问：我感冒了 答：去大医院看 q：I caught a cold answer：Go to large hospital to see

问：我发烧了 答：没药 q：I have a fever a：myrrh

类似回答还有：不能做血常规、做皮试的医生没上班、没退烧药…… Similar answer and：Can't do routine blood、Have a skin test doctor didn't work、No antipyretic...

　　大医院晚上人满为患，社区医院却门庭冷清。昨天本报N3版报道出来后，不少读者打来热线，说不是不愿去社区医院看病，而是社区医生把他们往大医院推。

Big night overcrowded hospitals，Community hospital but were a lot of empty seats。This newspaper reported yesterday N3 version，Many readers call hotline，Say not to community a hospital，But the doctor they went to the community hospitals push。

　　本报记者昨晚暗访后发现，这种现象在一些社区医院确实存在。

Our reporter after investigations found last night，This phenomenon in some community hospital does exist。

　　对此，业内人士分析，有三方面原因：

this，Analysis of the personage inside course of，There are three reasons：

　　首先，基本药物制度实行以来，客观上社区医院医生能开的药少了，一些医生用惯的药不能开，对诊治的把握有所下降。

first，Since the implement system of basic drugs，Community hospital doctors can objectively open medicine less，Some doctors used to medicine can't open，Diagnosis and treatment of the grasp of the drop。

　　其次，近年来医患关系紧张，一些医生不大愿意承担风险，特别当病人是老人、小孩时。

second，In recent years the doctor-patient relationship nervous，Some doctors are reluctant to take risks，Especially when the patient is old man、A child。

　　最后，与基本药物制度匹配的绩效工资制度，虽然提倡多劳多得，可实际操作中没有拉开差距，一些社区医生没有积极性。

finally，And the performance of the system of basic drugs matching salary system，Although advocate more gain for more pay，But in practical operation not crossed，Some community doctors without enthusiasm。

　　宁波市卫生局表示，他们已注意到这种现象，正向上级部门建议，对现行绩效工资制度进行调整，充分调动社区医生的积极性。

Ningbo health bureau said，They already pay attention to this phenomenon，The department is suggested，In the current performance salary system adjustment，Fully arouse the enthusiasm of the community。

读者来电：我们并不想去大医院扎堆 Reader calls：And we don't want to go to large hospital cluster

社区医院医生把我们往大医院推 Community hospital doctors put our big push to hospital

　　昨天上午，家住海曙区的厉先生致电本报热线，说前两天，他吃完晚饭后感觉有些发烧。妻子说，离家不远的社区医院这两天晚上也开门诊了，发烧反正不是大病，就去社区医院看看好了。

Yesterday morning，Live in the Mr. Develop business calls our newspaper hotline，Said two days before the，He after dinner feel some fever。The wife said，Near the community hospital two days this night also open outpatient service，A fever but not a serious illness，Will go to the community hospital and see it。

　　晚上8点许，厉先生来到社区医院。医生一听他的症状，马上说，最好做个血常规吧，晚上医院不能做，建议他去市一医院。

8 o 'clock in the evening make，Mr Greatly to the community hospital。The doctor a listen to his symptoms，Immediately said，Had better do a routine blood，Night hospital can't do，Suggested that he go to a city hospital。

　　厉先生说，这天晚上，市一医院急诊大厅里全是人，他等了个把小时才看上医生，等打完点滴已经是深夜11点多了。

Said Mr. Complete，That night，A city hospital emergency hall was full，He waited for an hour or so after only the doctor，After a bit, it was already 11 PM。

　　厉先生的电话挂断不久后，慈城的赵先生也打来电话说：“是医生把我们推到市区来的。”原来，上周，赵先生在当地社区医院连续打了几天点滴，看到不少发烧病人来医院就诊，医生们说，没有退烧针，建议他去市区就诊。

Mr. Complete the telephone hang up soon，CiCheng also called the Mr. Zhao said：“Is the doctor push us to the city。”The original，Last week，Mr. Zhao in the local community hospital a few days for a bit，See many feverish patients to hospital，Doctors say，No TuiShaoZhen，Doctor suggested him to the city。

记者暗访：没退烧药、不能做血常规、做皮试的医生没上班 Reporter investigations：No antipyretic、Can't do routine blood、Have a skin test doctor didn't work

医生的回答有很多种，结论只有一个：去大医院吧 The doctor answer has more to it，Conclusion: only one：Go to large hospital,

　　昨晚6点40，福明社区医院

6 points last night 40，Yu heng rocks community hospital

　　进了医院，没看到病人，一个女医生和一个护士在聊天。女医生看起来比较年轻。

Into the hospital，Didn't see a patient，A woman doctor and a nurse in the chat。Female doctors look younger。

　　记者说头晕、咳嗽，怀疑自己感冒发烧。

The reporter said dizzy、cough，Doubt yourself a cold fever。

　　医生给量了体温，体温正常。

The doctor gave measured the body temperature，Temperature is normal。

　　记者咳嗽两下，说：“下午我一直在咳嗽，还流鼻涕，是不是感冒了？”

Reporter cough two times，said：“Afternoon I always cough，And my nose is running，Have a cold？”

　　医生马上回答：“要不你去第六医院看看，做个血常规，挂几瓶盐水。”

Doctor immediately answer：“Or you go to the sixth hospital looking，Do a routine blood，Hang a few bottles of salt water。”

　　记者：“这里不能看吗？”

reporter：“Here can't see？”

　　医生摇头：“检验科没上班，不能做血常规。”

The doctor shook his head：“Jablonski didn't go to work，Can't do routine blood。”

