感冒发烧：药费2.03元钱——她单张处方均额16元 The cold has a fever:Expenses for medicine 2.03 yuan money - she is single prescription forehead 16 yuan

　　作为洛阳儿科领域的顶级专家，她开的药几乎是全国最便宜的 As luoyang pediatric field top experts,She open medicine almost is the cheapest

　　可这些药管用、能治病 几十年来，1元钱能治好她就不让患者花10元 But these medicine works/Can cure for decades,1 yuan can cure she will not let patients spend 10 yuan

　　这意味着什么？她放弃了什么？她的“抗争”，有推广的可能吗？ What does it mean?She gave up her???????her"struggle",The possibility of a promotion?

　　河南商报记者 王向前 文/图

The henan business reporter wang forward text/diagram

　　不知道她是不是唯一的，但她肯定是稀缺的。

Don't know if she only,But she must be scarce.

　　作为洛阳市儿科医疗领域的顶级专家，她开的处方却是洛阳市，或者说在目前全国医疗行业里，最低的。她即是洛阳市妇女儿童保健中心(以下简称洛阳市妇儿中心)儿科专家毋剑梅。

As luoyang pediatric medical field top experts,She open prescription is luoyang,Or in the present national medical industry,The lowest.She is luoyang women and children care center(Hereinafter referred to as the "luoyang fu center)Paediatrician no sword mei.

　　她的行为，是否为同行所容？是否被医院接纳？她又是如何与自我利益作斗争的？

Her behavior,Whether for counterparts capacity?Whether it is the hospital acceptance?She is how to fight and self interests?

　　“偶像”毋剑梅 "idol"Sword may not

　　15日上午，新一届中央领导集体亮相。中午12点半，毋剑梅对这一中国政治生活中的大事，还知之甚少，没有空闲去关注这方面的动态。

15 morning,The new central leading collective appearance.At 12 at noon,No sword mei to the China's political life event,Still know very little,They have not had the leisure to focus on this aspect of dynamic.

　　她甚至连下班的时间都延迟了半个小时。她很忙。从上午上班到中午吃饭这段时间，她的诊室外面候着一个又一个病人。

She even the work time is delayed for half an hour.She is very busy.From the morning go to work to noon to eat this period of time,Her clinic outside wait one patient.

　　他们都在等她。

They are waiting for her.

　　“我们只想让她看病。”家住洛阳市安乐镇的孙阳听说记者打听毋剑梅的情况，很是热情。他说，他家距离医院有四五公里，家附近也有医院诊所，但这几年孩子头疼发烧，他都来找毋剑梅。

"We just want to let her see a doctor."Happiness in luoyang town of SunYang heard reporters ask no sword mei situation,Is very enthusiastic.He said,His house is four or five miles from the hospital,Near the house, also have the hospital clinic,But in recent years children have a fever have a headache,He came to find no sword mei.

　　“她给孩子看病，态度好，药费也低得不得了。”刚拿着处方从诊室出来的傅会利更是毋剑梅的“超级粉丝”，两个双胞胎儿子，毋剑梅分得清清楚楚。

"She gave the child a doctor,Attitude good,Expenses for medicine is low also fun."Just with a prescription from clinic out FuHui is not the sword mei"Super fans",Two twins son,No sword may share clearly.

　　她生病的儿子傅方强坐定，毋剑梅诊断间隙，不经意问，孩子额头怎么了？以前不是这样的。傅会利说，在学校调皮碰伤留下的疤。

Her sick son fu FangJiang sit quietly,No sword mei diagnosis clearance,Casual asked,The child how forehead?I was not such.FuHui said the,In the school naughty bruising leave scar.

　　“我孩子病了，也都是找毋大夫。有时候来找她看病打车的费用，都远远多过医药费。”傅会利说。

"My child is sick,Are also find no doctor.Sometimes to find her a doctor the cost of taking a taxi,Are far more than medical expenses."FuHui said the.

　　感冒发烧，药费2.03元 The cold has a fever,Expenses for medicine 2.03 yuan

　　毋剑梅的事迹，以“小处方”闻名。真耶？秀耶？

No sword mei's deeds,to"Small prescription"famous.True"?Show"?

　　11月15日上午，洛阳市妇儿中心人头攒动。记者跟随患者家属孙阳进入毋剑梅的专家门诊。

November 15, morning,Luoyang women crowded at center.Reporter to follow patients SunYang into families not sword mei expert outpatient service.

　　挂她的号，费用5.5元，5元钱诊断费，0.5元挂号费。

Hang her number,Cost 5.5 yuan,Five yuan ZhenDuanFei,0.5 yuan registration fee.

