我们能解决医生的职业倦怠吗？

讨论让世界持续运转。

Discussion keeps the world turning.

这里是圆桌论坛。

This is Roundtable.

从北京的心脏到全球舞台的边缘，您正身处圆桌论坛。

From the heart of Beijing to the edges of the global stage, you are at Roundtable.

我是牛红林。

I'm Niu Honglin.

在许多国家，医疗体系都面临着类似的困境：如何在保障医疗质量的同时，保护提供医疗服务的医护人员。

Across many countries, health care systems are confronting a similar dilemma, how to maintain quality care while protecting the workforce that delivers it.

中国关于医生职业倦怠的讨论，反映了这一更广泛的全球性挑战。

China's discussion about physician burnout reflects that broader global challenge.

我们能做些什么来应对当前的肺部疾病激增、患者需求增长以及情感压力，这些因素正将医疗工作者推向崩溃的边缘？

What can we do to curb the current lung shifts, growing patient demand, and emotional pressure, which are pushing medical professionals toward a breaking point?

在今年的两会上，人大代表和政协委员正在展开热烈讨论，圆桌论坛诚邀您与我们一同参与这场头脑风暴。

In this year's Two Sessions, lawmakers and political advisers are having heated discussion, and Roundtable invites you to join this brainstorm with us together.

今天的节目，我邀请到了史蒂夫·哈瑟利和玉山。

For today's show, I'm joined by Steve Hatherley and Yushan.

现在请坐下来，加入我们的讨论。

Now pull up a chair and join the conversation.

医生们将一生奉献于照顾他人。

Doctors dedicate their lives to caring for others.

那么，谁在确保他们得到支持、保护和尊重呢？

Then who's ensuring that they are supported, protected, and respected?

随着中国政策制定者探索从资源改革到人工智能辅助医疗等多种解决方案，有一点非常明确。

As policymakers in China explore solutions ranging from resource reform to AI assisted health care, one thing is clear.

保护医护人员的福祉，对医疗体系的未来至关重要。

Protecting the well-being of medical workers is essential for the future of health care itself.

那么，目前的情况如何？

So how's the situation now?

我们正在采取什么措施来缓解他们的压力？

What are we doing to release their pressure?

今天我们讨论的另一个议题是，我们可以采取哪些其他措施来应对医疗专业人员面临的挑战。

And what are some other measures we we can take to address the challenges facing the medical professionals would be the topic of today.

我们讨论这个问题的部分原因在于，确实，在每一个行业、每一个工作场所，我们都可能面临倦怠问题。

And the reason we're talking about this is partly because, yes, in every different career, in every different workplace, we might be facing burnout issue.

我们可能面临巨大的压力。

We might be facing high pressure issue.

但如果我今天特别糟糕，我可能会跳过这期节目，去做点别的事情。

But if I am having a particularly bad day, I might skip the show and just, you know, find something other other things to do.

但在医院里，情况可能是致命的，字面意义上的。

But in a hospital, the situation can be life threatening, literally.

是的。

Yeah.

你说得对。

You're right.

我希望通过今天的对话，我们能有所收获。

And I hope through today's chat that we can learn yeah.

我们将讨论医生、医院和医疗专业人员的倦怠问题，但这种情况可能发生在任何行业、任何地方的任何人身上。

We're gonna be talking about burnout in the context of doctors and hospitals and and medical professionals, but this can happen to anyone in any industry, anywhere.

它可能发生在工作中。

It can happen at work.

它也可能发生在家里，所以我们来看看它究竟是什么。

It can happen at home, so we'll see what it's about.

当我们谈到医疗行业时，我们会讨论公立医院，然后我想稍后比较一下公立医院和私立医院之间是否存在差异。

And then when we do talk about the medical industry, we'll talk about public hospitals, and then I want to a little bit later compare and see if there's any difference between public hospitals and private hospitals.

所以我们有很多内容要讨论，但让我们先从这一点开始。

So we have a lot to discuss here, but let's start with this.

倦怠不仅仅是下班后感到疲惫。

Burnout, it's not just feeling tired at the end of the day.

这是一种对工作压力或疲惫长期积累的慢性反应。

This is a chronic long term response to a buildup of your work stress or a buildup of your exhaustion.

它本身并不是一种医学疾病，没有被这样定义，但世界卫生组织将其定义为一种职业现象。

It's not a medical disorder per se, it's not defined that way, but it is defined as an occupational phenomenon, at least that's how the World Health Organization defines it.

关于其特征，人们认为有三个关键维度，使其区别于普通的疲劳或一般的疲惫感。

Terms of the characteristics, there are three key dimensions, they say, that make it different from your regular fatigue or your regular feelings of exhaustion.

一个是情绪耗竭。

One is emotional exhaustion.

我们接下来会逐一讲解这些内容。

We're gonna go over these, by the way, one by one.

一个是情绪耗竭，第二个是所谓的去人格化，第三个是个人成就感降低。

One is emotional exhaustion, two is a term called depersonal and three is low personal accomplishment.

如果我们从情绪耗竭开始，我认为这很容易理解，就是当你在工作上感到身心俱疲，完全没有任何精力可言。

So if we start with emotional exhaustion, I think that's pretty self explanatory, This is just when you feel like so drained physically and emotionally and mentally from work, like you have no more energy to give whatsoever.

你的能量已经耗尽了。

Your tank is at zero.

这种感觉可能由许多不同的原因引起。

And that kind of feeling can happen because of so many different reasons.

例如，在《圆桌讨论》中，第一点是我们的话题不够多。

For example, here on Roundtable, one, we do not have enough topics.

我感觉有点压力。

I feel a little bit stressed.

首先，我们在常规节目之外做了很多工作，我可能会感到情绪上的疲惫。

One, we do a lot of work outside of the regular show, I might feel emotionally tired.

所以对于任何职业来说，我们都有不同的原因，想象医生来自各方面的压力其实并不难。

So for, you know, any occupation, we can have different reasons, and it's really not that hard to imagine a doctor's pressure coming from all different fronts.

