病人愛逛醫院／遇上熟面孔 醫師只好陪聊天

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http://udn.com/NEWS/HEALTH/HEA1/5834153.shtml
病人愛逛醫院／遇上熟面孔 醫師只好陪聊天

【聯合晚報╱記者黃玉芳/台北報導】 2010.09.07 04:31 pm


「阿伯，你怎麼又來了？」和慢性病、精神科有關的科別，經常看到令醫師頭痛的「熟面孔」；有的醫師陪病人「聊聊天」就退號不收錢，不敢再開藥。但醫師表示，當病人遊走各醫院時，現階段的健保IC卡，其實看不出患者在不同醫院間的就醫紀錄，這也成為輔導高診次對象的盲點。

健保局發現，高診次患者中，有一些是罹患精神疾病，卻沒有確實的就醫診斷，未列入重大傷病，經常遊走於大小醫院。中山醫學大學附設醫院精神科主任賴德仁也表示，有些患者很令人頭痛，領了一個月的安眠藥，卻提前半個月，又到門診想領藥。

賴德仁說，這些患者常是依賴藥物成癮，明明一天只能吃兩顆，劑量卻越吃越重，一下子把藥吃光。而且當醫師警覺到不對勁，不想再開藥時，患者卻拒絕醫師對他憂鬱、失眠的積極治療，直接換另外一家醫院領藥比較快。

另一位心臟內科醫師更苦笑著說，慢性病領藥一次可領30天，甚至長達三個月；但有些患者提前跑來看診，也沒什麼特別的不舒服，醫生這時只好不開藥、「純聊天」，退號不收錢。

不過，這位醫師也說，從健保卡上，只能看到患者在同一家醫院的病歷，不能看到不同醫院間的就診紀錄，就算患者兩個小時前才去A醫院看病拿藥，下一間B醫院醫師也無從得知；這已成為輔導高診次民眾的一個盲點。

他也抱怨，健保局不希望患者今天看腸胃科、明天看神經內科、後天看精神科，希望一次就診時醫師提供整合服務，但醫師若「好心」針對症狀幫患者開不同科別的藥物，卻容易遭到健保核刪費用，反而增加醫師的困擾。
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
那位醫師的說法怪怪的…

[ceciltcy]

新聞不是製造業嗎 ??
古奇大你當真了.........

[e42166]

這位醫師也說，從健保卡上，只能看到患者在同一家醫院的病歷，不能看到不同醫院間的就診紀錄，就算患者兩個小時前才去A醫院看病拿藥，下一間B醫院醫師也無從得知

除非患者自設密碼，否則IC卡內容還有看不到的?是沒插醫事卡?還是卡到陰?
(爽) (爽) (爽)

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