Brief introduction of French doctor system
In western countries, doctors are one of the most respected occupations, and their salaries are very high. This is inseparable from the cruel screening and long-term strict training they have experienced.
First of all, it is not difficult to get into medical school. All students with a bachelor's degree in Hong Kong can register for medical school. But after one year, you must pass a strict qualification examination before you can continue your study. There are only 200 places in this exam, and as many as 80% students will be eliminated. Moreover, a candidate can only take this exam twice at most. Failure means that there is no chance to be a doctor in my life. Therefore, there are all kinds of cram schools for medical students in society, and almost all the admitted students have participated.
After this, medical students need to receive at least six years of training, including three years of basic medical education and three years of clinical practice. The course adopts the integral system and there are exams every year. If they fail, they can make up the exam. After the stage of basic medical education, there is a more stringent specialist qualification examination (Internat) waiting for them. Only those who pass the exam can become specialists (Spé cialist), and those with high scores will give priority to their majors. Those who don't take the exam or fail the exam become general practitioners. Relatively speaking, specialists have higher social status and more expensive consultation fees. In addition, they can increase their fees on the basis of the consultation fees prescribed by the state, but for patients, this part of the increased fees is not within the reimbursement scope of the general social insurance (Sécuritésociale).
Next, the future general practitioners and specialists will receive three and five years of hospital internship respectively, and then write their graduation thesis. Students can choose their own topics. In other words, it takes at least 9 years to become a general practitioner, and at least 1 1 year for a specialist. In France, you can practice medicine as long as you have a medical college diploma. L'ordre des médecins is an institution that decides whether doctors are qualified to practice medicine and issues medical licenses. Mainly consider whether the distribution of doctors in different regions is balanced, and prevent doctors with bad behavior records from continuing to practice medicine.
Medical college students go to work in hospitals after graduation and are called residents. Their positions are equivalent to teaching assistants in medical colleges, and their work nature belongs to training. After working for two years, you have to write a thesis and get approval before you can be promoted from a resident to a clinic director, which is equivalent to a lecturer. The longest stay in the hospital is four years, and the department of service and the professors who follow it have to change once every six months, thus avoiding the "inbreeding" in academic circles.
From the doctor's point of view, the net income of practicing medicine in private hospitals or clinics is high, but there is pressure from customers, rent and equipment investment. So many doctors choose to stay in public hospitals, work in hospitals for a few days a week, and work in their own clinics or private hospitals for the rest of the time. Even some people only need to come to the public hospital once a week for classes, or just come to the weekly meeting. The advantage is that critically ill patients who need long-term treatment can be transferred from their own clinics to public hospitals, reducing the cost pressure. In addition, due to the high investment in opening their own clinics or joining private hospitals, new specialists generally choose to change doctors first, so as to establish a relatively fixed patient network, namely customers. Private hospitals are also divided into closed and open hospitals. The number of doctors in closed hospitals is fixed, and no vacancy will attract new people. Doctors who want to enter can spend money to buy doctor vacancies, but good hospitals are expensive, and a position can reach one or two million euros. An open hospital embodies that doctors can bring their own patients to join and then pay a certain fee to the hospital.
Medical students must pass rigorous examinations to stay in medical school after graduation. In the end, there are very few people who can become professors in medical schools, and they are real authorities. They have a high social status and will be re-elected after death. Accordingly, their generous remuneration generally consists of two parts, one from medical college and the other from hospital.
French hospitals also have many external experts, scholars and foreign doctors. They are called pratician attach, that is, "visiting doctors", with outstanding professional knowledge and excellent medical skills. Dr. Don Hong Xiao was hired as a visiting doctor in digestive surgery by Paris VII Bichater Hospital and Bicai Private Hospital. Especially good at the world's advanced hepatolithiasis and laparoscopic surgery. He believes that the French medical community has a very objective evaluation and high respect for the talents of outstanding foreign doctors.
The profession of doctor needs to constantly accumulate experience and update knowledge. General practitioners in France have regular medical training every year to master the latest medical technology and drugs. Specialists must also participate in peer consultations regularly. If they don't speak at the meeting for three times, they will be considered to be backward in their majors, and their position will be difficult to stabilize.
How to choose doctors and hospitals
In France, it is very important to choose a hospital, and the key is to choose a doctor in the hospital. In particular, the new medical reform stipulates that starting from July this year 1, you must first go through your own community doctor (Médecin traitant, also called family doctor or doctor handler), and then he will recommend other specialties, otherwise the medical expenses will not be reimbursed according to the maximum social insurance limit (except psychiatry and other specialties).