是的。

Sure.

第二个是疏离感。

The second one: depersonalization.

这个可能稍微严重一点？

This one's a little bit more serious, maybe?

我不确定这样说是否公平，但疏离感指的是，你开始对医院的病人、其他工作人员，或任何行业中的同事产生疏远、冷漠，甚至毫无情感的感觉。

I'm not sure if that's fair to say, but what depersonalization is, it's when you start to feel detached or even cold or even having feelings of no feelings towards your patients in the hospital or the other staff in the hospital or in any other industry your colleagues for example.

疏离感是一种心理体验，员工——可能是医生——会对工作、同事，甚至在医院中对病人产生近乎消极或愤世嫉俗的情绪。

Depersonalization, it's kind of a psychological experience where the employee, and that could be the doctor, develops almost negative or cynical feelings about the job or towards the coworkers or in a hospital even towards the patients.

所以这在某种程度上也是一种自我保护机制，出于某些原因。

So this can also be a self defense mechanism in a certain way and because of certain reasons.

你在工作，

You're working,

但你只是在靠肌肉记忆机械地操作，而真正的你自己则在保护自己，避免感受更多或受到伤害。

but you're just muscle memory optioning while you're yourself is protecting yourself from feeling more or feeling hurt.

没错，就是这样。

Well, it's that.

我认为疏离感也源于你身心情感上都过于疲惫，以至于变得易怒。

And I I think depersonalization too, it's about you're so exhausted mentally, physically, emotionally that you become cranky.

嗯。

Mhmm.

当你变得易怒时，即使只是一两天、三四天、一周或更久，你也会失去对工作的热情。

And when you become cranky, you lose your passion for your work even if it's just for a day or two or three or a week or whatever.

你失去了热情，然后就会对医院的同事、病人或同伴变得烦躁，而如果你没有情感上的耗竭，本不会产生这些情绪。

You lose the passion and then you become irritable towards the staff in the hospital or your patients or your coworkers when if you weren't emotionally exhausted you wouldn't have those feelings.

这都和职业倦怠有关，对吧？

It's all connected to burnout, right?

然后是个人成就感低，这是第三个维度或特征，当你因倦怠而感到：我在这里做什么呢？

And then low personal accomplishment, that's the third dimension or characteristic, and that's when you feel because of burnout you feel like, what am I doing here?

我对这个组织、这家医院没有任何贡献。

I'm not making any difference to this organization, to this hospital.

或者对整个行业也没有影响。

Or to the industry.

对患者也没有帮助。

To the patients.

是的。

Yeah.

我

I'm

在这里浪费时间。

wasting my time here.

把这三种特征结合起来，就会让你感受到非常严重和极端的倦怠。

You put all of those three characteristics together, and that's when you're going to feel some very severe and extreme burnout.

是的。

Yes.

而且这些感受或症状通常是长期持续表现出来的。

And that is also the kind of feelings or symptoms that showed in a long term way.

只有当这些症状长期持续时，我们才能用它们来识别倦怠。

It's only when it's showed in a long term way that we can use it to somehow identify burnout.

所以，如果你只是今天状态不好，第二天又能恢复过来，那只是普通的一天而已。

So if you're only having a bad day and you can strive up again the next day, then it's just a bad day.

那就只是普通的一天。

Then it's just a bad day.

没错。

That's right.

是的。

Yes.

让我们对这个问题产生关注的原因，是最近发表在《BMC公共卫生》国际期刊上的一项研究，该研究公布了一个令人震惊的数字。

So what really caught our attention on this whole matter is because of a recent study that's published in the international journal, BMC Public Health, which really dropped a shocking number.

这项研究涵盖了中国近20万名医生。

So this one, it included nearly 200,000 doctors here in China.

数据显示，超过六成的医生正在经历职业倦怠。

And the data revealed that more than six out of ten doctors are suffering from burnout.

这意味着，他们经常经历史蒂夫刚刚提到的那三个维度中的至少一个。

Meaning, they experience at least one of those three dimensions that Steve just mentioned regularly.

更令人担忧的是，有12%的医生患有严重的职业倦怠，即三个维度全部存在，并且正在干扰他们的日常工作和私人生活。

And even more concerning is the fact that twelve percent of doctors have severe burnout which means all three dimensions are present and are interfering with their daily work and personal lives.

根据这项研究，我们发现这种情况在急诊科医生中尤为普遍，也就是ED医生。

So this happens as we discover from this particular research very often with a higher burnout rate among the emergency department doctors, the ED doctors.

我觉得这很好理解，对吧？

I think it's quite understandable, right?

因为他们面对的是高风险、快节奏且不可预测的工作环境。

Because they really face high stakes, fast paced, and unpredictable working environment.

急诊科医生

The ED doctors

而且没完没了。

And nonstop.

是的。

Yeah.

没完没了。

Nonstop.

他们每天都在应对生死攸关的情况。

They are constantly dealing with life or death situations on a daily basis.

此外，他们还要经历漫长的轮班，患者源源不断，根本没有喘息的时间。

Also, they experience long shifts and a steady stream of patients with no time to really catch their breath.

我从社交媒体上看到过医生的评论。

I've heard from online social media comments from Doctor.

哦。

OI.

有人提到，这位医生在急诊科工作，就在病人进出的间隙，我喝了一口水，病人还以为我在休息。

Somebody said that OI works as an ED doctor and just between doctors excuse me, just between patients coming in and out, I took one sip of water and the patients were thinking that I was resting.

对于急诊科的医生来说，他们的工作是处理紧急情况，如果当前的病人需要长期治疗或真正康复，他们会转诊到其他科室，这意味着他们看不到百分之百成功的病例。

And also for doctors working in emergency rooms, what they do is to deal with the urgent situation and if the current doctor or excuse me, the current patients need any long term care, if they really need to recover, they will transfer them to other departments, which means they do not see real 100% successful cases Right.

