Release date: 2015-02-05 In 2014, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine completed more than 1,000 cases of artificial joint replacement, which is far more than many western hospitals in China. When He Wei, the deputy dean of the hospital, talked about the operation, he had a lot of helplessness and worry. The confusion stems from a paper document from the former Ministry of Health in 2012. Since then, Chinese medicine and Chinese and Western medicine have no qualifications for artificial joint replacement. Under the ban of the former Ministry of Health, Chinese medicine hospitals continue to carry out, and once there is a problem with surgery, waiting for Chinese medicine will be the risk of the defendant going to court. Administration: Three documents in three months Artificial joint replacement, represented by artificial hip and knee joint, has become the most common and mature operation for joint surgery for advanced severe joint diseases such as femoral head necrosis and rheumatoid arthritis. 80% of patients can use it for 20 years. In fact, there was no Chinese or Western medicine for artificial joint replacement before 2012. However, in 2012, a ban on the former Ministry of Health blocked the doctors of Chinese medicine and Chinese and Western medicine from the threshold, which also confused and puzzled many Chinese medicine practitioners. On May 29, 2012, the former Ministry of Health issued the “Management Specifications for Artificial Hip Replacement Technology†to regulate the medical institutions, doctors and training for the operation. In principle, it can only be carried out in tertiary hospitals and conditional secondary hospitals, and the scope of practicing doctors for hip replacement technology is surgical, Chinese medicine and integrated Chinese and Western medicine. Two months later, on July 24, the former Ministry of Health issued the “Manual Specification for Artificial Knee Replacement Technologyâ€, which has similar contents and establishes access standards for artificial knee joint replacement. However, the practice of practicing the knee replacement technique is limited to the surgical profession. The combination of Chinese medicine and Chinese and Western medicine is not in scope. Since then, traditional Chinese medicine and Chinese and Western medicine can only be used for artificial hip joint replacement, and no artificial knee replacement can be performed. The professional background of this specification is that knee replacement is more strict and finer than the hip replacement, and is called "millimeter engineering". However, two weeks later, on August 6th, the Ministry of Health issued the Supplementary Notice on the Management of Artificial Joint Replacement Technology again, clearly stipulating that “as of the date of issuance of the document, the scope of practice is Chinese medicine and integrated Chinese and Western medicine. Physicians can directly identify the qualifications for the implementation of artificial joint replacement technology. Other doctors who do not meet the requirements of the "Notice", the scope of practice is Chinese medicine, integrated Chinese and Western medicine, no longer awarded the qualification of artificial joint replacement technology." The introduction of three documents has made the Chinese medicine industry in vain. This means that Chinese medicine practitioners and Chinese and Western medicine doctors who meet the requirements before can continue to carry out, but later Chinese medicine practitioners and Chinese and Western medicine doctors can no longer do it. The Chinese medicine orthopedics artificial joint replacement surgery will be followed by no one, which undoubtedly gives A serious blow to the Chinese medicine community. Chinese medicine doctor: If you are stuck in thin ice, you are confused. "This ban is tantamount to blocking our road." He Wei, deputy dean of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, said that in Guangdong, the operation time of the Chinese medicine hospital is no later than that of the Western Hospital. No matter from technology or quantity, it is not under the Western Hospital. Another Foshan Chinese Medicine Hospital, which has 1,200 artificial joint replacements per year, has 1,000 orthopaedic beds, and is unknown in the field of orthopedics in the country. For Guangdong, a large Chinese medicine province, the impact of the ban is greater than that of other provinces and cities. In January 2013, the Guangdong Provincial Association of Chinese Medicine and the Guangdong Association of Chinese and Western Medicine jointly applied to the National Health and Family Planning Commission to request the cancellation of restrictions on the qualification of artificial hip and knee replacement techniques for Chinese medicine practitioners and integrated Chinese and Western medicine professionals. It is said that this does not comply with the relevant provisions of the Chinese Medicine Ordinance to protect, support and develop Chinese medicine, and encourage Chinese and Western medicine to learn from each other. In the undergraduate study of Chinese medicine hospitals, all courses of almost Western medicine such as Anatomy, Pathology and Surgery have been opened. Students in the direction of Chinese medicine orthopedics also need to take courses such as Orthopaedic Surgery. The basis and background of the surgery. Wen Jianmin, a member of the National Committee of the Chinese People's Political Consultative