Of course, everyone wants to find a doctor with smooth language communication and good art, so they generally choose China people recommended by relatives and friends. This is of course true, but we suggest that you also consider the following aspects:
1, the clinic is near your address. After all, people who are sick are unwilling to spend a lot of time and energy going to see a doctor by car, and sometimes they are too lazy to go to the doctor's office for treatment, which will delay their illness and even cause serious consequences. If there is no language problem, you can also call Pages jaunes or check the doctors near your residence online.
Doctors have enough time for consultation. Some doctors are famous. Because of this, it is inconvenient for most patients to make an appointment one or two months in advance to see him once. In fact, there are some doctors in every community, and they have a fixed period of time every week (such as Tuesday and Friday afternoon) to receive patients who have not made an appointment in advance, so it is much more convenient to watch them when they arrive.
3. It is best to find a doctor who is familiar with your medical history. For example, some patients are allergic to certain drugs, or when taking certain drugs, they will have great side effects and must cooperate with other treatments at the same time. A doctor who is familiar with your medical history and constitution will find the best plan to reduce unnecessary risks.
If you are suddenly injured or have an emergency, you must go to the hospital for first aid. There are more than 100 public hospitals and 100 private hospitals in Paris. Assistance publique is the largest medical aid organization, which can also be called "Health Bureau" in Paris (website www.aphp.fr, with detailed information about hospitals online), and its chairman is French President Jacques Chirac. The institution includes a number of public hospitals and has tens of thousands of beds in Paris.
France attaches importance to medical economics. In order to avoid unnecessary waste, almost all emergency rooms in hospitals are open during the day, and the subjects are more comprehensive. But at night, only some hospitals have expert emergency services. For example, according to Dr. Tong, it is best for Paris residents to go to HOTEL DIEU Hospital (1, Place du Parvis Notre-Dame, 75004 PARIS) next to Notre Dame de Paris, which is also a specialized police hospital and a criminal case injury appraisal hospital. Otolaryngology and maxillofacial trauma can go to the largest PITIE-SALPETRIERE hospital in Europe (47-83, boulevard de l'Hopital, 750 13), or the LARIBOISIERE hospital near the North Railway Station (2, rue Ambroise- Paré, 750 10 PARIS). In addition, Pitie Hospital also has vascular surgery. BEAUJON Hospital (100, Boulevard du Gé né ral Leclerc 92 1 10 Clichy) on the outskirts of Paris has night emergency services for liver, gallbladder and pancreas in vascular surgery, hand surgery trauma and digestive surgery. AMBROISE-PARE Hospital (92100 Boulogne-Bilancourt) near the Boulogne forest in western Paris also has emergency vascular surgery at night. Burn can go to Cochin Hospital (75014, No.27 St. Jacques Street, Paris); Hand surgery trauma, cardiac surgery, especially infectious diseases, can go to the seven affiliated hospitals in Paris (Ruehenri-Huchard No.46, 750 18 PARIS). Georges Pompidou European Hospital (20-40, Rue Leblanc 750 15 Paris) also has emergency department of hand surgery and cardiac surgery. If you need to see a pediatric emergency, especially nephropathy, you'd better go to necker Pediatric Hospital (149, rue de Sèvres, 75015 Paris). Go to St. Louis Hospital (1, Avenue Claude-Vellefoux, 750 10 Paris) for emergency treatment of hematological diseases and dermatology; Tumor and liver transplantation went to PAUL-BROUSSE Hospital in the southern suburbs of Paris (12, Avenue Paul-Vaillant-Couturier, 94804 VILLEJUIF), and intestinal diseases in digestive surgery went to St. Anthony Hospital (184, Rue du Faubourg Saint-Antoine, 75065438+). Wait a minute. If you don't know the hospital you should go to, you can call the emergency number 15 or 1 12 directly.
These are large public hospitals. It is not convenient to introduce the situation of private hospitals in detail here Its main features are: 80% private hospitals are surgical hospitals, but only large private hospitals can provide intensive care services. Private hospitals only have attending doctors, which can ensure high-level treatment, and can directly designate famous doctors for surgery.
Misunderstandings and suggestions of French people going to China for medical treatment
In addition, the main problems or misunderstandings encountered by China people in seeking medical treatment in France may include:
1, language barrier. In this regard, we suggest that friends who are not fluent in French should find relatives and friends with good language skills to accompany them to see a doctor. Otherwise, you can prepare a written explanation in French at home, describing the symptoms in detail, including symptoms, the time and frequency of attacks, drugs taken, foods that may affect the condition, and so on. Always keep a handy Chinese-French dictionary at home, such as the Pocket Foreign Language Teaching and Research Press's Chinese-French Classified Vocabulary Manual, which contains common daily words to describe diseases.
