Pediatrician in a Walled City

They are not only pediatricians, but also kindergarten teachers who soothe children and detectives who deduce illnesses from clues.

There is a saying in physician circles: “Gold ophthalmologist, silver surgeon, dead don’t go to pediatrics. “

It is an accepted industry fact that pediatricians are underpaid, tired, and have a high probability of medical problems.

However, pediatricians are often the most patient and tired group of people.

Children are less cooperative and are always venting their frustrations by crying. This makes treating a child more demanding than treating an adult.

They are not only pediatricians, but also kindergarten teachers who soothe children and detectives who deduce things from clues.

They are dealing not only with children, but also with anxious parents – few of whom can maintain their sanity when their own flesh and blood is ill.

In addition, the physician’s performance depends largely on the number of surgical procedures and the amount of medication administered. Yet children’s avoidance of surgery and cautious use of medications have also made pediatricians the lower income bracket among their peers.

Many pediatricians have left their jobs in the face of this hostile work environment.

According to statistics, the number of pediatricians per 1,000 children in China is only 0.53, far below the WHO’s minimum standard of one pediatrician per 1,000 children.

This microscopic story is about a group of pediatricians who.

There are people who have been pediatricians for more than 20 years and are reluctant to give up the children just because they think they are cute and need him, even if they are poorly paid and tired.

Some are caught in the uncertainty of a two-year pediatric residency, and as an insignificant individual, she finds it difficult to confront the contradictions of the entire pediatric system and chooses to leave.

Others have followed the “clinical bedside manner” and escaped from the big city general hospitals to their hometowns, finding a career and life balance in a relatively relaxed environment. ……

To them, pediatrics is like a walled city surrounded by enemies, with those who stand their ground and those who are overwhelmed and evacuate.

The siege cannot be lost, and the people inside need supplies and reinforcements.

The following are true stories about the pediatricians.

I’m tired, but I can’t bear to leave my lovely children behind.

Dr. Ling Zhang, 42 years old, pediatrician at a tertiary hospital.

In 1995, after completing my undergraduate medical school and graduate school, I chose pediatrics just because I thought the kids were cute.

My mother was an elementary school teacher. I was always surrounded by older children since kindergarten, and then in elementary and middle school, I was still surrounded by 7 and 8 year olds.

Until I finally went into pediatrics myself, I felt like I was stuck with kids for the rest of my life.

The adult department was mostly full of dreary older people, and there was an unexplainable depression in the room.

As a doctor, you can only temporarily relieve their discomfort.

But for the elderly, who are becoming less and less able to function physically, the quality of life can become a little worse after a single illness hit, and they may even need specialized care.

From this perspective, are we really helping them to get better by saving their lives? I can’t help but always think of it this way.

Pediatrics is different in that children are incredibly resilient.

They are just beginning their lives, and once they are cured, they can grow up healthy and become whatever they want to be. This sense of accomplishment is unmatched in an adult unit.

Everyone says, “Golden Eye, Silver Surgery, Crying Pediatrics, Buried Tide Obstetrics and Gynecology”.

In the beginning, I also wanted to choose surgery, eager to play a unique role on the operating table, like a shouting general.

As I continued to learn, I realized that humans can only cure a fraction of diseases, and that most of the time we are powerless against viruses, bacteria, and unknown diseases.

Pediatrics is pretty interesting.

It’s especially rewarding when a child is listless and sick, and you give him some medication and a few shots, and then he bounces around for a follow-up visit a few days later.

Besides, children are always very simple.

When you heal her, she will express her affection, kiss, and hug you with all kinds of words she has just learned, which is a sense of happiness that cannot be brought by healing adult patients.

I’ve also witnessed the death of children.

There was a six-year-old girl named Mo, who had osteosarcoma, a disease that affects adolescents. She had osteosarcoma, a malignant tumor that occurs most often in adolescents and has a particularly high mortality rate.

She was the only child in the room who could say thank you to the doctors and nurses.

By the time Mo came to me, she was already in the middle to late stages.

I wasn’t sure if the cancer had spread, so I quickly transferred her to the ICU when conservative treatment didn’t improve.

The focus of her disease was in her leg, and we amputated Mo’s right leg during treatment.

Even after what happened to her, she was still the least crying girl I’ve ever met, knowing that osteosarcoma attacks are extremely painful.

Unfortunately, we still couldn’t keep Mo alive.

The doctors and nurses in charge of Xiao Mo’s life were sad for a long time as they watched it slowly pass before your eyes.

It was then that I decided to stay in pediatrics for the rest of my life.

I couldn’t leave the kids behind. If no one else worked in pediatrics, there would be more and more kids who wouldn’t survive, and how many tragedies like Mo’s would happen!

The practice environment for pediatricians is indeed deteriorating, as has been rumored.

Many of my colleagues have changed careers or gone on to other positions, leaving pediatricians with even more work to do.

I am getting older, and in the last few years I have felt the strain on my body.

As for the income, it’s quite a bit less compared to other doctors, but it’s still adequate.

Perhaps it is because I live a simple life and don’t think much of money. Nowadays, most of the people who complain about the low salary are young doctors who are under more pressure to survive than we are.

Although I have encountered a few cases of parents pulling your hair and throwing it against the wall or yelling at you, there are still very few, and the vast majority of parents have special respect for you.