在他们的眼前。

Under their watch.

这也某种程度上剥夺了他们的自我成就感。

And that is also something that is depriving their self accomplishment feeling in a way.

他们知道自己在治愈病人，知道自己在挽救生命。

They know they're curing them, they know they're saving lives.

但他们看不到治疗的全过程。

They don't get to see it through though.

没错。

Exactly.

是的，所以急诊科医生、ED医生，排在第一位。

Yeah, so ER doctors, ED doctors, number one on the list.

紧随其后的是骨科、重症监护室医生，还有传染病科医生。

Right behind them are orthopedics or intensive care unit doctors, also infectious disease department doctors.

他们的倦怠率也很高，约为百分之七十七。

They also have high burnout rates, around seventy seven percent.

他们谈到了不同的原因。

They talk about the different reasons.

骨科医生需要长时间进行体力消耗巨大的手术，有时一次手术超过八小时，显然并不容易。

Orthopedic doctors, they face long physically demanding surgeries, sometimes eight plus hours at a time, not easy to do, obviously.

此外，研究指出，缺乏机构支持会为本已繁重的工作增添另一层压力，我认为这一点我们稍后还会再提到。

Also, the study noted that the lack of institutional support can add another layer of stress on already grueling work, and I think that's a point that we're going to come back to a little bit later.

重症监护室医生面临着一种独特的压力，因为他们照顾的是病情最危重的患者，而这些患者的存活率往往较低，这无疑会给医生和工作人员带来巨大的情感负担。

ICU doctors, intensive care unit doctors, they have a unique kind of pressure too because they're caring for the sickest of patients, and oftentimes they will have lower survival rates, and that can take obviously a huge emotional toll on the doctors and on the staff that work there.

倦怠率，是的，是百分之七十七。

The burnout rate, yeah, it's seventy seven percent.

他们重度倦怠的比例最高，达到百分之三十九，这意味着超过三分之一的重症监护室医生正遭受重度倦怠的困扰。

They do have the, highest rate of severe burnout at thirty nine percent, and that's more than a third of ICU doctors that are struggling with severe burnout.

所以我认为这很容易理解。

So I think that's pretty easy to understand why.

另一方面，我们也看到，不同科室的医生倦怠率有所不同，有些科室相对较低，比如精神科和牙科医生，部分原因在于他们工作的性质：例如，牙医的工作时间相对可预测，压力也较小，主要是治疗牙齿问题，通常都能取得积极的成果。

And on the flip side, we also see that depending on the department, some tend to have higher burnout rates while some others tend to have a relatively lower rates such as those doctors in psychiatry and dentistry because part of that is due to the nature of their work because dentistry, for example, they have more relatively more predictable working hours and less life or death pressure is just fixing your teeth and it's usually turning out hopefully to the more positive outcome.

而精神科医生通常建立的是更规律、长期的医患关系，因此往往能获得一种成就感。

While psychiatry often involves more regular and long term relationships, then they can usually foster a sense of accomplishment.

这正是你所说的。

Which is what you're talking course.

他们能看到整个过程的进展。

They can see it through

坦白说，这项研究的结果令人震惊，我们确实需要关注医生倦怠的问题。

To to the be honest, the results of the study is, of course, alarming and we want to address the issue of doctor burnout for sure.

我们会就此展开讨论。

We're going to discuss it.

但我想稍微岔开一下话题，诚实地讲，这些结果让我深受触动——我妈妈是一名心血管科医生，我知道是的。

But just a tiny little detour point I want to make here is that I find the results deeply moving, to be honest, to big My mom is a cardiovascular physician and I know the yes.

我了解医生的生活。

I know the life of a doctor.

我知道，在她的一生、职业生涯、整个工作经历中，她几乎有80%到90%的时间每三到四天就要值一次夜班，而且她一直都在看医生。

I know that in her entire life, in her career, in her entire, let's say, working experience, she had to for the 80 or 90% of it, she had to go through graveyard shift every three to four days, and she sees doctor all the time.

当她在医院的门诊工作时，每天要看40到90位病人，差不多是这个范围。

And when she's working in clinics, like the clinics in the hospital, she would see over from 40 to 90 patients a day, give or take.

根据这些结果，我知道医生非常勤奋，承受着巨大压力，但如果你看看这些数据，就会发现，导致倦怠的最主要原因几乎都与工作体验有关，即医生是否能治愈足够多的病人。

And from the results so I know that doctors are very hardworking and they face a lot of pressure, but if you take a look at the results, we can realize that most reasons or almost the defining factor of burnout relates to the work experience in the sense that whether or not the doctors are curing enough patients.

当他们能治愈足够多的病人时，感觉就会好很多。

When they're curing enough patients, they're feeling much better.

这不仅仅是努力工作的问题，还关乎他们作为专业人士对救死扶伤的执着，能否做好这件事对他们影响极大。

So it's not only about working hard, it's also about them, like this professional being so dedicated to saving lives and whether or not they can do it well affect them a lot.

哦，这其中涉及很多因素。

Oh, there are a number of factors that that go into it.

这确实是其中一个关键因素。

And that's definitely one of them.

在我们继续之前，让我们把数据和美国做个比较。

Let's compare the numbers to The United States now before we go any further.

我想现在来看看这些数据，因为我想要说明这并不是文化问题。

And I want to look at these now because I want to show that this isn't cultural.

要知道，这跟中国医院或中国医生无关。

Know, this isn't about Chinese hospitals or Chinese doctors.

这是一个全球性的问题。

This is a worldwide thing.

我找到的最新研究来自美国医学会网站，是去年发布的，他们对全国倦怠调查进行了研究，发现2023年有超过45%的医生报告至少出现一种我们提到的倦怠症状，这比2021年的63%以上有所改善，但那是疫情期间的数据。

The most recent study that I could find was from the American Medical Association website, which was from last year, and they did a study on the national burnout survey, and they found that similar numbers, forty five percent over forty five percent of physicians reported at least one symptom of burnout, the ones that we talked about, in 2023, which is better than 2021, which is over sixty three percent, but those are pandemic times.