2, unfamiliar with French medical habits. In China, you go directly to the hospital, while in France, you usually go to the clinic of a community doctor. You need to make an appointment with a doctor by phone for non-emergency situations, so you go to a general hospital unless it is during the doctor's free consultation period.
3. The psychology of seeking medical treatment is different from that of the French. People in China generally want to know their illness and treatment in detail, while French patients are used to completely following the doctor's arrangement. Dr. Tong gave an example that a French patient went to the hospital to see a doctor. The doctor asked him about his past illness, but he couldn't answer, so he asked the doctor to check the medical record or ask his past doctor. The doctor asked him if he should have an operation. He has only one sentence: "It's up to you, because you are a doctor." This is common in France, but it is hard to imagine in China. The same is true for signature before operation. In France, adults only need to sign their own consent before surgery, and children need the signature of their guardians. But in China, it needs the signature of the patient's family and even the unit leader. Before the entry into force of Kouchner Law in 2002, French doctors even had the right not to explain the treatment methods and drugs used to patients. But now, all patients in France have the right to consult their medical records and all the information about treatment.
4, I hope to find specialist treatment directly. In fact, patients often just guess which doctor to see, but the judgment may be inaccurate, which may easily lead to misdiagnosis or delay treatment. In addition, some specialties in France (such as neurology, endocrinology, cardiology, etc. Patients are required to go to the general practitioner to complete the preliminary examination before they can be treated according to the specific situation. Therefore, the first stop to see a doctor must be to find your own community doctor, consult all kinds of medical information and transfer to another hospital. In addition, all information about the medical system can be consulted by your community doctor or social insurance management department. For example, in France, people with social insurance can enjoy a comprehensive physical examination every five years (including mammography, electrocardiogram, blood test, etc. ), and women over 50 can enjoy free mammography once every three years. Please consult the insurance department for the specific physical examination location.
The main problems or misunderstandings encountered by China people in French medical treatment are:
1. Language barrier. In this regard, we suggest that friends who are not fluent in French should find relatives and friends with good language skills to accompany them to see a doctor. Otherwise, you can prepare a written explanation in French at home, describing the symptoms in detail, including symptoms, the time and frequency of attacks, drugs taken, foods that may affect the condition, and so on. Always keep a handy Chinese-French dictionary at home, such as the Pocket Foreign Language Teaching and Research Press's Chinese-French Classified Vocabulary Manual, which contains common daily words to describe diseases.
2. Not familiar with French medical habits. In China, you go directly to the hospital, while in France, you usually go to the clinic of a community doctor. You need to make an appointment with a doctor by phone for non-emergency situations, so you go to a general hospital unless it is during the doctor's free consultation period.
3. The psychology of seeking medical treatment is different from that of the French. People in China generally want to know their illness and treatment in detail, while French patients are used to completely following the doctor's arrangement. Dr. Tong gave an example that a French patient went to the hospital to see a doctor. The doctor asked him about his past illness, but he couldn't answer, so he asked the doctor to check the medical record or ask his past doctor. The doctor asked him if he should have an operation. He has only one sentence: "It's up to you, because you are a doctor." This is common in France, but it is hard to imagine in China. The same is true for signature before operation. In France, adults only need to sign their own consent before surgery, and children need the signature of their guardians. But in China, it needs the signature of the patient's family and even the unit leader. Before the entry into force of Kouchner Law in 2002, French doctors even had the right not to explain the treatment methods and drugs used to patients. But now, all patients in France have the right to consult their medical records and all the information about treatment.
4. I hope to find a specialist directly. In fact, patients often just guess which doctor to see, but the judgment may be inaccurate, which may easily lead to misdiagnosis or delay treatment. In addition, some specialties in France (such as neurology, endocrinology, cardiology, etc. Patients are required to go to the general practitioner to complete the preliminary examination before they can be treated according to the specific situation. Therefore, the first stop to see a doctor must be to find your own community doctor, consult all kinds of medical information and transfer to another hospital. In addition, all information about the medical system can be consulted by your community doctor or social insurance management department. For example, in France, people with social insurance can enjoy a comprehensive physical examination every five years (including mammography, electrocardiogram, blood test, etc. ), and women over 50 can enjoy free mammography once every three years. Please consult the insurance department for the specific physical examination location.