Reporter Tang Wenjia and Li Chenyan

"Doctor, you guys are on the night shift now?!" Recently, some community health service centers and district medical institutions in Shanghai have successively opened night outpatient clinics, and for a while, the good news of convenience for the people spread rapidly. Some residents immediately notified the family group and the landlord group, "You can go to the community hospital at night to see a doctor, without queuing!" Some residents joked that this was a "night healer".

The reporter learned from the Minhang District Health Commission that from next week, on the basis of the early pilot, the community health service center in Minhang District will fully promote the "night clinic".

What diseases can I see in the night clinic? What is the patient experience like? To further optimize the city's hierarchical diagnosis and treatment pattern, so that more people can obtain greater convenience for nearby medical treatment, what new challenges does the opening of night clinics mean for hospitals? How to make this good thing better? The reporter recently squatted at night clinics in Minhang, Jiading and other places to find out.

What are the advantages of the community clinic being lit up at night to facilitate people's medical treatment?

At 4 p.m., after the day's outpatient clinic, general practitioner Gu Hongwei quickly ate two rice dumplings and rode a motorcycle on the road. Depart at 4:20 and arrive at the destination at 4:40 - Longbai Branch of Hongqiao Community Health Service Center in Minhang District.

"Wuzhong Road is too congested at night rush, I'm afraid of being late!" Gu Hongwei commutes to work and drives on weekdays, and this night, he scheduled his shift to the sub-center to go out of the "night clinic", so he specially decided to "change four wheel drives into two wheels" and go to work on time.

A brightly lit consultation room, a doctor, at 5 p.m., the community's "night clinic" opened on time. Since May 5 this year, the Minhang District Health Commission has launched a "night clinic" convenience service, hoping to solve the needs of some residents, especially "office workers", for medical treatment at their doorstep at night. Four community health service centers, including Xinzhuang, Gumei, Hongqiao and Maqiao, took the lead in piloting this "night clinic" extended service in centers, sub-centers or service stations.

Who comes to the community at night? The uniform sign of the "night clinic" light box lit up, and someone followed the light.

Near 6 p.m., a guy in his early 20s ran in, "Can this remove the stitches?" "After getting an affirmative answer, the guy quickly registered at the window and followed nurse Li Jiaxin into the operation room." The outpatient clinic of the big hospital is over, and I am not an emergency, but tomorrow morning I will go to the field to board the ship, and it is great that it can be dismantled here. The guy said.

The clock crossed 6 p.m., and several more patients came, basically without queuing, and they could see a doctor when they came.

A high school girl has a stomachache and is accompanied by her mother. "After the start of school last September, she was not quite right, maybe she was not used to sharing the bathroom in the dormitory, and she even lived on campus for a week without defecating, and she died urgently." Mom was very anxious. "Maybe it's also related to mental pressure, don't be in a hurry." Gu Hongwei asked carefully and patiently explained.

"Doctor, I start to have a headache in the afternoon, could it be 'yang'?" "Auntie, you have a little low-grade fever, I'll prescribe you some medicine, don't be nervous in case of 'yang', there are small molecule drugs in our community." Gu Hongwei comforted the old man.

In the Longbai sub-center, the "night clinic" runs for less than a week, and the patients spread word of mouth: there are "office workers" who take time to prescribe medicine to the elderly at home; An aunt passing by felt "recent stomach upset" and came to make an appointment for an HP Helicobacter pylori test at a daytime outpatient clinic; There are also people who have found out "unexpected diseases".

In Gu Hongwei's consultation room, Ms. Le originally wanted to dispense dermatitis ointment. "Would you like to have a blood pressure measure?" Inserting her medical insurance card, Gu Hongwei's doctor's computer platform automatically pops up a "first diagnosis and blood pressure" reminder for people over 35 years old. Looking at the test results, "160/106", the blood pressure is obviously high! Under the doctor's advice, Ms. Le first went to dispense the medicine, and then tested it after 10 minutes of sitting down. “170/100”。

The atmosphere in the consultation room was a little tense. "It may also be that I saw that the white coat was nervous, but when it reaches 170, I should be vigilant, and I will self-test and observe it in the next two days." Gu Hongwei advised Ms. Le that there are many young people with high blood pressure now, and they should not be taken lightly.

Seeing off Ms. Le, Gu Hongwei took off the mask and drank saliva. Near 8 p.m., the patients did not come one after another, at this time, he turned on his mobile phone and began to use the fragmented time to reply to messages from the family doctor's contracted residents.

What is the role of the "night clinic" in decompressing the emergency department?

At Jiading District Traditional Chinese Medicine Hospital, the newly hung blue banner is very eye-catching: "Night clinic working day 17:00-20:30".