对吧？

Right?

所以他们对这些数字会持保留态度。

So they kind of take those numbers with a grain of salt.

最近，美国医生的倦怠率有所下降，但美国医生的倦怠水平仍高于其他行业的美国工作者。

The burnout numbers among US physicians has improved as of late, but still US physicians, their burnout levels remain at a higher risk relative to other US workers in other industries.

所以数字相似，是的，这正是我想讨论这一点的原因，因为这不是文化问题。

So similar numbers and, yeah, that's why I wanted to talk about that because it's not a cultural thing.

无论医生来自哪里，都会经历这种情况。

This is something that doctors experience no matter where they're from.

是的。

Yeah.

除此之外，史蒂夫已经提到，导致医生职业倦怠的因素其实有很多，不仅仅是

And besides that, Steve has already mentioned the fact that there are actually a lot of different factors at play in causing doctor burnout, not only

在中国，而是全球范围内的问题。

in China but worldwide.

除了我们已经提到的，不同科室的工作强度不同，情况也不同。

Besides the long well, the fact that we've already mentioned that for different departments, are different situations.

我们还应该关注哪些其他因素？

What are some other factors we should be paying attention to?

研究中提到的一个因素是，个人因素，比如年龄，确实会对他们的倦怠程度产生影响。

One thing mentioned in the study is that personal factors such as their age can really play a play a role regarding their burnout ratio.

所以中年的医生更容易出现职业倦怠。

So doctors in their middle ages can be more likely to burn out.

为什么？

Why?

当然，医生也是普通人。

Of course, doctors are human too.

他们也是父母。

They're parents too.

他们既要照顾长辈，又要照顾孩子。

They have their elders to take care of and and their kids to take care of.

所以这正是

So this is

夹心一代。

Sandwich generation.

没错。

Exactly.

而且他们正处于所谓的职业巅峰期。

And they are at the so called peak of their career.

与此同时，在这个阶段，他们往往要在工作重担和家庭生活之间平衡，比如照顾孩子或年迈的父母。

And in the meantime, at that place, they are probably juggling heavy work responsibilities with family life in the middle, like caring for children or elder parents.

有时，未婚医生、教育程度较低或职位较低的医生也有更高的倦怠率，这通常是因为他们在高压的工作环境中获得的支持较少，却需要付出更多努力来证明自己。

And sometimes unmarried doctors, those with lower educational levels and those with lower job titles also have higher burnout rates, and that's often because they have less support or more pressure to prove themselves in their that very sometimes high pressured working environment they they work in.

是的。

Mhmm.

在这样一个时刻被病人和病菌包围的环境中工作，压力巨大。

There's the stresses of working in an environment where you're surrounded by sick people all the time and germs all the time.

还有感染性疾病等带来的危险。

There's the dangers of infectious diseases and things like that.

当我们谈论医生倦怠时，这并不是一个个人问题。

This isn't a personal problem when we talk about doctor burnout.

这是来自这项研究的结论。

And this is from the study.

顺便说一下，我们今天分享的所有信息都来自这项研究。

And by the way, all the information we're sharing today is from the study that came out.

这不是个人问题。

It's not a personal problem.

不是医生不够坚强。

It's not that doctors aren't strong enough.

不是医生不够合格。

It's not that doctors aren't qualified.

不是他们无法承受压力。

It's not that they can't handle the pressure.

这是一个源于工作本身的系统性问题。

This is a systemic issue that comes from the work itself.

当我花了一些时间浏览美国医学会网站时，我发现了一段让我印象深刻的话，这是来自一位名叫克里斯汀·辛格西的医生的观点。

And as I spent a little bit more time on the American Medical Association website, I found I found a a quote that stood out to me, and this is from a doctor by the name of Christine Singhsi, and this is the point that she's speaking to.

她说，虽然倦怠表现为个体问题，但其根源在于系统。

She said, whilst burnout manifests in individuals, it originates in systems.

医生的倦怠并非源于其韧性不足，而是源于他们所处的工作系统，这一点在中国的研究中也得到了完全相同的结论。

Burnout is not the result of a deficiency in resiliency among physicians, rather it is due to the system in which physicians work, and that was exactly the finding from the Chinese study too.

是的。

Yeah.

因为这篇论文还指出，在中国14亿人口且医疗需求不断增长的背景下，我们正目睹医生面临繁重的工作量，并受到医生与人口比例相对较低的压力。

Because the paper also kind of point out that China's among China's 1,400,000,000 population and rising health care demands, we seems to have are witnessing a challenging workload for our doctors and pressurized by a relatively lower physician to population ratio.

这与西方世界以及其他一些国家相比而言。

That's comparing with Western world and some other countries around the world.

我们医院内的专业人员数量往往偏少，难以维持一个健康且充足的系统，让每个人都能获得足够的休息并公平分担工作量。

We we tend to have lower professionals inside the hospital to maintain a healthy or sufficient system for everybody to get enough rest and share a fair share of workload.

所以这是其中一个方面。

So that's one thing.

此外，还存在地区差异。

And then there's also the regional differences.

当我第一次听到这一点时，我觉得特别有趣，因为我们自然会认为，中国经济更发达的东部地区拥有更好的医院和专科，同时还有大量患者从全国各地前来寻求更好的治疗。

And this one is particular particular curious to me when I first heard about it because we naturally think or rather assume that in Eastern China with the better economic development and more top tier hospitals and specialties along with, you know, the huge numbers of patients traveling from all across the country for for better treatment.

看起来东部中国的医院工作人员和专业人士会有更高的职业倦怠率，但根据这项研究，实际情况却呈现出完全不同的图景。

It seems like the Eastern Chinese hospital staff and professionals would have the higher burnout rates, but the real cases the real deal is, according to the study, is that a very different story is painted here.