Conference and the director of the Department of Orthopaedics of the Wangjing Hospital of the Chinese Academy of Traditional Chinese Medicine, even requested a policy to loosen the policy, but it has not been successful so far. “I went to study artificial joint replacement surgery from the late 1980s to the 1990s. After returning to China, I brought a lot of students. Some of the students from the West Hospital went back to the operation after I studied. So, just master this. The technology, both Chinese and Western medicine can be competent." In Henan, Luoyang Zhenggu Hospital and Zhengzhou Orthopaedic Hospital can carry out about 1,000 cases a year. Sun Yongqiang, chief physician of the Department of Orthopaedics and Traumatology, Henan Provincial Hospital of Traditional Chinese Medicine, feels that he is “skating on thin iceâ€. He likes “like a person driving a car, but no driver's license. If something goes wrong, it will be very troublesome. Any operation is risky. ." Shen Jirong, chief physician of the Department of Orthopaedics, Jiangsu Provincial Hospital of Traditional Chinese Medicine, believes that traditional Chinese medicine has advantages in preoperative conservative treatment, perioperative reduction of complications and post-operative rehabilitation. In the past, the Department of Orthopaedics of Jiangsu Provincial Hospital of Traditional Chinese Medicine has been using Chinese and Western medicine. In combination with the treatment of bone diseases, three of the four leading experts in the department are Chinese medicine practitioners. "I can only take Western medical students to do surgery together. Chinese medicine students are not willing to learn from me. They can't do it after they finish school. The end result is that the Chinese medicine orthopedics are completely westernized, and the advantages of Chinese medicine are gradually lost." Expert opinion: policy formulation is relatively hasty Before the introduction of the standard, China's artificial joint replacement surgery from the top three hospitals to the county-level hospitals everywhere, there is no limit on the scope of practice. Lu Houshan, former director of the Institute of Joint Diseases of Peking University, said in an interview: "Because of the large number of developments and popularization, we are in a time when it is easy to make mistakes." The number of revision operations is increasing, and many patients fail to undergo surgery. . A well-made artificial joint can be used for 20 years, infection or poorly done, and it is good to maintain 1 to 2 years. Therefore, many orthopaedic experts agree that a management specification and access criteria should be set for this procedure. On October 17, 2005, the former Ministry of Health issued the "Management Specifications for Artificial Total Hip Implantation Technology (Draft for Comment)" and "Management Specifications for Artificial Total Knee Implantation Technology (Draft for Comment). At that time, the physician who made the total hip implant was limited to surgery, and the physician who made the total knee implant was limited to surgery or sports medicine. Chinese and Western and Chinese and Western medicine were excluded from the beginning. From the "Consultation Draft" to the "Management Norms" to the "Supplementary Notice", in the past seven years, Chinese medicine and Chinese and Western medicine have suddenly entered and exited, and eventually they were stopped outside the threshold. It is worth noting that in the “List of Drafting Experts†published by the former Ministry of Health, there were 27 orthopedic experts from 15 provinces and cities nationwide, all of which were Western medicine. Chinese medicine and Chinese and Western medicine have not entered this list. A member of the expert group who did not want to be named told reporters that the norms were formulated in a hurry, and that the members of the expert group lacked sufficient management experience and did not fully consider many specific situations in policy formulation. Looking at it now, there are some unreasonable places in the specification. For example, the threshold should not be set at the hospital level, and Chinese medicine practitioners should not be cut off. On January 27, 2015, the Health Times reporter sent an interview letter to the Health and Medical Administration of the Health and Family Planning Bureau to inquire about the details of the norm and the reasons for restricting the operation of Chinese medicine and Chinese medicine. However, as of the date of publication, no reply has been received. . Local regulations: the actual implementation of the "green light" for Chinese medicine After 2012, the arthroplasty of Chinese medicine practitioners in various places gradually tightened. In 2013, local health administrative departments successively announced the list of qualified medical institutions and physicians, and most of the Chinese medicine hospitals and Chinese medicine practitioners were not on the list. In the northeast, northwest, southwest and other areas where the strength of traditional Chinese medicine orthopedics is weak, most of them are silent. In Guangdong and Henan provinces with better development of traditional Chinese medicine orthopedics, they each came up with a solution. On October 24, 2012, the Henan Provincial Department of Health issued the “Notice on the Administration of Access Control for Artificial Hip and Knee Replacement Techniquesâ€, and all eligible Chinese and Western doctors