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Department of Spine
Peng Hu
From March to June 2016, I have studied in the Orthopedics Department of Lippe Hospital. During these three months, I went through a hard and happy time.
Detmold located in the west of Germany, under the Nordrhein-Westfalen, is the capital and largest city of Lippe County. Lippe Hospital is located in Detmold, Lemgo, Batesatimeswufulun three cities, with headquarters in Detmold. Lippe Hospital is the main affiliated hospital of Hannover University. Spine surgery is one of the most famous departments in the hospital, with four wards, 160 fixed beds, 36 doctors; 2 professors, 6 senior physicians, 6 attending physicians, 8 specialist physicians, 14 physician assistants. Clocttman and Vollkerman are my mentors in Germany. Director Clocttman is responsible for the department administration and operation. After the three months of training, I have made improvements in operation skills, and I have also learned a lot from the resident training and research groups.
German health insurance is the world’s first implementation. It has been enforced from the beginning of the 19th century, the statutory health insurance mainly supplement private commercial health insurance. Private health insurance mainly for freelancers, entrepreneurs, and pay more than a certain amount of corporate employees. According to the German Federal Bureau of Statistics, 87% of the population joins the statutory health insurance, 13% of the population joins the private commercial insurance; only 0.2% of the population has no health insurance. When a German is sick, whether he goes to community hospitals or large hospital, the insurance will cover at least 90% of the cost.
If a person gets a disease, he first needs to make an appointment to see the family doctor; according to his condition, the family doctor will determine whether he needs to go to a specialist doctor. The outpatient department of orthopedics is family doctor referral or the hospital referral of patients. The hospital will treat according to the patient’s condition.
Each operating room is composed of four parts. In addition the operating room at the end of most health care is also a rest room, separated from the general practitioner and professor (Professor by the separate lounge, equipped with a desk and computer facilities shelves). Here surgeons, anesthetists and operating room nurses have a cup of coffee or some cake instead of having a formal lunch.
Proportion of day surgery is very high. There are a lot of spine fractures, admitted during operation day, discharged one or two days after operation. Most of the fracture patients are discharged three or four days after operation.
Medical students need residency training after graduation from medical university. Residency is 6 years long in the department of orthopedics, FMC, with a fellow stage of 1 year, equating to a total of 6 years of residency training. The resident will become a doctor with independent work ability after residency training. Residency training is only a study program, and the resident is not a formal employee of the hospital. Upon completion of residency training, you can become an attending physician. The doctor’s growth period is very long; the time of universities and medical schools is at least 8 years, plus 4 to 7 years of residency training. To become a doctor with independent work, one generally needs 12 to 15 years to go.
Case discussion consists of two parts. In the first part, they review yesterday’s surgery, the main details of surgery image data, and so on. Doctors may also can discuss the main process of operation, including fracture reduction difficulties, and internal fixation in detail. After that, they will discuss today’s surgery. The responsible doctor will introduce the condition of the patient, then each doctor will express his own views, and finally the professors will determine the surgical plan. There are some academic lectures every Friday from 7am to 8am. Each speaker usually prepares 2-3 cases and the latest literature to present an in-depth analysis, and then doctors will have a careful discussion. The organization of various forms of academic activities can benefit the young doctors a lot.
My supervisor Clocttman is currently Head of Orthopedics Center. He goes to outpatient every Wednesday and sees more than 40 patients. There are 6 consulting rooms, and it is the nurse who is responsible for the reception of patients, hospitalization and surgery. The patient waits in the consulting room, the resident first asks the history, reports to the doctor, and then the doctor goes into the consulting room. There are also many referral patients. The doctor decides on the treatment, introduces the patient’s condition, and guides the patients to exercise. In Germany, doctors and patients address each other, shake hands, like old friends.
The patient and the doctor respect and trust each other sincerely. Doctors usually follow the doctor’s recommendations carefully, which makes some of the problems (such as re-operation, the medical use of consumables, etc.) disposal very timely and reasonable, in contrast, domestic doctors are tolerating so many concerns and pressures.
We did not see X-ray or CT film anywhere in the hospital. They have developed an electronic medical record system and an imaging system to see the hospital medical records, test results and image results. Nearly 10 years of all cases are available to view; more powerful is the provincial information sharing access to the system. As long as a patient’s ID is inserted, all the information is available at a glance. And the hospital’s computers are everywhere, all connected to the Internet to facilitate access to information.
In recent years, the level of medical care in our country has been improved rapidly, we feel that the gap between us and the developed countries is getting smaller and smaller, but some concepts need to be updated, and some new technologies and theories need to be introduced and put into practice.
Three months in Germany for further study is one of the most valuable memories in my life. Unfortunately I have not learned German before departure, so there are certain difficulties in some in-depth exchanges.
Thanks again for the leadership of the hospital to give me this opportunity to learn in Germany. I will work harder during the clinical work and try to make greater contributions for the rapid development of BMUH!
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