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“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Monday, July 16, 2007
    Teaching Medicine by Video

    An interesting article from last week's Wall Street Journal describes a company designed to bring courses in basic medicine to rural doctors in China. The term "rural doctor" may be misleading, as most of these health care providers have no formal medical training. One doctor interviewed for the article finished school at 17 and learned to practice medicine by training with his mother. There are about one million of these rural doctors, who are also known as "barefoot doctors," in China; in most cases they provide the only medical care available outside cities. Most got started as farmers who were appointed to be village doctors by local officials. (Imagine being told "You're going to be the doctor for this town.") They were sent to hospitals for basic medical training, which was unfortunately minimal in most cases.

    The purpose of the videos is not to provide a complete medical education but to bring the doctors up to date on problems they're likely to see in their local clinics. One doctor successfully resuscitated a baby using CPR techniques she'd learned from the class (she'd never learned how to open an airway or perform CPR properly). Another said he'd learned about drug allergies for the first time. Unfortunately, the instruction is by video only with no doctor on hand to answer questions (the company says it's too expensive to do this except at the end of the course). Nevertheless the feedback has been good. A three-year course of instruction costs 3400 yuan - about $448 - and the cost is partially subsidized by the government.

    The Chinese government, in an effort to improve the medical care available to rural residents, has ordered all rural doctors to earn a basic medical degree by 2010. The video classes sound like a great way to ensure that this happens.




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