Professor Li Jin's own account: a conscience can become a good doctor

Since i have become a doctor, this life to save people is my job, but also the source of my life, nothing elseAlthough the World Health Organization has long defined cancer as a chronic disease, the fear of cancer is deeply rooted, not only because of its high mortality rate, but also because of the huge burden of disease
After more than 30 years of dealing with cancer, Professor Li Jin, Director of Oncology Medicine department at Shanghai Oriental Hospital and former President of the Chinese Society of Clinical Oncology (CSCO), is a true "anti-cancer fighter"He has reaped many achievements and praise from the industry, but privately he describes himself as a "sharp temper", "straight talk" or even "easy to offend people"
Professor Li Jin Why do our cancer patients live shorter lives than Europeans and Europeans?
We once published an article in a well-known international magazine, because our patients have a relatively short life, which has aroused the question of foreign counterparts, how can the survival period be so short? Later in the international exchange, I truthfully explained with our foreign counterparts: many of our patients who participate in clinical research, because there is no money, can not afford health insurance drugs, only to take the initiative to find us to participate in clinical trials, so the survival period than the United States is much shorter
When I say this, i am actually very sadWhy do we have to live shorter lives than Americans and Europeans Chinese?
"So we have to work hard, not arrogant, we are far from the world's advanced level, we have to recognize the situation, we have to work hard." At present, China's tumor survival rate compared with foreign developed countries, there is a large gap, there are several reasonsFirst of all, China is the largest developing country, although our total GDP is very high, but we have 1.4 billion people, per capita GDP ranking is relatively lowDeng Xiaoping has said before that any number divided by 1.2 billion is smallSo China's economy is still lagging behindWe cannot blind ourselves, blindly blind our selves to the General Assembly
China's tumor 5-year survival rate is lower than Japan, South Korea, Western developed countries is also very natural, this is consistent with our economic level, we have not yet reached the state of a comprehensive census, many early tumor patients can not be found in time, found in the late stage, 5 years survival rate is naturally relatively low
And we do not have so many new drugs, innovative drugs are now in Europe and the United States developed countries, in China is often listed 2-3 years later, the treatment effect will be relatively poorAnd Because of China's unbalanced economic development, the western region, poor areas, patients even ordinary medical insurance reimbursement chemotherapy drugs are not available, can not affordYou think, how can his life last?
In the next two or three years, the five-year survival rate of tumors will be greatly improved The world's annual cancer death son of about 8 million patients, but the majority of early-diagnosed tumor patients can be cured, so we speak of early prevention and early treatment, especially to promote cancer screening in the community
If the patient has a family history of tumors, such as bowel cancer, then he also has chronic enteritis, intestinal polyps, he belongs to the high incidence of bowel cancer, we need to do more screening, if early detection, early intervention to do treatment, many patients can be cured, so we say that 1/3 of the tumor patients can be cured
There are also some patients who are diagnosed relatively late, after the operation will still relapse, such a patient to achieve a complete cure is more difficult Therefore, we advocate to prevent the main, try to avoid bad living habits, if there are already bad living habits, such as smoking, to quit smoking as soon as possible In addition, to control pollution, such as air, water pollution and so on, pay attention to early screening of the community, early intervention of precancerous lesions, can be achieved prevention
"Even if you get a tumor, the recovery rate of the tumor will certainly be higher and higher in the future, and I estimate that the five-year survival rate of the tumor should increase significantly in the next two to three years." Mainly because of the emergence of new therapies, such as immunotherapy, cell therapy, double-target, dual-functional monotophobic, etc , the therapeutic effect is getting better and better, the patient's survival is getting longer and longer, the 5-year survival rate in the next 5 years will have a clear rapid climbing process, which I am very confident
Multidisciplinary therapy is still a more extravagant idea Any patient at a certain stage, there must be a most suitable treatment, but each person's ability is limited, knowledge is also limited, especially now, our division of labor is getting more and more detailed A surgeon, heart surgery is wonderful, but he may not do well in lung surgery, he concentrates on heart surgery
Now many hospitals, large intestine and gastric surgery are also separate, the same surgeons are divided so fine, and the difference with physicians is even greater, and radiotherapists are very different So the patient to a certain stage, whether it is suitable for surgical treatment, or do internal medicine treatment, or do radiotherapy, or other treatment, each doctor only master his own professional side, this time need to sit together with doctors in different disciplines, including pathology, imaging diagnostics, intervention, internal medicine, surgery, radiotherapy, etc., on the patient's current situation, to work out the most appropriate treatment strategy, so that the patient's interests maximized, this is MDT multidisciplinary
In the UK, all cancer patients have to go through MDT discussion stolouring and give the best treatment, and the patient's survival will naturally be longer However, MDT cannot be widely carried out as a status quo in China