　　孙阳的小女儿发烧，毋剑梅一番诊断，说孩子没大问题，不用担心。开处方前，毋剑梅问，家里有什么药？孙阳说，护彤(一种治感冒药)。

SunYang little daughter have a fever,No sword may a diagnosis,Said children don't big problem,Don't worry.Prescribe before,No sword may ask,Your home is what medicine?SunYang said,Guard Paul(For a cold medicine).

　　处方出来了：次苍片、潘生丁、复合维生素B片、多酶片。

Prescription out:Time pale piece/dipyridamole/Vitamin B complex tablet/Multienzyme tablet.

　　毋剑梅叮嘱，配合家中的护彤服用，并且要注意孩子的护理，对孩子的护理有时比药还管用。孙阳不放心，问用不用输液，发烧好几天了，几个月前孩子还得过肺炎。

No sword mui told,Cooperate with the home guard ever take,And should pay attention to the child's care,To the child care sometimes than drug works.SunYang not trust,Ask use need not infusion,Have a fever for several days,A few months ago children had pneumonia.

　　毋剑梅看了看他，说，输液有什么好的，该输液时我自然让你输了，花那冤枉钱干吗，再说输液也是输一些激素，对孩子不好。她让孙阳先喂孩子吃这些药，吃完后病情不好再来找她。

No sword mei looked at him,said,Transfusion has what good,The infusion I natural let you lose,Take the injustice,Besides infusion is also lose some hormone,Is not good for them.She let SunYang feed the child first take the medicine,After eating condition not good again to find her.

　　拿处方到交费处。“共2.03元。”收费人员说。傅会利的药费也只比孙阳的贵了0.63元。经诊断，傅方强是急性上呼吸道感染，给出处方：潘生丁10片，复合维生素B片30片，头孢氨苄胶囊2板。

Take the prescription to pay place."A total of 2.03 yuan."Charge researchers said.The medicine of FuHui only SunYang than the expensive 0.63 yuan.The diagnosis,FangJiang fu is acute upper respiratory tract infection,Given prescription:Dipyridamole 10 piece,Vitamin B complex piece of 30 piece,Cephalexin capsules 2 plate.

　　傅会利对这个处方有信心，说，别看药便宜，可都很管用，她是医院的专家，孩子吃她的药，每次都治好了病。

The FuHui to this prescription have the confidence,said,Although medicine cheap,But are very useful,She is the hospital experts,Children eat her medicine,Every time healed disease.

　　医院缺钱，却允许她存在 Hospital lack of money,But allowed her to exist

　　记者说明来意后，毋剑梅不好意思：“采访我有什么用呀！医疗体制大环境下，一个人两个人这么做，没什么用的，改变不了什么。”

After reporter mentioned what,No sword may feel embarrassed:"Interview I have what use!Medical system environment,A person two people to do so,Nothing in,Change??????."

　　直到中午一起吃饭，她还坚持这个观点——她的行为别人是不会学习的。

Not until noon to eat together,She also insisted the view - her behavior others won't study.

　　现行医疗体制下的医院，也不会鼓励所有大夫像她那样去开处方。照她的话说，“如果都开小处方，医院早关大门了。”

The current medical system of hospital,Also won't encourage all like her so the doctor to prescribe.As her words,"If all open small prescription,The hospital early shut the gate."

　　具有公共服务属性的医院，中国在改革开放后让其在市场化道路上“脱缰”，使得看病贵、看病难、以药养医等现象日益严重。

With the public service attributes of the hospital,China's reform and opening up to the market on the road"bolt",Makes the doctor your/See a doctor difficult/To raise the phenomenon such as medical medicine becomes more and more serious.

　　北京大学医改专家刘国恩教授说，医院利润通常约40%来自卖药，还有40%至50%来自诊断和治疗，不到10%来自政府。

Beijing university professor LiuGuoEn medical experts said,The hospital profits usually about 40% from selling medicine,There are 40% to 50% from diagnosis and treatment,Less than 10% from the government.

　　这在洛阳市妇儿中心同样存在。

This in luoyang fu center also exist.

　　该中心成立于1953年，是河南省市级医疗机构中唯一集妇女儿童系统保健、疾病防治、教学科研为一体的三级妇幼专科医院。

The centre was established in 1953,Is the only city in henan province medical institutions set of women and children health care system/Disease prevention and control/Teaching and scientific research as one of the three levels of maternal and child specialized subject hospital.

　　妇儿中心党委副书记、纪委书记郭俊惠介绍，即使如此一所医院，现在洛阳每年给医院的财政补助才80万元，对医院发展来说杯水车薪，且这个补助标准还停留在上世纪80年代水平上。

Fu, vice secretary of party center/Discipline inspection commission secretary GuoJunHui is introduced,Even so a hospital,Now each year to luoyang hospital financial aid only 800000 yuan,To the hospital for development in the ocean,And this subsidy standard still stay in the 1980 s level.