In addition, as anyone who has been to medical school knows, pediatrics has very few unrelated medical factors that can interfere with your treatment.

On a spiritual level, pediatricians are richer for it.

I often say that I was born to be a pediatrician. In my 20 years of practice, I have always thought that these children are lovely and worthy of our care and attention, and even though there are people changing careers all the time, I don’t want to leave.

I gave up my pediatric practice after two years, and I would rather choose a department where I can realize my personal values!

Li Man, a 25-year-old woman, is studying for her master’s degree in pediatrics.

I initially chose pediatrics only because my research scores were not sufficient.

Although I had heard about the current situation in pediatrics, I was naive and thought that the difference would not be too big since we were all doctors.

I also had the mentality of “if not me, then who” and wanted to work hard in pediatrics.

In graduate school, our work in the hospital mainly consisted of rounds and case management.

During that time, I saw the realities of pediatrics and my mind was shaken.

Most of the children in the pediatrics department of a general hospital were from the nearby community, and many of the hospitalized children would go home after getting their shots (except for the very sick ones).

As a result, every morning rounds are a cycle of “waiting for patients, rounds, orders, waiting for patients”.

With so many patients, you can’t think of anything else to do in the morning.

Doctors spend a significant portion of their work time sorting through cases, both to standardize care and to protect them.

In pediatrics, however, the situation is special.

Children’s constitutions make them sick and heal quickly, making the organization of pediatric cases particularly complicated.

With so few pediatricians and so many patients, I was forced to work overtime every day to sort out the cases, and I didn’t even get off work on time during my two years of practice.

The real pediatricians – my teachers – were even more exhausted.

When you get into pediatrics, the day-to-day work takes up most of the doctor’s energy.

It’s unrealistic to ask these doctors to think about research, continuing medical development, and realizing the value of life after they’re done with the work at hand.

A senior once said that a doctor can help an adult to cure a terminal disease and extend his life expectancy by 10 years, which is enough to help him to move from the prime of life to middle age and create great value for his family and society.

But for a child, 10 years of life extension is not enough. We need at least 20 to 30 years of life extension if we want him to overcome his disease and live longer.

Pediatricians have a much higher burden, but the development of pediatrics is much less than that of adult medicine.

However, for all the reasons mentioned above, pediatrics in China is lagging behind in both clinical and scientific research.

Children’s diseases are no less complex and specialized than adults, and many problems are worth a lifetime of research.

Without the support of a mature, well-defined system of pediatric internal medicine and pediatric surgery, it would be difficult to achieve much, and would eventually reduce pediatrics in China to a “pediatric department” that sees patients with fever, cough, and diarrhea.

Personally, I don’t see any hope for the development of pediatrics in China, and I don’t want to spend my whole life to fill in the hole of pediatrics.

If I had a choice, I would prefer to spend my limited energy in a place where I can be more valuable and grow.

The problems with pediatrics are there, and they will not just disappear into thin air.

I will probably leave pediatrics, but I still hope it will get better and better.

I will probably leave pediatrics, but I still hope that pediatrics will get better and better.

Kai Wang 38 years old male county private pediatric outpatient clinic

“Clinical lying” is a buzzword in medical circles in 2020.

The idea is to get out of the “inside-out” environment of a top-three hospital in a big city and into a relatively relaxed, low-stress environment to practice medicine.

For example, “the county hospital in my hometown”: lower prices in the county, higher income and social status for doctors, and therefore a more comfortable life working in a county hospital.

The philosophy behind the “clinical lying” is becoming more and more popular among younger doctors.

I finished my training at the age of 28 and stayed on as a pediatrician in one of the largest hospitals in our province, but the life there really didn’t suit me.

I had to work like a robot, and I had to do research in my spare time, or else I would not have been awarded the title.

Doctors also have research tasks, and the number and value of published papers are the most important indicators. I am in a university teaching hospital, and the requirements are even stricter in this area.

Many young doctors like me, who are new to the field, have a very hard time.

On the one hand, we all learn clinical experience by doing rounds and bed management with our supervising doctors, and on the other hand, we have to run labs, learn English, write papers, and prepare for exams one after another.

This was not the life I wanted to lead. I enjoyed the clinical experience and the process of treating and saving patients.

After weighing my options, I chose to go it alone. After eight years at the provincial hospital, I returned to my home county in the northeast and opened a pediatric outpatient clinic.

Because of my experience in a top-notch hospital, the parents of the children still trusted me.

Now the entire county will send their children to me when they get sick, and I feel that I have gained a foothold here.

The stereotype that many people have of private clinics is “ask questions, take a temperature, and start an IV.

I rarely use infusions, but instead I ask detailed questions and provide parents with medical information, which has gradually developed into its own model, and I have a good reputation with parents.

My clinic charges a bit more than the department, and most of the medications I prescribe go through the clinic’s pharmacy, so my income is more substantial, much more than before.

I am not a very competitive person, I just want to simply do one thing well, and to be rooted at the grassroots level is also to contribute to the cause of health in China.

In fact, in most counties, fourth- and fifth-tier cities and towns, there is also a shortage of professional and reliable pediatricians, so I think my choice is still a great one.

So I think my choice is still a great one. Choosing “clinical lying” may not be the real lying, but it will also realize our personal values.

As for how to choose, that is a matter of opinion.