Think about it, our Chinese doctors a morning to see 50-70 patients, I am talking about in the hospital, such a heavy burden of the case, how can seven or eight doctors around a patient to discuss half an hour? I can't do it So MDT can only stay in the propaganda stage
Now some hospitals do MDT is more suitable for multidisciplinary learning, one morning a week, with one or two hours, multidisciplinary discussion of a complex patient, can only say that the multidisciplinary concept throughout the doctor's practice process, just an improvement, but can not fundamentally change the status quo
Especially in smaller hospitals, the discipline itself is incomplete, how to do multidisciplinary discussion? Who's going to talk about it? Even the doctors are at a bad end So this multidisciplinary discussion is a luxury for us, and it's not possible for every patient to do a multidisciplinary discussion at the moment But that's not to say we don't have the ability to do it yet, we're going to try to do it and try to instill the MDT concept in our doctors
Professor Li Jin team in China to do doctors, we must have a basic conscience We do multidisciplinary discussion process, is a learning process, is to other departments of experts learning process, the next time I meet the patient, I know, the original patient I can not only give him systematic chemotherapy, but also after the tumor reduction, the patient to the surgeon hand, let him cut the lesions, not to achieve the purpose of controlling the tumor? So when doctors treat patients, don't be standard-based, don't just consider your profession, but stand in the patient's point of view to set the best treatment strategy for the patient
In fact, it is not the best strategy, only our doctors know, others have no way to know, so when I communicate with our doctors, I said that there is no problem in the United States, because the United States is very developed, the diagnosis and treatment is very standardized
"Because China is economically underdeveloped, many doctors treat patients on their own (by experience, not by guidance), and then your conscience determines how long the patient can live." So I often joke with people that people with a conscience in China must be able to be a doctor in order to be a good doctor If this person is born bad, all day long thinking of scraping some oil from the patient, what benefits, this kind of doctor is not a good doctor, to do business, of course, businessmen can not make money can not be without any means, but also to comply with the
So to do doctors in China, must have a basic conscience, I am very pleased to see that the vast majority of our doctors in China are very conscience, you see this outbreak, how many doctors and nurses actively signed up to support Hubei, this is to risk their lives, it can be said that Chinese doctors are no worse than Western doctors, especially in taking risks in this regard, Chinese doctors may do a little better, I personally feel that our doctors are more dedicated, the courage to sacrifice
Pictures from the network to save people is my job, nothing else in the past our country believes that all drugs that have not been approved for listing in China, are fake drugs, if the doctor to the patient after the use, will be subject to the corresponding punishment
At an international conference a few years ago, a Chinese doctor asked me what he said about the use of new drugs in China that are not yet on the market I said that sometimes I also give the patient, I think life is greater than the regulations, regulations are made to protect life, if our patients' lives can not be protected, then what use of regulations? Right?
So at that time, if the patient bought his own medicine, I also for the patient, I am willing to take legal risks But I'll ask the patient to sign an informed consent form and ask his family to sign a commitment, and if I'm asked to take administrative responsibility, I'll take responsibility for any adverse reactions caused by the drug, because the drug was bought by you, right?
"We have been shouting that life is greater than all else, life can not be repeated, we want to put the patient's life safety first, when the patient from abroad to buy life-saving drugs, why can't we give the patient?" Isn't that contrary to our philosophy? How can we embody the idea of saving lives and wounded? So after the relevant departments of the state amended the regulations, I raised my hands in favor Over the years, When I gave patients their own medicine, I had some minor problems, but the patient's family understood that no one had ever asked me for trouble because they knew I was really helping them I feel that the mind to find a doctor trouble of course also, is very few It is not right that our doctors can't help patients because of the presence of individual patients Because in this world after all, there are bad people ah, our patients must also have bad people, but not because of a bad patient or family, all patients as bad people
I must still be me, and if you're going to sue me, there's no way, because that's my job So some patients give me kneeling or something, I said you don't like this, don't thank me, this is my job, the hospital gave me wages, is to let me come to see the doctor, and I saved you, I also have a sense of achievement
So I think, since being a doctor, this life to save people is my job, but also the source of my life, nothing else
Professor Li Jin, Director of Oncology Medicine Department, Tongji University Oriental Hospital, Chairman of the Asian Oncology Alliance (FACO), Chairman of the CSCO Foundation, former Chairman of the Chinese Society of Clinical Oncology (CSCO), Chairman of the CSCO Drug Safety Committee, Vice Chairman of the Chinese Physicians Association Colorectal Cancer Professional Committee, and Deputy Chairman of the Abdominal Oncology Committee of the Chinese Medical Continuing Education Society
Author: Tian Dongliang Source: Medical