After learning the news, Ms. Hou, an office worker, came to hang up the number of the dermatology department after dinner. Just a few days ago, I don't know whether it was a mosquito bite or an allergy, Ms. Hou had a small bump at the corner of her right eye, "It's itchy, it's swollen when I scratch it, and now it's painful and itchy." After listening to Ms. Hou's self-statement, Liu Jie, deputy chief physician of the Department of Dermatology of Jiading District Hospital of Traditional Chinese Medicine, began to palpate." Considering it to be a styes, it is recommended that you go to an ophthalmologist to take a look. ”

"Does that need to be re-registered?" Ms. Hou was a little puzzled. Liu Jie pointed with his finger, "The ophthalmology department is on the opposite side, you can go directly to it." After a few steps, the sign of "Night Clinic Ophthalmology" was very conspicuous, and the director of ophthalmology, Song Xiaoli, was sitting in the examination room. After understanding the situation, she suggested that Ms. Hou take medicine first and then observe for a period of time... In less than 10 minutes, the two doctors "seamlessly connected", and Ms. Hou's problem was successfully solved.

From May 5, Jiading District Traditional Chinese Medicine Hospital officially launched the "Night Outpatient Clinic", with a total of 4 clinical departments expanding medical services, including ophthalmology, otolaryngology, internal Chinese medicine, acupuncture, tuina, dermatology and gynecology. At the same time for the convenience of patients, in order to save operating costs, the hospital also replanned the route of treatment, and the ophthalmology, ophthalmology, ophthalmology, internal medicine, dermatology, and gynecology consultation rooms were all located on the 7rd floor, and the acupuncture and tuina departments were located on the 3st floor of the outpatient clinic on Qiliang Road.

"During the preliminary research, we found that there were many patients on weekends, especially dermatology, gynecology, ophthalmology and other departments, and there were mostly young patients. In addition, there are many patients who are busy on weekdays and have no time to see a doctor, so they have to postpone their needs and save up until weekends. Jin Weiguo, vice president of Jiading District Traditional Chinese Medicine Hospital, said that it is based on these backgrounds that the hospital began to brew a new plan, considering using the evening time to further facilitate citizens' medical treatment. At the beginning of this year, the "Night Outpatient Program" was listed as one of the annual key work plans of Jiading District Traditional Chinese Medicine Hospital. After thorough preparation, 7 popular departments were finally selected and launched last month.

With the operation of the dermatology night clinic for more than half a month, Liu Jie observed that the types of patients began to be enriched. "At the beginning of the clinic, the patients were mainly allergic to the skin, such as allergic dermatitis, acute urticaria, acute eczema, etc. Now, there are more types of diseases, and the common diseases in dermatology have been basically covered. ”

Less than 1 hour after the opening of the day, Liu Jie saw nearly ten patients. Eyelid dermatitis, contact dermatitis, pityriasis rosea, scars, shingles and other patients are available, including children.

"With the launch of 'night clinics', we also want to break the stereotype of some patients. For example, if you are sick during the day, you can see the outpatient clinic, and at night, if you have a slight headache and brain fever, do not rush directly to the emergency department. In Jin Weiguo's view, the "night clinic" is not only convenient for the people, but also relieves the pressure of emergency to a certain extent, giving the emergency life channel to patients in more need.

How is the Night Clinic experience compared to the daytime?

For doctors, the head of the outpatient clinic at night is likely to mean "working during the day and at night", needless to say. What do the white coats think about this?

Talking about this topic in the interview, Gu Hongwei inadvertently remembered a past professional experience - many years ago, he had seen the "night clinic" and was familiar with this work rhythm.

"Our generation graduated from technical secondary school at the age of 20 and joined the work, and at that time it was still called Hongqiao Health Center, and from July to September every year, 'night clinics' would be opened, and sometimes 7 or 9 patients would be seen at night, busy until dawn." Gu Hongwei sighed that in the past, due to limited living conditions, air conditioning had not yet been popularized, and many people blew electric fans overnight at night, and they got cold if they couldn't get it right.

In addition, in the "summer night clinic" launched at that time, there were more patients in the intestinal clinic, because the food was easy to spoil in summer, the storage conditions were limited in the past, and the public's awareness of food safety was not high, and it was easy to eat a bad stomach.

Gu Hongwei started working in 1986, and it has been 37 years since he saw the transformation from Hongqiao Health Center to Hongqiao Community Health Service Center. As he said, the once hot "night clinic" is actually closely related to urban construction and the layout of health resources.

However, for both doctors and patients, some experiences at night are still very different.

"There is relatively more time at night, there are not so many patients, you can communicate more, and patients may feel better."

Including Gu Hongwei, many community white coats have mentioned that as more and more people have new expectations for the hospital at their doorstep, the community general clinic is sometimes busy during the day, patients inevitably have to queue, and doctors can only see a doctor with their heads down. In addition, general hospitals not only have to attend consultations, but sometimes visit homes to provide home bed services or visit residents' homes to assist in long-term care insurance assessments. When things come together, community doctors have less time to communicate with residents. In Gu Hongwei's view, the family doctor contract service is inseparable from the "stickiness" between doctors and community residents, and this trust and tacit understanding are accumulated in daily communication with residents. Relatively speaking, the "night clinic" is not so crowded, and the communication between doctors and patients can be more relaxed.

In Minhang District, following the successive launch of "light consultation rooms" and "micro-emergency departments" in the early stage, the relevant person in charge said that on the basis of the pilot of four community health service centers, taking into account the needs of residents, since June 4, all community health service centers have achieved full coverage of "night clinics".


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