　　但医院的原则是：该挣的钱可以去挣，不能挣的钱，坚决不能拿。去年，医药收入占医院总收入36%左右，低于规定值4个百分点。

But the hospital principle is:This money can go to earn,Can't earn money,Resolutely can't take.Last year,Medical income of hospital income 36%,Less than 4% of the rated value.

　　因此，30多年来，他们一直支持毋剑梅的行为。

therefore,More than 30 years to,They always support not sword mei behavior.

　　郭俊惠说，不久前，在对门诊医生处方的统计中，毋剑梅的单张处方均额只有16元，总是全院处方金额最低的医师。

GuoJunHui said,Not long ago,In the outpatient service a prescription from a doctor in the statistics,No sword mei's single prescription are amount only 16 yuan,Always partial minimum amount physicians prescription.

　　洛阳市妇儿中心主任王茅帅说，虽然单张处方平均费用低，次均住院费用低，但是患者口口相传，良好口碑给医院带来了持久效益。

Luoyang, director of the center for women WangMao handsome said,Although single prescription average cost low,Times are low cost in hospital,But the patient of mouth,Good public praise to the hospital brought lasting benefits.

　　工资不多，却不追逐利益 Pay little,But don't chase interest

　　小处方的毋剑梅，成了医院的金字招牌。但医院一工作人员说，这样的人，只能是例外，每个大夫都如此，医院不会同意，大夫个人也要蒙受重大经济损失。

Small prescription of sword may not,The gold-lettered signboard of a hospital.But a hospital staff said,Such people,Can only be exception,Each doctor are so,Hospital won't agree to,The doctor individual will suffer great economic losses.

　　学者汪丁丁曾说，与创造的价值相比，中国医师的合法收入很大程度上偏低，这催生大量灰色交易，导致医师通过手中处方权获得补偿。

Scholars murphy said,Compared with the creation of value,Chinese doctors legal income to a large extent on the low side,This has a lot of grey trading,Lead to physicians through the hands ChuFangQuan get compensation.

　　据调查，一位内科医师从处方药中获取的各种回扣大约占其总收入的80%。这也是看病贵居高不下的根源。

According to the survey,A physician from prescription drugs for various rebate for about 80% of its revenue.This is the source of your high to see a doctor.

　　可毋剑梅拒绝了这80%的丰厚收入。她说，到现在，她没有拿过一分钱药品回扣，也没有违背良心开过一种不该开的药。

Can not sword may refuse to the 80% of the rich income.She said,To now,She didn't get a penny drug rebate,No against conscience open a shouldn't open medicine.

　　“药品利润都在新特药上，”她称，“我开的药都是极普通的药，便宜，疗效又好，实在必须用，才开新药。”

"Drug profits are in the new TeYao on,"She says,"I open medicine is a common medicine,cheap,Curative effect and good,Really have to use,To open new drug."

　　其实，这些药都在国家的基本药物目录中，各医院都有，但同类药性的药品种多，一些大夫并不愿用这些便宜的药。

In fact,These all in the national essential drugs list,Each hospital has,But a similar drug kind of many,Some doctor does not want to use these cheap medicine.

　　作为洛阳市顶级的主任医师、儿科专家，不拿药品回扣的毋剑梅能领多少工资？毋剑梅说，扣除杂七杂八费用，拿到手的有4000多元。

As luoyang top chief physician/paediatrician,Don't take drugs kickbacks no sword mei will bring many wage?No sword may said,Deduct miscellaneous expenses,With our 4000 multivariate.

　　她说，爱人也在洛阳一家军队医院，两人工资加起来，一个月一万多元，足够花了。曾有药商找到她，给她塞红包，点明回扣的事儿。出于礼貌，她应付道，药品介绍放这里，需要的话，自然会用。

She said,Love and a military hospital in luoyang,Two people pay up,A month ten thousand multivariate,Enough spent.There have been druggist find her,Give her a red envelope plug,Point out rebate business.Out of politeness,She cope with the way,Drug introduce put here,needed,Natural will use.

　　可实际上，毋剑梅从来不用，用的还是那些基本药物。“能一块钱治好的，为啥要让患者花十块？”

But in fact,No sword may never,Use of or the essential drugs."Can a dollar of cure,Why to make patients spend 10 block?"

　　她的原则是，用药必须根据诊断。一毛钱能治好不要用一块钱，一毛钱治不好，也可以用一块钱。

Her principle is,Medication must according to the diagnosis.A dime can cure don't use a dollar,A dime not cure,Can also use a dollar.

