生应该能跟上世界…     

如何成为一名优秀的医生

Conti教授为美国佛罗里达大学教授,曾任心内科和内科主任。美国心脏病学学院前主席,美国临床心脏病学杂志总编辑,心脏病学院影像出版总编辑。Conti教授十分关心中国心血管事业的发展,曾多次访华和做学术报告,并任同济大学医学院名誉教授。Conti教授这一文章言简意赅,说明了临床医师成长和临床工作中一些主要的原则,值得我们深思:在现代医学条件下,是否只要外文棒、会上网检索最近的循证医学信息就能满足临床工作要求、就能成为一名好医生?另一方面,是否只要拼时间、熬年头,随着临床工作年限的增长自然会成为有经验的好医师?随着现代检查项目的创新和发展,详细地询问病史、体检还有没有必要?是不是浪费时间?各种辅助检查是否做得越多、越全面、越先进才能表明一名医生、一个单位的医疗水平高?效益好?总之,过去所强调的临床工作中的“三基三严”是否还有现实意义?Conti教授作为美国心血管界的泰斗,应当是站在临床医学现代化最前沿的领军人物,来自他毕生医疗实践的心得应对我们有所启迪。     

做一名有温度的医生

3岁的时候,在当地医务界享有盛名的父亲因为成分不好,被下放到了距离县城30公里外的大山里,我也开始了在秦岭和巴山之间山坳坳里的童年生活。父亲是一个生性乐观、豁达的人,并没有因为“被下放”而消沉,到了这个山清水秀、民风淳朴的地方,就继续做他的老本行,高高兴兴地给当地的人看病。山坳坳里交通十分不便,只有高高低低、曲曲折折的...     

我为什么选择做医生

18岁的时候，我希望走一条不同寻常、不落俗套的路。偶然有一日，看到一个纪录片，几句话、几个画面，就勾勒出了一个灰砖绿瓦中的白衣天使。我承认我在一刹那被击中了某根神经，所以我报考了协和医学院。但实际上，直到交志愿表的前一个月，我都没有真正想过有朝一日自己成为医生会是什么样子。     

以病人之心做医生

2008年,相信对很多人来说,都是终生难忘的。一些人的记忆定格在5月都江堰的残墙断壁上,有一些人对8月那个盛世华宴永生难忘,而周伟同时经历了二者。可是,不管是在地震中需要冲到前面的医生,还是能够向世界传递和平．光明、团结与友谊的奥运火炬手,都不是她最真实的一面,真实的周伟是一名有超过十年病龄的糖尿病患者。     

如何与医生打交道？

很多人害怕去医院，可是得了糖尿病，又不得不常常和医生打交道。那么，看病时需要注意些什么呢?     

临床医生如何提出好的临床研究问题?

随着大型医疗机构向研究型医院转型的规划和循证医学的不断推广,临床医生在完成临床医疗基本工作的同时,参与临床研究的热情高涨。然而如何提高临床研究的质量,产生高水平、规范化的临床研究成果是当前面临的巨大挑战。凝练好的临床研究问题是开展高质量临床研究的前提条件。笔者将通过阐述临床研究问题的属性和来源,探讨如何在临床工作中提出好的临床研究问题。     

On how a myosin tryptophan may be perturbed.

A well-known indication that a nucleotide has bound to myosin is the enhancement of the fluorescence of a specific tryptophan in the "subfragment 1" segment of the protein. Empirically the effect has been enormously useful in myosin enzymology. But beyond an early suggestion that it arises from a purine-tryptophan charge-transfer complex, the mechanism of the effect has not been considered. Here we consider the alternative that it arises from an ionizable group (either another residue or the phosphate of the nucleotide) whose proximity to the tryptophan is altered by substrate binding. We study this possibility by studying the interaction of an ionizable residue and tryptophan when both are incorporated in a diketopiperazine structure. The geometry of the situation is inferred from molecular mechanics simulations. Unexpectedly, the best explanation seems to be that the field of the imposed charge, acting across space, affects events in the excited state of the indole.     

The doctor will see you shortly

Many physicians and health care leaders express concern about the amount of time available for clinical practice. While debates rage on about how much time is truly available, the perception that time is inadequate is now pervasive. This perception has ethical significance, because it may cause clinicians to forego activities and behaviors that promote important aspects of the patient-physician relationship, to shortcut shared decision making, and to fall short of obligations to act as patient advocates. Furthermore, perceived time constraints can hinder the just distribution of physician time. Although creating more time in the clinical encounter would certainly address these ethical concerns, specific strategies-many of which do not take significantly more time-can effectively change the perception that time is inadequate. These approaches are critical for clinicians and health systems to maintain their ethical commitments and simultaneously deal with the realities of time.     

Finding solutions to the rural doctor shortage: the roles of selection versus undergraduate medical education at Newcastle

Abstract Background: Australia has a rural doctor shortage. Proposed solutions have included both increasing the medical student admissions from rural areas and modifying the curriculum content of rural medicine. Aim: To examine the differences between doctors who chose to practise in rural areas and those who chose urban areas after graduation from the University of Newcastle medical school. Methods: A cross-sectional survey of 331 graduates who had completed at least their intern year was undertaken in 1990, using a mailed self-report questionnaire. Results: A 75% response rate was achieved from those completing their degree before 1987 (N = 217). Twenty-two per cent of respondents were employed in a rural area and the great majority of these doctors were in general practice. Those from earlier graduating years, those from rural backgrounds (relative risk [RR] 2.5,95% confidence interval [CI]: 1.4–4.4), and those who chose an undergraduate rural general practice attachment in their final year (RR = 3.0,95% CI: 1.3–7.3) were more likely to become rural doctors. However, there was a tendency for those who chose an undergraduate rural rotation in year 3 not to be more likely to become rural doctors (RR = 0.7, 95% CI: 0.4–1.2). The most frequent reasons given for working in rural areas related to lifestyle, whereas work related reasons were given more often for those who chose urban practices. Conclusion: Our data suggest that the rural doctor shortage would be improved by medical school admission policies favouring students from rural areas, and by encouraging rural placements towards the end of undergraduate training. (Aust NZ J Med 1995; 25: 512–517.)     

Functional somatic syndrome: how it could be relevant to rheumatologists

Abstract

Functional somatic syndrome (FSS) is defined as a group of related syndromes characterized more by symptoms, suffering, and disability than by structural or functional abnormality. The diagnostic criteria and/or symptoms of FSS often overlap, and co-morbidity is commonly found among the diseases of FSS. For example, patients with irritable bowel syndrome often suffer from chronic pain, and a high percentage of co-morbidity can be found with fibromyalgia. Accumulating evidence indicates the presence of visceral and somatic hyperalgesia in FSS as a common feature, and the central sensitization mechanism has been suggested to play an important role in the pathophysiology of FSS. In the present article, the authors introduce the concept of FSS focusing on its possible relevance to rheumatology in terms of pain perception. A possible implication of mast cells and proteinase-activated receptor-2 (PAR-2) in FSS is also reviewed.