Speeding to save lives(2)

On the road an ambulance driver has to concentrate to get through city traffic quickly. Photo: Yang Hui/GT

After medical school graduates work as interns for a year and then they are allowed to sit the licensed medical practitioners' diploma exam. This enables them to then go on to other specialist studies and diplomas. But ambulance doctors can only sit for physicians' or general practice licenses and this mostly involves work that is outside their regular work, Yao Ming explained. The 44-year-old Yao is one of Shanghai's most experienced ambulance doctors.

Yao worked at the Shanghai First People's Hospital ambulance base and although Yao passed medium-level specialist exams he never applied for a higher grading. "It's much more difficult and we have to be assessed by a review board system. It doesn't fit our work."

Things are changing. He is one of the first full-time ambulance doctors who trained at the Shanghai Municipal Health School. Before Yao and his classmates began their course, there were no professional ambulance doctors in Shanghai. The Shanghai Medical Emergency Center had to "borrow" doctors from hospitals for duty.

Not suited

"This is inconvenient. The hospitals only send doctors who are available for ambulance duty but these doctors come from different departments and not every department's medical staff members are suited for ambulance work," Yao said.

In 1988, the former Shanghai deputy mayor Xie Lijuan, who was a doctor herself, pushed for specific training for specialist ambulance doctors and 30 young men joined Yao to become the first batch of students on the first two-year professional ambulance doctor course.

Yao explained that until the early 1990s Shanghai ambulances were mostly patients-only vehicles, but since the mid-1990s state-of-the-art equipment was introduced and the city began to build a fleet of modern ambulances as well as improving the training for drivers and paramedics.

After working in emergency services for more than 20 years, Yao has a relaxed approach to the job and believes firmly that he is part of a "service industry." One relative of a patient traveling with him in the back of the ambulance one night commented that it was rare to see doctors of his age working in ambulance. Yao smiled quietly to himself. He is used to the work and wouldn't want to do anything else.

In the early days many Shanghai people were reluctant to call an ambulance but after 2000 the number of calls began increasing. Today most ambulance crews have to handle between eight and 10 calls a shift. A bonus system gives crews more money for more complex cases and for extra duties.

On the night when the Global Times rode with Yao's ambulance, on the way back from delivering a patient, the crew received a call to the intersection of Wujin and Shuidian roads where a man was reported to have collapsed after being assaulted. As an experienced ambulance doctor Yao knew the local hospitals and first told the driver to head to the nearest, the Yueyang Hospital.

In pain

As he examined his patient, however, he discovered the man had been hit in the eye and was now suffering a great deal of pain. Yao knew that the Yueyang Hospital did not have an ophthalmology department so he changed the destination to the First People's Hospital.

But when they arrived there were already two other ambulances with patients ahead of them - a regular problem at major city hospitals. Especially at third-tier hospitals queuing is a problem. While they wait for staff and beds to come available the ambulance crews have to tend to their patients in the meantime.

Back at the center there are back-up plans if several ambulances are tied up like this. And older vehicles are on standby so that they can be put into use for emergencies.

Some of the ambulance drivers told the Global Times that on the road when their sirens and lights are switched on drivers do try to let the ambulances pass when possible - especially drivers with Shanghai number plates. And although ambulances can move through intersections against red lights the drivers are still held responsible if an accident occurs doing this.