　　曾有药商塞给她500元钱，她死活退不掉，最后交给了科室。慢慢地，她的“绝情”在药商中流传，没人再去她那里碰钉子。

There have been druggist plug to give her 500 yuan,Her life and death back off,Finally to the department.slowly,her"heartless"The druggist spreads,No one will ever again to her there get the cheese.

　　药剂科科长程宇说，毋大夫开的一些基本药物，很难采购的，都是到全国各地去买，药厂其实也不愿生产这些药，利润太低，药厂热衷新特药。

Agent coco long yu said,No doctor open some essential drugs,Difficult to purchase,Is to all parts of the country to buy,Pharmaceutical factory in fact they are not willing to produce these medicine,Profits is too low,Pharmaceutical companies keen to new TeYao.

　　“错不在医生 "Is not wrong in the doctor

　　而在现行制度” And in the current system"

　　就在洛阳争相传诵毋剑梅事迹的时候，11月17日，2012医院院长高峰论坛在武汉举行。中华医学会党委书记饶克勤认为，医患冲突根源在于公立医院“灵魂”公益性的缺失。

In luoyang scramble to be widely read no sword may when deeds,On November 17,,2012 hospital dean peak BBS held in wuhan.The Chinese medical association secretary of the party committee RaoKeQin think,Doctor-patient conflict root public hospital"soul"The lack of public welfare.

　　数据显示，2008年~2011年，医生遭遇暴力袭击从3.7%升到4.5%，语言侮辱从22.1%升到27.3%，其中一些恶性案件更是举国震惊。而公立医院“灵魂”公益性缺失的表现之一，即医生、医院从药品中获得的层层收入。

Data display,In 2008 ~ 2011,The doctor encountered violent attacks jumped to 4.5% from 3.7%,Language insult from 22.1% up to 27.3%,Some of the malignant cases but also the whole nation shocked.Public hospital and"soul"One of the symptoms of lack of public welfare,Namely the doctor/From a hospital drug layer of income.

　　毋剑梅说，我理解他们的行为，不是每个人都看淡金钱的，“我的病人，有些人让他住院治疗根本不多余，但我没让住，只开了几天药。”

No sword may said,I understand their behavior,Not everyone see light money,"My patients,Some people let him hospitalization don't redundant,But I didn't let,Just opened a few days medicine."

　　“错不在医生，而在现行制度。”在她看来，与国外相比，中国医师的合法收入太低，医院的财政补助太少。

"Is not wrong in the doctor,And in the current system."In her eyes,Compared with foreign,Chinese doctors legal income is too low,The hospital financial aid too little.

　　体制改革前 System reform before

　　她只能是个“传说” She can be a"legend"

　　“一个病人，我200元钱治好病，其他人5000元钱治好，你说谁的技术好，谁对社会的贡献大？”毋剑梅反问，“对医院来说，你说它是喜欢我，还是喜欢另外一个大夫？”

"A patient,I 200 yuan cure disease,Others 5000 yuan cure,You say who technology good,Who contribute to the society big?"No sword may ask,"On hospital for,You said it was like me,Or like another doctor?"

　　洛阳市妇儿中心信息宣传部主任李万江说，医院如果没有一个宽松的环境，毋剑梅这样的大夫是没法生存的。

Luoyang fu center information publicity department director LiWanJiang said,The hospital without a relaxed environment,No sword may this doctor is can't survive.

　　医院展开了向毋剑梅学习的活动。

Hospital launched to no sword mei learning activities.

　　然而，大多数的医生，还是要受体制束缚，还是要面对生活压力。

however,Most of the doctors,Still want to suffer system bound,Still want to face life pressure.

　　一位大夫说：“很多医生要顾及科室效益，要顾及家庭生活，不可能像她那样超脱。”

A doctor said:"Many doctors to take account of department benefit,It should take account of family life,May not like her such detachment."

　　基于这些认识和现实，毋剑梅说，宣扬她的做法于事无补，根本做法还是彻底进行医疗体制改革，推进公立医院改革，实行管办分离、支付方式改革和医药分开，建立有序医疗体系。

Based on the understanding and the reality,No sword may said,To promote her practice to no avail,Fundamental approach or completely in medical system reform,Promote public hospital reform,A tube to do separation/Payment reform and medicine apart,Establish orderly medical system.

　　这一天会远吗？

This day will be far behind?

　　在这一天没到来前，毋剑梅只能是中国市场化医疗市场的一个传说。

In the days before arrival,No sword may only is China's marketization of medical market a legend.

　　“过几年，她退休了，像她这种做法的人，洛阳不但没有了，整个中国，估计你也很难再找到第二个。”毋剑梅的一位同事评价说。

"In a few years,She retired,Like her this way people,Luoyang not only have no,The entire Chinese,Estimate that you have is hard to find the second."No sword mei a colleague said evaluation.