实际上，中国西部的医生报告了更高的整体职业倦怠率和情绪耗竭。

Doctors in Western China actually report the higher overall burnout rate and emotional exhaustion.

因此，我们看到医生职业倦怠率的预期与现实之间存在差异。

So we see there are differences in terms of assumption for burnout rate among doctors and the Is

是因为那里医院更少吗？

that because fewer hospitals there?

是的。

Yeah.

这项研究也提到，那里医院数量较少，先进设备不足，当地医疗人员短缺。

That's something mentioned in the study too that there are fewer tend to have fewer hospitals and advanced equipment and shortage of medical staff locally.

这解释了原因。

So that explains why.

除此之外，我认为今年早些时候，我们看到一些外国人分享他们来中国看医生的经历，因为中国的医疗效率很高，体验非常顺畅，而且花费也不高。

And besides that, we I think earlier this year, we've had a little trend of people sharing their well, foreign people sharing their experience coming to China and seeing doctors because it's quite efficient and they find the experience very smooth, and also it does not cost a lot.

很多人在社交媒体平台上分享他们的经历，拍短视频，这是原因吗？

Was the reason that many of those people are sharing their experience on social media platforms with short videos and everything.

但这同时也展现了我们这里所处的医疗环境。

But it also showed that that is the kind of medical environment we're having here.

我们习惯于去医院，挂号，最多几个小时后就能见到医生。

That is we're accustomed to going to a hospital, get a registration number, and after maybe several hours at most, you would be able to see a doctor.

但这同样也反映出医生们所承受的工作负荷，哦，医生们面临的压力。

But that is definitely painting also a picture of the workload that Oh, doctors are looking

工作负荷不仅仅是看病人，对吧？

the workload is not just seeing a patient, right?

是的。

Yeah.

老师的职责也不仅仅是站在学生面前讲课。

It's like a teacher's job isn't just to stand in front of the students.

老师很多工作其实是在办公室里处理文书、批改试卷之类的事情。

A lot of what the teacher does is also in the office doing paperwork, grading exams, and things like that.

医生也是如此。

It's the same for doctors.

电子健康记录。

EHRs.

电子健康记录就是电子健康档案。

EHRs are electronic health records.

你知道吗，当你去看医生时，我不确定你有没有这种感觉，在我了解电子健康记录这回事之前，我每次去看医生都会想：为什么你一整段时间都在盯着电脑？

You know when you go to the doctor, and I don't know if you've felt this, before I understood this whole thing about EHRs, I kind of felt when I went to a doctor, why are you just staring at the computer the whole time?

为什么你一直在敲键盘？

Why are you just clicking in the computer?

看着我。

Look at me.

和我说话。

Talk to me.

但他们实际上是在录入你的电子健康记录。

But what they're doing is your electronic health record.

这是你的医疗历史、人口统计信息、手术史以及你曾经使用过的药物清单。

And that's your medical history, that's your demographic, that's your surgical history, that's your medication list that you've had.

这部分是工作内容。

This is the work part.

这是对你作为患者身份的临床记录。

This is the clinical documentation of who you are as a patient.

还有计费、编码以及所有需要完成的文书工作。

There's billing and coding and all of the paperwork that needs to be done as well.

很多医生，根据我之前看的那个美国网站，一天中根本没有足够的时间来完成所有的电子健康记录工作和文书工作，所以他们常常把工作带回家，甚至周末也要做。

A lot of doctors, again from that American site that I was looking at, a lot of doctors don't have the time in the day to complete all the EHR work, all the paperwork, so they'll take it home with them at night and even do it on the weekend sometimes.

他们称之为‘千次点击致死’，因为他们一直在不停地点击，即使是开一个简单的处方，也需要大量的鼠标点击操作来完成电子健康记录系统中的流程，这让人精疲力尽。

They call it death by a thousand clicks because they're just constantly clicking, and even something as simple as a simple prescription, it requires a lot of clicking, a mouse clicking on the computer for this EHR purpose, and it's exhausting.

所以，医生们不仅要接诊病人，不仅要拥有良好的医患沟通技巧——也就是对病人友善、关心，还要处理这么多额外的文书工作。

So not only do they have to see the patients, not only do they have to have wonderful bedside manner, meaning, being pleasant with the patients, being caring with the patients, but they have all this extra paperwork to do too.

此外，在当今时代，我们看到人工智能在医疗系统中发挥作用，它们帮助医生提供新的诊断线索，但同时也给他们带来了压力。

And besides that, in this day and age, we see artificial intelligence playing a part in the medical system in a way that they're helping doctors, giving them new clues how to diagnose a patient, but they're also giving them pressure.

许多医生正在学习如何与人工智能共存，如何从人工智能中学习，如何确保自己超越人工智能。

And a lot of doctors are learning how to coexist with AI, how to learn from AI, how to make sure that they outplay AI.

他们在人工智能的帮助下做得更好，这也是一种学习。

They are doing a better job with the help of AI, and that is also study.

这仅仅是持续自我教育的最新形式，因为对于一代代医生来说，他们整个职业生涯都在这样做。

And this is only the latest form of continue to educate themselves because for doctors, generations of doctors, they've been doing this their entire career.

他们总是希望更新自己的知识，以便为患者提供最新、最好的服务。

They would always want to update their knowledge so that they can provide patients with the latest and the best service that they can.

是的。

Yeah.

说到可能的解决方案，我们现在正在召开今年的全国两会，这是为来年构建政治框架的机制。

Speaking of possible solutions, now we are, as we speak, going through this year's annual two sessions, which is the political framework that's building for the coming year.

在此期间，许多全国人大代表和政协委员提出了能够推动政治层面更新的建议，这些后续将落实到社会实践中。

And during which time, a lot of MPC deputies and c c CPPCC members, are proposing things that that can actually push up the update of the political side, which later will come into the implementation in in our society.