昨晚7点出头，东柳社区医院 7 points last night in，East willows community hospital

　　医生办公室病人不少，一个女医生在看病。

The doctor's office many patients，A woman doctor in the doctor。

　　一个中年男人手拿药盒，问医生有配吗？医生瞄了一眼回答说：“没有，要去大医院。”中年男子一听，转身退了挂号费，急匆匆走出医院大门。

A middle-aged man hand bag，Ask the doctor have match？The doctor took a glance at replied：“no，Want to go to large hospital。”A middle-aged man a listen to，Turn back the registration fee，Rush out of the hospital gate。

　　接着，进来一名六七岁的小男孩，发烧。一量完体温，医生说：“去大医院。”

then，In a six or seven years old boy，fever。The temperature of a，The doctor said：“Go to large hospital。”

　　大概晚上7点40，明楼街道社区医院

About 7 PM, 40，Ming street building community hospital

　　两个病人在打点滴，门诊室还有一个病人。一个中年男医生坐诊。

Two patients in was put on a drip，Patient room and a patient。A middle-aged male doctor ZuoZhen。

　　记者提出，有点感冒发烧，想打点滴。

Reporters put forward，Cold fever，Want to drip。

　　男医生回答：医院没药。

Male doctor answer：Hospital myrrh。

　　记者：“为什么连打点滴的药都没有？”

reporter：“Why even was put on a drip medicine all have no？”

　　医生解释说，打点滴要用青霉素、头疱类抗生素，这些药使用前要做皮试，但做皮试医生没上班。

The doctor explained，With penicillin was put on a drip、Head blister class antibiotic，These drug use skin test should be done before，But have a skin test the doctor didn't work。

业内人士：有些回答是借口 The personage inside course of：Some answer is an excuse

医改一些政策伤害了社区医院的积极性 Some medical policy hurt the enthusiasm of community hospital

不能做血常规、做皮试的医生没上班、没有退烧针…… Can't do routine blood、Have a skin test doctor didn't work、No TuiShaoZhen......

　　一位业内人士告诉记者，这些其实都是能做到的。比如说退烧的药物，基本药物那么多，怎么可能连退烧药都没有？

An industry insiders told reporters，These are indeed can do it。For example the fever drugs，Basic drugs so much，How can even antipyretic to all have no？

　　这位人士介绍，这与三方面有关：

The personage introduces，The three aspects and relevant：

　　首先，基本药物制度实行以来，虽然目录上有500多种药，但客观上社区医院医生能开的药少了，一些医生用惯的药，不能开，所以对诊治的把握有所下降。

first，Since the implement system of basic drugs，Although catalog has more than 500 kinds of medicine，But community hospital doctors can objectively open medicine less，Some doctors used to medicine，Cannot open，So for the treatment of master fell。

　　其次，近年来医患关系紧张，特别是老人、小孩生病，有时候情况复杂，一些医生不大愿意承担风险。

second，In recent years the doctor-patient relationship nervous，Especially the old man、The child was ill，Sometimes the situation was complex，Some doctors are reluctant to take risks。

　　最后，与基本药物制度匹配的绩效工资制度，虽然提倡“多劳多得”，但在实际操作中平均主义倾向严重，收入最高的医生与最低的相差不多，医务人员积极性受挫。

finally，And the performance of the system of basic drugs matching salary system，Although advocate“More gain for more pay”，But in practice the average tendency serious，The highest income doctor with minimum phase almost，Medical personnel enthusiasm frustration。

市卫生局：已注意到这一现象 The municipal bureau of：Already pay attention to this phenomenon

正向上级建议微调绩效工资制度 Positive superior suggest fine-tuning performance salary system

　　昨天下午，记者就业内人士说法联系了宁波市卫生局。卫生局妇幼保健与社区卫生处章处长说，已注意到这种现象，他也在利用各种机会，向省厅和上级卫生部门建议，对现行的医改方案进行一些微调。

Yesterday afternoon，The reporter said the personage inside the employment contact ningbo health bureau。Maternity and child care and health community health place chapter director said，Already pay attention to this phenomenon，He used all kinds of opportunities，To ShengTing and superior department of health advice，The scheme of the current medical some fine-tuning。

　　章处长说，客观上，以前社区医院有专科专病门诊，有床位，能做手术，医生工作积极性比较高。实施基本药物制度后，不少社区医院从治疗为主逐渐向慢性病服务和管理职能转变。医务人员积极性受到不同程度挫伤。医改目的是希望市民在社区医院看小病，但现在的情况有点背离了初衷。

Chapter director said，objectively，Before ZhuanBing specialist community hospital outpatient service，Get a bed，Can do surgery，The doctor work enthusiasm is quite high。Implement basic drugs after system，Many community hospital treatment for chronic disease mainly from gradually to the service and management function change。Medical personnel by different degree contusions enthusiasm。The main purpose is to cure of the people in the community hospital to see ailment，But now the situation is somewhat deviates from the original intention。

　　章处长表示，解决这些问题首先要突破绩效工资的“天花板”，在财政保证医务人员基本收入前提下，实施真正多劳多得的分配方案，充分调动医务人员的工作积极性。现由国家规定的分配方案参照的是内陆省份模式，并不适合宁波。其次，增加基本药物目录中的药品种类，社区医院能配的药应该要和市级医院一样。(记者 周皓亮)

Chapter director said，To solve these problems first to break the performance-based pay“ceiling”，In financial guarantee the medical staff basic income premise，More gain for more pay real implementation of the scheme，Fully arouse the enthusiasm of the medical staff。Now by the regulations of the state scheme is to inland province mode，Is not suitable for ningbo。second，Increase the basic drugs catalogue of drug types，Community hospital for medicine should be and municipal hospital。(Reporter ZhouHaoLiang)