[Wan Qing Yi Care]Doctors promote home medical care so that the elderly can live at home with peace of mind

WenZhu Yixin PictureLin Aiyi

Most doctors are interviewed, and they will tell some touching stories about their dreams of becoming a doctor.

However, Feng Zhiben, one of the founders and directors of the elderly medical social enterprise DoctorNow NEEDS (Old Friend’s Doctor), a door-to-door and video consultation platform, said that he has no touching stories about his relatives or his own serious illness when he became a doctor, but only curiosity and love. I love science and feel satisfied with my job as a doctor. Because he was serving the elderly in a nursing home, he began to reflect on his life. Did he spend his time in the nursing home with his throat stuck in his old age?

Therefore, he hopes to promote “medical care at home”, so that patients can die at home, and he can return to his duty as a doctor’s home visit.

(Hong Kong News) Near dusk this afternoon, the doctor Feng Zhiben (Wilson) who came to be interviewed said that there was a medical case at home at 3:00, and he came with a doctor’s box, which was very different from the doctor in the movie. In the movies, the doctors who visited the clinic in the 1950s and 1960s were always wearing a suit and carrying a leather bag with two handles in the middle of the bag. From there, you can find the receiver and heat probe.

But the look of his visiting doctor is very different. He said that this morning he was also seeing a doctor in a nursing home for the elderly. This doctor was dragging a trolley suitcase with a large bag on it, giving the impression that he was on a business trip. However, when I opened the box and the big bag, I found that there was a universe inside.

He said: “If I go to a nursing home for the elderly, I will only bring a large bag. If I am at home for medical treatment, I will bring this suitcase.”

Travel to Japan and Taiwan to investigate medical treatment at home

He opened the box and bag, and it was a small mobile clinic. In addition to basic blood pressure measuring tools, blood sugar measuring tools, basic pain relief and antiemetic drugs, etc., there are also sampling books, drip tools, etc.

“Currently, I work with more than 20 elderly care homes, and I go to outpatient clinics two days a week. This is all in cooperation with NGOs. Because this part has gradually stabilized, I started to develop home medical treatment last year!”

“I have been in the elderly care home for several years. I have some reflections. I have seen many elderly people who are in poor condition. They have a tube inserted and cannot communicate with others. Whenever something happens, the home will call (call) us to come to the door. I am thinking , I will get sick when I get old in the future, and some situations are unavoidable. How should DoctorNow Needs go on? So, I went to Japan and Taiwan to investigate other people’s home medical treatment, and only then discovered that not to mention home medical treatment, it is even a video. Hong Kong also seems to be lagging behind other places in terms of telemedicine, such as seeing a doctor.”

He took out a book from his pocket and asked the reporter if he had read it. The title of the book was “In-Home Medical Care——From CURE to CARE”. It turned out that Taiwan had launched the “Home Medical Care Integration Plan” in 2016, which included home medical care in the national health insurance. payment items.

He said: “This is a book written by Taiwanese doctor Yu Shangru. He was my first teacher. This book has influenced me. Japan has been doing home medical treatment for 20 years, and Taiwan started doing it a few years ago. What about Hong Kong? It is almost zero.”

Under the new crown pneumonia epidemic, telemedicine in Hong Kong has only seen improvement. For example, it is possible to obtain medicines without follow-up consultation in chain pharmacies, and the Medical Council has also issued telemedicine guidelines, but this is still different from “home medical treatment”-patients can receive it at home. Medical treatment by a doctor and a medical team.

Front line during SARS

Becoming a doctor and jumping out of the hospital to create a new medical platform is something Wilson never thought of before. So does he like being a doctor?

“I like it! After I became a doctor, I loved being a doctor very much, and I loved seeing a doctor.” But before he studied medicine, he never thought about the dream of hanging the pot to help the world. It was only because of an interesting story that he became a doctor.

“At that time, I was studying in Canada and was about to finish my bachelor’s degree in biochemistry. One day my father was playing mahjong with a friend in Hong Kong. The mahjong friend said that his son had entered the University of Hong Kong to study medicine, so he told my father: “Take your son back to Hong Kong.” La! “

Later, this enthusiastic mahjong friend was more concerned about the return of young people than the ‘Immigration Bureau’, so he went to the University of Hong Kong Medical School to get the application form and asked Wilson’s father to send it to his son: “Dad sent it to me in Canada, and I went back to Hong Kong for an interview. The medical degree should be reserved for local students, and I will definitely not be accepted, so I returned to Canada.” But to his surprise, he soon received a notice from the University of Hong Kong to accept him.

Wilson has worked in a public hospital for 7 years. He has worked as a doctor in the emergency department and in the internal medicine department. People say that the public hospital is difficult, but he said that he is very happy.