can apply for admission. According to Sun Yongqiang, "I want to manage this part of the work myself." The measures taken by Guangdong Province are that some Chinese medicine orthopedic specialists including He Wei have also joined the qualification assessment committee, so that each criticism can be selected from a list of qualified institutions and physicians. Chinese medicine is admitted. Among the first list of qualified medical institutions announced in Guangdong Province, 6 Chinese medicine hospitals have both hip and knee replacement qualifications, and 12 hospitals have qualifications for hip replacement. Obviously, a "Supplementary Notice" that has been violated by various places will be taken away in actual implementation in various places. The 12320 hotline staff of the Beijing Municipal Health Bureau told the Health Times that the Chinese hospitals in the country were supervised by the State Administration of Traditional Chinese Medicine, and that the Chinese Medicine Hospital was responsible for the problems in the operation of the Chinese medicine hospitals. According to Vice President He Wei, after the introduction of the Supplementary Notice, the State Administration of Traditional Chinese Medicine once told a local Chinese medicine hospital at a video conference attended by a national Chinese medicine orthopedic surgeon that the Chinese medicine hospital was allowed to continue the operation. The dilemma is to be solved: Who can do artificial joint replacement? On the one hand, the policy is banned, and on the other hand, it is the local Chinese medicine practitioners. For the patient, it is a fog. Ms. Zhang from Shanxi had a 70-year-old mother with a femoral head necrosis to seek a conservative treatment at a Chinese hospital in Beijing. She underwent a total hip replacement surgery at the doctor's suggestion. Because the elderly suffer from severe heart disease, the sudden death of acute myocardial infarction after surgery is invalid. Afterwards, Ms. Zhang, who was grieved, found the list of the first batch of physicians with clinical application skills for artificial hip replacement technology published by the Beijing Municipal Health Bureau and the list of medical institutions that allowed artificial hip and knee replacement techniques. It was found that the Chinese medicine hospital and doctors were not listed. With incomparable guilt and anger, Ms. Zhang resolutely brought the hospital and doctor to court. Although the dispute is still inconclusive, similar disputes may be staged again at all Chinese hospitals that carry out the operation. The patient is confused because the truth is not known. Chinese medicine is helpless, but with technology, it is impossible to perform surgery with peace of mind. Once something goes wrong, it often hurts both. The question is, who can do artificial joint replacement? The most crucial thing is "people." Professor Lu Houshan believes that artificial joint replacement surgery should also have an access system, the purpose is to check the health of patients, but the most important thing to measure is the hardware level of medical institutions and the technical level of doctors. This is also the standard for patient evaluation and selection. "There are good things in Chinese medicine, and there are also bad things in Western medicine." Another director of orthopedics at a hospital in Beijing said that doctors need to understand the patient's condition, choose the right prosthesis, and then implant it into the ideal position. There must be a higher technical threshold. However, this operation is very mature in China. As long as it is properly trained and mastered the technical essentials, 90% of orthopedic surgeons can do well. Lu Houshan believes that doctors who have performed 3,000 operations and doctors who have only performed 300 operations are definitely different. But if there is a problem, it is wrong to say that it is Chinese medicine. This is not reasonable. "However, it is not necessarily a good thing that Chinese medicine is completely westernized." Many orthopedic experts interviewed by the reporter also generally believe that the normative setting should be the technical threshold and hardware threshold, not the threshold of the practice category. This is the key to who can do artificial joint replacement surgery. In fact, in addition to artificial joint replacement, it is very common for Chinese medicine to carry out other surgical operations. However, since May 1, 1999, the "Practitioners' Law of the People's Republic of China" was officially implemented. After that, the Ministry of Health successively issued a series of prescriptions for doctors' practice, such as the "Interim Measures for Physician Qualification Examination" and the "Interim Measures for the Registration of Physicians". Graduates of the TCM category are not allowed to apply for qualifications in the clinical, oral and public health categories. The Chinese medicine community generally believes that this will bring many obstacles to the operation of Chinese medicine. In the specific practice, in the event of medical disputes or medical accidents, Chinese medicine practitioners will appear to be unnamed and lack the basis for practice. This is also a place that the Chinese medicine community has always considered unfair. Source: Health Times Bulk Garlic Powder,Bulk Organic Garlic Powder,Minced Garlic Powder,Ried Garlic shandong changrong international trade co.,ltd. , https://www.cragriculture.com