Chapter 189 Three factors that determine a doctor’s status, has Director Jia made a mistake?
"Director Liu mentioned you more than once when we were chatting. He had promised to take you in as his apprentice and teach you personally. But when several major departments were selecting general practitioners for intern training, you were selected for the emergency department. You also know that competition between departments is very fierce and interests are intertwined. Old Liu is only an associate chief physician, in a position that is neither high nor low. He has no ability to take you from the emergency department."
It seems that Director Jia and Mr. Liu have a very good personal relationship.
Otherwise, the two of them would not be able to talk about these topics.
Dr. Liu's status in the general surgery department is pretty good, but in the entire Tuya Hospital, he might not be able to get a number.
Nowadays, doctors who have no academic achievements generally do not have a high status, even if they have rich clinical experience.
The status of a doctor is determined by three key factors. First, surgical ability or diagnostic and treatment ability. A doctor should be able to treat diseases, overcome some difficult and complicated diseases, and be extremely good at a certain field.
These doctors are often famous doctors or experts in a certain field.
They have great influence and can attract a large number of patients to the hospital.
Such doctors are the flagships of the hospital and enjoy an exceptional status.
Even if their academic achievements are not that good, it still does not affect their status in the hospital and the industry.
The second type is those with outstanding academic achievements.
There are many papers published in important journals and core journals, at least one of which has caused a sensation in the industry. It even leads the industry trend and creates a precedent. Or the scientific research achievements are extremely outstanding.
This type of doctor often holds senior teaching positions in medical schools, and generally starts as a third-level professor.
The most common one is the third-level professor.
As for those who can become first-level professors, they are often at the level of academicians.
Not only do they have a very high status in the hospital, they also have a very high status in academia and society.
This is also the reason why all doctors, regardless of whether they are suitable for the job or not, have to spend a lot of time studying academic subjects.
Since ancient times, there has been a rule that everything is inferior except reading.
The same applies to the medical profession.
The third type is those who hold a high administrative position or have someone above them.
This needs no explanation.
No matter how great a doctor is, he is just a younger brother in front of this kind of people.
Of course, everyone generally respects each other and lives in harmony.
It is difficult to describe Mr. Liu's academic achievements, and his surgical skills can only be said to be above average. His rich experience in diagnosis and treatment can barely be considered an advantage. However, at the deputy director level, which doctor does not have rich experience?
Therefore, Mr. Liu's status in the hospital is relatively poor.
He is totally incomparable with big guys like Wu Baihe, Yin Hua and Hu Kan.
Given his status, he really has no power to transfer a general practitioner trainee selected by the emergency department.
Back in the operating room, Elder Liu had just casually said that he wanted to train Zhou Can personally.
Even Zhou Can didn't dare to take it too seriously.
I didn't expect that the person who made it would always remember this promise.
"Old Liu asked me to teach you, which is also an indirect fulfillment of the promise I made to you. I hope you can understand this."
Director Jia said to him again.
"I understand! Thank you, Mr. Liu, for always remembering a little person like me. Thank you for being willing to teach me in person."
Zhou Can expressed his attitude very seriously.
"From today on, whether I am seeing patients, performing surgery on patients, or making rounds, you can follow me. As long as you are capable, you can come anytime. If you don't understand something, you can ask me directly."
Director Jia basically meant to tell Zhou Can that he would do his best to guide him.
And give Zhou Can the greatest freedom to develop.
This kind of treatment is something that no trainee would dare to imagine.
For a trainee, being appreciated by a chief physician is a stroke of luck, and the chances of being fully nurtured by a chief physician are about the same as buying a lottery ticket.
“Boom boom boom!”
At this time, a rather young and beautiful female doctor stood at the door and knocked.
"Good morning, Director Jia! Is it convenient for you to come over for rounds now?"
The female doctor asked with a smile.
"I'll be there right away! Qiuhong, I have a new student named Zhou Can, who has just been assigned to the Department of Digestive Surgery as a resident trainee. If he has any questions in the future, please help him."
Director Jia is obviously very familiar with this female doctor.
After the introduction, he looked at Zhou Can again.
"Her name is Qiu Hong, and she has been studying with me for almost five years. She has made great achievements in the fields of gastritis and ulcerative enteritis in the field of digestive surgery. She has also reached a high level in the diagnosis of various malignant diseases and surgical procedures for digestive tract diseases."
Director Jia was quite satisfied with this female student and gave her a high evaluation.
"Hello, Senior Sister Qiu. Please take care of me in the future."
Zhou Can is never rigid when it comes to being sweet-talking.