“Working in a public hospital, it is important to learn medical technology, but it is also important to learn how to behave as a doctor. When I work in internal medicine, I can get in touch with many departments, which is very interesting. Ultrasound, or when doing outreach services for the elderly, it is very fun to get on the van and set off with the nurses to the day care center in Yau Ma Tei! During SARS in 2003, I was also on the front line.”

Humanized medical service

Nowadays, many doctors are laughing when they say that patients do not complain, and they also say that they should learn how to behave?

Instead, he spoke for the patients: “People are very unhappy when they are sick. You are a doctor and you have to stimulate people and speak harshly… Some doctors will say whether the trust between people is gone. I think doctors must have skills to win it.” Balance, if the medical treatment is cold, it will make the patient feel very uncomfortable. I think Hong Kong people still value human touch.”

He said that after the in-home medical treatment was carried out, the happiest thing was that when he came to the door, the doctor was welcomed as soon as the door was opened, which gave him the feeling of being an ancient doctor: “I have done three cases of death at home this year. I was very touched by the kind of family affection that I chose to ‘walk at home’.”

One of the cases that made him sad and gratified was a female patient in her 30s who had a caesarean section last year and was already suffering from cancer. “She knew she was going to die, but she also wanted to have a baby. It was a pity that the patient passed away at such a young age, but when she chose to die at home, I saw that the whole family was there and the baby was still in the basket. Sleeping in the middle, I am very touched.”

Home medical care is a more humane medical service. Apart from hospice patients, other patients also use it. “For example, recently we (the medical team) came to visit a patient with fever and pneumonia, because private hospitals were afraid to accept it because they were worried that it was new coronary pneumonia. , In fact, he was suffering from other pneumonia. Other home medical treatment also includes depression patients who do not want to go to the hospital. “

The medical model pays attention to care

So when to use telemedicine or in-home medical care? “It’s mainly patients with mobility issues and difficulty going out to see a doctor. In many cases, patients often have no other options and are sent to the emergency department. Of course, due to the recent epidemic situation, the elderly do not want to go out to see a doctor.”

The development of telemedicine in Hong Kong is catching up quickly. In addition to DoctorNow NEEDS, there are other teams that provide services, such as arranging follow-up appointments for the elderly, waiting in the emergency room and matching doctors. Modern in-home medical treatment is no longer just a doctor with a package for outpatient consultation, but behind it is the cooperation of an entire medical team—doctors, nurses, physical therapists, and various caregivers. Doctors only occupy one part, and the platform is the link.

However, he also said frankly that although he really wants to promote home medical care in Hong Kong, home medical care still depends on fate for patients. He has a case and finally sends it back to the hospital.

“More than half of our patients are elderly and terminal cancer patients,

You must know that the concept of medical treatment at home is not to cure him.

They are nearly a hundred years old, how can they be cured?

Cancer is at the terminal stage, how can it be cured?

The whole concept is care and care,

The whole thing is covered with care. “

Just like the book he showed reporters,

Home medical care is from cure to care.

This medical model pays attention to care,

in high efficiency,

For the metropolis Hong Kong, where everything is quick and quick, and people don’t pay much attention to human feelings and aesthetics, it may be the most lacking.

“When I was young, I believed in the Buddhist Mahayana’s mission of “pursuing all living beings”, but when I grew up with the National People’s Congress, I realized that it is very rare for people in the world to be able to save all living beings! Now I like the Hinayana instead, just to do my duty, just like a A screw in a machine, if everyone can do their duty well, the society will be better, if you do better than your duty, the society will be better.”

Created the concept of social enterprise DoctorNow NEEDS

As for social enterprises, Hong Kong actually developed very early. For example, the New Life Club started to operate food stalls in the social enterprise mode as early as 1994. However, despite the large number of social enterprises in Hong Kong over the years, their development has been very limited, and they generally remain in the NGO category. Supporting the survival of social enterprises born by oneself like “bringing children”.

Wilson said that this is related to the general environment of a place. The urbanization of Hong Kong makes daily activities such as shopping and seeing a doctor convenient, and there is no opportunity for development. However, the slow development is also related to the cautious thinking of users and stakeholders in this place.

He said: “Stakeholders are conservative, and users are also conservative!”

The social enterprise model of “DoctorNow NEEDS” has not come easily, but he and the medical staff who joined the team do not rely on this social enterprise to make a living.

He said with a smile: “I’m not under too much pressure. Although I have to maintain a group of colleagues with income, I don’t use this platform to support my family. After I left the hospital, I went to do medical cosmetology. If my life depends on this job , doing good deeds is also the job, so miserable! It takes a long time to change the concept of stakeholders in an industry.”

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