我来举一个关于人工智能的例子，因为这一点确实很有趣——利用技术应对繁重的工作量，已经在往届两会中引起了关注。

So I'm going to give you an example on the AI part because this one is really interesting that using tech to tackle the heavy workload has caught attention in previous two sessions indeed.

这个建议来自刘兰生，他在2022至2023年期间是政协委员。

So this one comes from Liu Lan Sheng was who is then a CPPCC member back in 2022 to 2023.

这个人提出，减轻医生职业倦怠的一个有效技术方案是扩大人工智能在临床实践中的应用，就像我们现在看到的，以及2025年已被多次在圆桌讨论中提及的那样，AI如何助力医疗临床实践。

And this person proposed that one effective tech driven solution to reduce physician burnout is to expand the use of artificial intelligence in clinical practice, like how we see nowadays, like how it's been practiced in 2025 and got on roundtable as topics for multiple times, how AI is helping with medical clinical practices.

因此，他当时提出的建议是将大型医疗AI模型整合进医院，进而构建统一的多源医疗数据库，以支持数据驱动的诊断与治疗决策。

So what he what this person proposed back then was to in integrating large medical AI models into hospitals that can be later built into unified multisource medical database that support data driven diagnosis and treatment decisions.

同样，我们看到这一技术也已应用于临床试验，该提案还被政协评为2023年度优秀提案之一。

And again, we see that being used in clinical trials too and that proposal has also been recognized as one of the proposals of the year 2023 by the CPPCC.

所以，确实有很多方法可以真正缓解医生的职业倦怠，或在他们开展工作时给予支持，而人工智能无疑是其中之一。

So, yes, there are many ways to really relieve these doctors from burnout or or or helping them in the case of how they practice doing their work, and AI is definitely one of

这些解决方案之一。

the solutions.

是的。

Yes.

史蒂夫已经提到，你必须结合患者的病史和记录等信息，以便下一位医生知道该如何处理这位患者。

And Steve already mentioned that you have to work with the patient's history and record and everything so that the next doctor would know what to do with this patient.

所以这一点几乎是完全可以避免的。

So that one is avoidable almost.

但医生们也会通过一些方式互相学习，比如开会、会诊，以及处理不同类型的文书工作。

But there are things that doctors also do in a way to learn from each other, having meetings and consults and having different times of different types of paperwork for sure.

所以，在江苏省有好几家医院。

So there's this one well, multiple hospitals in Jiangsu province.

它们从市级层面出台了政策，确保所有医院简化医生需要处理的文书工作，文书量减少了三分之一，这是一个相当显著的数字。

They, from a municipal level, have rolled out policies making sure that they want all the hospitals to streamline the paperwork that doctors would need to take care of, and it was streamlined by one third, so it's quite a significant number.

这减少了医生在日常工作中的文书处理时间，这也是一种良好且已被证实有效的解决方案。

It reduces the paperwork dealing with kind of time the doctor need to spend in their workdays, and that would also be a good solution, an approved effective solution already we're looking at.

是的，减少文书工作。

Yeah, cut down on the paperwork.

另一个建议是改善医院现有的预警和预防机制，这意味着建立一种系统，对医生进行某种程度的监测，以便及早发现并干预他们可能面临的任何情绪或心理健康问题，这包括对医务人员进行定期健康管理，并加强对管理人员的定期培训，提升他们识别医生压力的能力，营造支持性团队氛围。

Another suggestion is to improve the early warning and prevention mechanisms that hospitals have in place, and what that means, it means establishing a system where the doctors are kind of monitored in a way that would allow for early detection and also intervention of any types of emotional or mental health issues that they might be experiencing, and that would mean having a regular health management of medical staff and also have better training or regular training of managers to enhance their ability to identify certain stresses in doctor and create a support team atmosphere.

非常重要，而且美国也在做类似的事情。

Really, really, really important, and they're doing that in, pardon me, in The United States as well.

他们发起了一项全国性运动，帮助各州制定保密法律，保护寻求心理健康、倦怠或疲劳帮助的医生，同时从医生执照申请或续期表格中删除不恰当的污名化问题。

They established a national campaign to help states, individual states, enact confidentiality laws that would protect doctors seeking help for wellness or burnout or fatigue, and it would also remove inappropriate stigmatism questions on physician licensure or renewal applications.

这很重要，因为医生可能会担心，如果我因为倦怠或情绪压力而去接受心理咨询，这些信息可能会被公开，从而影响我未来的职业生涯。

So that's an important thing because doctors might fear if I go to a therapist to get help because I'm suffering from burnout or emotional stress or things like this, that information might become public and this might have an influence on my career in the future.

因此，他们强调在这些情况下隐私的重要性。

That's why they talked about privacy being so important for for those types of situations.

是的。

Yes.

还有一种叫做‘盲人小组’的东西。

And there is something called a blint group.

盲人小组通常由六到十二名医生或其他医疗专业人员组成，他们定期会面，讨论真实的临床案例，重点不在于诊断和治疗方案，而在于医患关系中的情感与互动。

A blint group typically consists of six to 12 doctors or other health professionals who meet regularly to discuss real clinical cases and focusing not on diagnosis and treatment plans, but on the feelings and interactions within the doctor patient relationship.

我们总是想当然地认为医生什么都能做到。

And we would always like to assume that doctors are they can do anything.

他们能救我们的命。

They can save our lives.

他们是我们中最聪明的。

They're the smartest among us.

是的。

Yes.

他们知道该怎么做。

And they know what to do.

但事实是，是的，他们在医学上知道该怎么做，但并不总是知道如何处理自己的情绪。

But the fact is, yes, they know what to do medically, but they not always know what to do with their own emotions.

一方面，刻意去情感疏离是不可能的。

From one side, it's impossible to depersonalize on purpose.

你有同理心。

You have empathy.

你想和病人交谈。

You wanna talk to the patients.

你想救他们。

You wanna save them.