The call of "Senior Sister Qiu" immediately brought a happy smile to the female doctor.
"Haha, you are not shy. Director Jia rarely takes on trainees, and you should be the first trainee he has taken on since he was rehired. But I have heard of your name, and it is said that you are as famous as Dr. Du, a returnee doctor. I am looking forward to seeing your true strength!"
She smiled and winked at Zhou Can, looking at him with curious, inquiring eyes.
Unfortunately, she was soon disappointed.
Because Zhou Can, apart from looking a little handsome, doesn't look like a master at all.
What is worn underneath the white coat is also very casual.
He was wearing casual sports pants and casual shoes. Compared with Du Leng's well-dressed appearance, the difference in appearance was quite large.
Du Leng always wears formal clothes to work every day. Suit, leather shoes, shirt and tie are almost his standard outfit. His hair is also meticulously groomed, a typical social elite.
"Senior Sister Qiu, please don't expect anything, because I'm afraid you'll be disappointed. Just treat me as an ordinary trainee who can't be more ordinary."
Zhou Can smiled modestly.
"You say you are ordinary, but your performance is not ordinary! Young male doctors like you are usually very proud and have strong self-esteem. They like to be praised, but you are the opposite of them. You just want to keep a low profile. Under Director Jia, hiding your abilities is never welcome. You must use your real abilities. Only in this way can Director Jia help you point out potential problems."
Qiuhong didn't buy his account at all.
This female doctor is not easy to fool.
"Xiao Zhou, there is really no need to hide your shortcomings. Whether you are accompanying me on ward rounds or seeing patients, you can freely express your opinions and views as long as it does not cause medical disputes."
Director Jia also told him that there was no need to be too low-key.
"clear!"
Zhou Can is very smart. He has never been vague about when to show his abilities and when to hide his shortcomings.
When he first entered the Department of Digestive Surgery, he would definitely seize the opportunity to perform well if given the chance to make a contribution.
"Let's go, let's go to the ward!"
Director Jia stood up first and walked outside with unsteady steps.
Qiuhong naturally stepped forward to support him.
Judging from his age, Director Jia must be over 60 years old. But he needed someone to support him even when walking, which was a little beyond Zhou Can's expectations.
For those who engage in light physical labor, it is difficult to tell their real age from their appearance even if they are older.
A man is in his prime at 41, and it’s not called that for nothing.
As soon as I walked to the corner of the corridor, I saw a dozen doctors and nurses standing there waiting.
Among them are many middle-aged and elderly doctors over 50 years old.
It seems that Director Jia is quite popular in the Department of Digestive Surgery.
Zhou Can actually doesn't like this type of ward rounds very much, because of his low status, and following the director on ward rounds is more like a cursory formality.
After entering the ward, he found that Director Jia's ward rounds were more direct.
He doesn't check ordinary beds.
Only check key beds.
Walk straight to bed number 3 and stand still.
Lying on the bed was a haggard old man with a sallow face, pale and bloodless lips, and sunken eye sockets.
"The patient in bed 3 is a 71-year-old male with a history of recurrent abdominal pain for 17 years. About three months ago, his condition began to worsen. Five days ago, he fainted several times due to the pain. Finally, four days after he had black stools, he came to our hospital for treatment because of the unbearable pain."
Zhou Can became interested as soon as the attending physician introduced the patient's basic condition.
Diagnosing various cases is his favorite.
Pathological diagnosis and tracing are one of the areas he is best at.
The patient has had abdominal pain for nearly twenty years, which means he definitely has a chronic disease.
These diseases are generally not fatal.
Many people coexist with the disease by taking medication to relieve symptoms.
In fact, more than 90% of people over 30 in my country have various chronic diseases. However, because they do not affect their lives and do not bring particularly serious consequences, such as unbearable pain and life-threatening, many people live with the disease and have never received any treatment.
Not to mention anything else, just a fungal skin infection is the most common disease among the vast majority of middle-aged and elderly people.
For example, tinea pedis, tinea capitis, vulvar itching, athlete's foot and so on.
Chronic gastritis, enteritis, diabetes, hypertension, asthma, etc. are also very common.
Tumors and polyps are actually chronic diseases.
This patient had abdominal pain and recent black stools, indicating gastrointestinal bleeding.
The lesions are likely in the stomach or intestines.
"Six days ago, the patient had abdominal pain and various discomforts without obvious cause, nausea, and vomited twice. There was no coffee-flavored blood, no obvious abdominal distension, no obvious acid reflux, and no heartburn. Then he fainted again, and after falling, he had fecal incontinence. He discharged about 200 grams of black stool, without convulsions or foaming at the mouth, and woke up on his own not long after..."