但与此同时，这也非常有压力，而且相当耗竭，因为你一直在面对这么多病人。

But at the same time, it's also quite stressful, and it's quite exhausting because you're seeing so many patients all the time.

而且我们甚至有一些研究表明，如果医生对病人表现出更多的同理心，这对医生自己也有益处。

And we also even have studies suggesting that if the doctor shows a bit more empathy to a patient, it's also beneficial to the doctor themselves.

这也有助于医生防止自己陷入倦怠状态。

It can be quite helpful for the doctor to prevent themselves from falling into the burnout situation as well.

因此，正是由于这个原因，不同医院才设立了这种盲组，例如在中国，复旦大学中山医院、上海交通大学医院，以及北京的许多医院都建立了这种体系，医学院和各个科室也越来越多地将盲组作为住院医师、全科医生或其他各科室的可选模式，以便医生们能够聚在一起，获得他们应得的同行支持。

And that is why having this kind of blint group in different hospitals, for example, here in China, in Fudan University's Zhongshan Hospital, in Shanghai Jiaotong University Hospital, as well as many hospitals here in Beijing, and they have this kind of system, and medical schools and departments also would increasingly include the Blind Group as optional models in residency, general practice, or all these different departments so that their doctors can benefit from getting together and getting the peer supports that they deserve.

关键就在于支持，对吧？

That's the thing, is support, right?

记住，回到那一点，这是系统性的。

Remember, going back to that point, is systemic.

正是系统导致了这些医生的倦怠，因此同行支持和机构支持都绝对必要。

It's the system that's causing the burnout amongst these doctors, so peer support, institutional support, all absolutely necessary.

所以现在我想谈谈公立医院和私立医院之间的差异或相似之处。

So now I want to talk about the difference or the similarities perhaps between public and private hospitals.

你认为会怎样？

What would you assume?

我找到一项研究，探讨了私立机构和公立机构医生之间的压力水平是相似还是不同。

I found a study that looked at whether the stress levels were similar or different between doctors in private institutions and public institutions.

我要说明的是，这个结果只是一个结果，来自马来西亚，时间是2018年。

Now I will say this result is one result, and it's from Malaysia, and it's from 2018.

但如果我们将这个结果视为整个社会的一个横截面，我认为我们可以从中获得一些启示。

But if we use this this result as a cross section of society as a whole, I think we can learn something here.

你觉得结果会是什么？

What what do you think would be the result there?

公立和私立机构的医生之间呢？

Public versus private institution doctors?

公立医院更高，私立医院更低。

Higher rate in public hospitals and lower in private ones.

我的假设也是这样，但事实并非如此。

That was my assumption as well, but that is not what they found.

顺便说一下，这篇论文来自Science Direct，如果你想查的话。

This is from Science Direct, by the way, if you want to look it up.

这是2018年马来西亚的研究。

This is from Malaysia from 2018.

所以他们做的正是这个研究。

So what they did was exactly that.

他们想知道压力水平是相似还是不同，结果发现公立和私立医院医生之间的压力水平实际上非常相似。

They wanted to know if the stress levels were similar or different, and what they found was that the levels between physicians in public and private hospitals were actually very similar.

与公立医院的医生相比，私立医院的医生在患者护理责任和职业不确定性方面承受了更高的压力水平。

Physicians in private hospitals experienced a higher stress level related to patient care responsibilities and professional uncertainty when compared to those in public hospitals.

听到这个结果时，我想，好吧。

Now upon hearing that, I thought, okay.

我能理解职业不确定性，因为你在私立机构工作，对吧？

I get the professional uncertainty because you're working in a private you're working in a private institution, right?

那么，作为一名医生，你的职业生涯会面临什么情况呢？

So what's gonna happen, you know, to your career as a doctor?

哦，我对这一点有点担心，所以我能理解这种压力水平。

Oh, I'm a little worried about that, so I understand that level of stress.

但我之前不明白的是关于患者护理这一方面。

But what I didn't understand was the patient care side of things.

私立机构中患者护理方面的压力更大，他们给出的理由是，当公立机构的医生照顾病人时，病人更像是系统的一部分，这么说吧。

Higher stress levels for patient care in private institutions, and the reason they say is that when a doctor in a public institution takes care of a patient, well, it's more about the patient being a part of the system, if you will.

医生与患者的关系主要是临床性质的，患者去医院接受治疗，医生在公共医疗体系的限制下提供服务，因此这种关系更简单直接。

The relationship between the doctor and the patient is primarily clinical, and the patient goes to the hospital for care, the doctor provides it within the constraints of the public system, if you will, so the dynamic is more straightforward.

这更像是医生是专家，你是患者，你们一起合作找出问题所在。

It's more like the doctor's the expert, you are the patient, and together you work on finding the problem.

但在私立医院，这就是为什么他们说压力更大，因为患者突然变成了顾客。

But in a private hospital, and this is why they say the stress levels are higher, it's because the patient suddenly becomes a customer.

是的，医疗人员面临更高的期望。

Yeah, there's higher expectations on their medical staff.

你说得对，因为现在患者对医生的期望更高了，这就是医生面临的一种压力。

You nailed it because now the patient has higher expectations for the doctor, so that's one stress that the doctor has.

天啊，我真得好好解决这个问题，否则对方会不高兴，因为他们直接付钱给我，几乎是为这项服务付费。

Oh my gosh, I really need to fix this person, or they're going to be upset because they're paying me directly for, almost, for this service.

因此，期望值更高，这也是他们感到压力的原因之一。

And so therefore, the expectations are higher, and that's one of the reasons that they feel stressed.

另一个与此相关的理由是法律追责。

The other reason connected to that, legal recourse.

如果发生任何差错，根据这项马来西亚的研究，私人患者相比公共患者提起法律诉讼的可能性要高得多，因此医生们对此也更加紧张。

If something happens to go wrong, according to this Malaysian study, the possibility of legal recourse from a private patient versus a public patient is much much higher, so doctors tend to be more stressed about that as well.

但话又说回来，我认为这也与医生的个性以及他们最关注什么有关。

But that being said, I think it also has something to do with the personality of the doctor, of what they focus on the most.

例如，一些医生从公立医院转到私立医院，并不是因为他们想要更低的工作量或更轻松的负担。

For example, the reason that some doctors transfer from public hospitals to private hospitals is not because they want a lower work or lighter workload.

而是因为他们希望多花点时间做研究，探索新技术和新方法。

It's because they wanna focus a bit or spend a bit more of their time doing studies, doing research, and researching for some new technique and some new method.

还有一些人是因为想搬到不同的地方，原因多种多样。

And some would be because they want to relocate to a different place, and there are so many different reasons.

在中国，我们看到政府大力支持和鼓励建立不同类型的私立医院，甚至正在考虑在某些地区引进完全由海外资金资助的私立医院。

And here in China, we see the supporting and encouraging encouraging of establishing different types of private hospitals, and even we are looking at possibilities of having entire overseas funded private hospitals in the country, at least in certain parts of the country.

我认为，所有这些举措都是为了使整个医疗体系更加完善，以满足来自不同地区、不同背景、患有不同疾病患者的多样化需求。

And all these would I think they are different tries to almost to also make the entire health system a bit more complete that can address more demand from more patients in different places with different background situation and with definitely different disease.

我们还看到不同成员和政策顾问提出许多想法，试图解决区域不平衡问题，努力建立更多非私立但面向基层的地区性医院，是的。

And we also see different members and also political advisers saying that they have a lot of ideas trying to address the issue of regional imbalance, trying to establish more not private, but regional grassroot hospitals Yeah.

在偏远地区

In remote

当我们谈到那个关于上海医院把医院搬上飞机的故事时，对吧？

When we talked about that story about it was the Shanghai Hospital, right, that brought the hospital onto the airplane.

啊，复旦大学，是的。

Ah, Fudan University or Yeah.

而且飞机飞往中国的西部偏远地区，那里的挑战在于公平性。

And and was flying to the far western side of The the challenge there is equity.

对吧？

Right?

好的，我们来谈谈人工智能的新闻。

Okay, so let's talk about the AI news.

所以，如果你在广州、上海或北京的顶级医疗机构部署人工智能工具，医生们的工作量能减少多少？

So if you're implementing AI tools in hospitals in Guangzhou or Shanghai or Beijing for, you know, the top medical institutions, and these doctors can reduce their workload by what was it?

你说是33%，对吧？

You said 33%, right?

减少三分之一。

By a third.

但这种减负效果在国家偏远的西部地区也成立吗？那里没有大型医院，也没有充足的人手。

Well, can that also be true in the far western remote regions of the country where you don't have big hospitals, you don't have large amounts of staff.

这是一个问题。

That's one issue.

如果这些好处只存在于一线城市，而其他城市没有，那么医学院毕业生就会面临一个问题。

And then if those if those types of things if those types of benefits are available in top tier cities, but they're not available in other cities, well, then you're gonna have an issue of doctors coming out of medical school.

你觉得他们想在哪里工作？

Where do you think they wanna work?

你觉得他们想去哪里？

Where do you think they wanna go?

对吧？

Right?

这同样也是一个问题。

This becomes an issue as well.

因此，在全国范围内创造一个公平的医疗环境，这确实是一个巨大的挑战，但如果能实现，确实有助于解决问题。

So creating a level playing field, a medical playing field all over the all over the country, I mean, it's a huge challenge, but it does help to solve the problem if you can achieve it.

而且，我们理想地认为，随着技术的发展，我们能够解决这种不平衡问题。

And ideally, we believe that with the development of technology, we would be able to solve the imbalance problem.

随着人工智能越来越多地投入使用，也许我们可以减轻医疗行业或医疗保健领域在社会中的工作负担。

And with AI come in place more and more, maybe we can reduce the workload of the medical industry or the medical care sector in the society.

但我们也知道，每个医院、每个科室，以及不同地区、不同城市、不同县、不同村庄，都需要付出大量努力，才能找到适合他们的解决方案。

But we also know that it takes a lot of effort in each and every hospital, in each and every department, in different places, different city, different county, different villages to find out the solution that is right for them.

但起点是意识到、认识到这个问题，并进行讨论，是的。

But the starting point would be noticing, realizing the problem, having it discussed Yeah.

从政策层面明确方向，观察人们如何根据自身情况适应，并找到解决方案。

Having a direction from the policy side and see how people adapt to their own situation and then find out the solution.

而且，这不会一夜之间发生，但会逐步改善。

And, no, it's not going to happen overnight, but it will be improved little by little.

是的。

Yeah.

请记住，希望这也是我们今天学到的一点。

And just remember, hopefully, this is one thing we learned today too.

下次你去看医生时，如果你觉得他们不够友善，是吧。

The next time you go to see a doctor, if you feel like, oh, they're not really being that friendly Yeah.

到

To

我身上可能稍微有点。

me to a little bit maybe.

也许他们只是盯着屏幕，不停地点击，却根本没有看着我。

Maybe if they're just staring at their screen and clicking away but not really looking at me.

请记住，他们一天中要面对各种各样的人，你并不是他们唯一的服务对象。

Just remember, well, all the things that they have to go through throughout the course of a day, you're not the only person that they see.

他们每天都要接待大量的病人。

They see a lot of patients all day, every single day.

他们真的非常疲惫。

They're really tired.

他们压力也很大。

They're really stressed.

所以也许给他们一点喘息的空间，

So maybe give them a break a

稍微放松一下。

little bit.

是的。

Yeah.

即使他们只花五分钟在你身上，这五分钟的判断，是建立在数十年的学习和经验之上的，非常值得。

And even if they only spend five minutes on you, that five minutes, that decision of the five well, within the five minutes that they make, it takes decades of study, of experience, and it's worth it.