This case is complicated and challenging.
No wonder Director Jia focused on examining this patient the first time.
"After that, the patient had black stools again, and the stool occult blood test was positive. He was also vomiting. His urine was not yellow. He was admitted to the hospital with duodenal ulcer and hepatosplenomegaly."
Judging from the patient's symptoms, it does look like duodenal ulcer.
Hepatosplenomegaly also needs to be included in the diagnosis.
"The patient had previously taken propantheline intermittently when he had abdominal pain, which soothed his stomach. The symptoms were effectively relieved after each dose of the medicine."
Most patients with chronic diseases are like this.
Taking medicine works, and no one wants to be hospitalized.
Buy some medicine and deal with it.
"The patient was treated once in a local hospital eleven years ago. The examination and diagnosis were duodenal bulb ulcer and superficial antral gastritis. He was later discharged after treatment."
"The patient's current body temperature is 36.8 degrees, pulse is 76/min, blood pressure is 120/80 mmhg..."
The attending physician explained the patient's basic condition, medical history, and treatment history.
Zhou Can stood at the end of the bed, and could only watch from afar with several residents and trainees. In fact, he really wanted to take a look at the patient's examination report and then make a comprehensive diagnosis.
Now, we can only listen to Director Jia’s opinions.
Director Jia finally diagnosed the patient with duodenal ulcer and arranged for surgical treatment.
For many gastrointestinal bleeding diseases, surgery is the only cure.
"Patient No. 13, male, 45 years old, felt discomfort in the upper abdomen, nausea and stuffiness. Two hours ago, he suddenly vomited a large amount of blood, accompanied by food residue in the stomach..."
The patient in this bed is another dangerous case.
Basically, all the patients admitted to the hospital are critically ill patients.
At first glance, Zhou Can felt that the man's face was pale and dark yellow, a typical appearance of anemia.
And liver disease is likely to be present.
Especially the patient's palms, which are obviously liver palms.
This hospitalization should be attributed to acute upper gastrointestinal bleeding.
The patient's current blood pressure is very low, which may be related to vomiting blood.
Surgery must be arranged as soon as possible.
After examining two patients in a row, Zhou Can had a general understanding of gastrointestinal surgery.
The volume of surgeries here is very high, and it seems that in the next two months, as long as Director Jia is willing to delegate authority to him, he will definitely be able to earn a lot of surgical experience points.
Don't even think about performing the operation alone, but you can strive to participate in important parts of the operation.
By then, with Director Jia's guidance, he will be able to quickly accumulate surgical experience in digestive surgery.
…
After the ward rounds, Director Jia gave guiding advice to key patients.
For example, guidance on medication, guidance on temporary treatment, and then checking the surgical arrangements for these patients.
Emergency patients whose lives are in danger will be given priority for surgery.
They thought Director Jia would take them to the operating room for surgery right away, but unexpectedly, Director Jia took Zhou Can and Qiu Hong directly to the outpatient clinic for consultation.
Sitting with the chief physician to see patients was something Zhou Can had always wanted but never had the chance to do.
Because he hasn't obtained both certificates yet, it's impossible for the senior doctors to have someone like him with them.
Unless he begged persistently, the senior doctor would consider taking him in once or twice.
It’s different now. Director Jia agreed with him in a private conversation that Zhou Can can follow him to see patients and perform surgeries every day in the future.
It seems that Zhou Can's pathological diagnosis experience points can finally be increased.
His pathological diagnosis is currently level four, and the attending physician is at a lower level.
This level is definitely not comparable to that of a chief physician.
But it is much better than the average resident doctor.
The three of them came to the outpatient department and entered Room 1 of the Specialty Clinic.
Wow, it seems that Director Jia’s position in the Department of Digestive Surgery is much higher than he imagined!
When I was doing the ward rounds just now, I could also get a glimpse of Director Jia's ability by listening to him diagnose those patients and the treatment plans he provided.
When other doctors are making rounds and explaining treatment plans to patients, they rarely use a positive tone.
When faced with patients' questions, Director Jia answered them with great confidence and in an affirmative tone.
"We can cure your disease. The recurrence rate will not exceed 1%."
"Your disease can be cured, don't worry, I have done many cases and none of them can't be cured."
Look, this is the confidence Director Jia shows when he speaks.
After hearing this, the patient felt as if he had taken a reassurance pill.
If a doctor does not have real skills, which doctor would dare to say such confident words to the patient and his family?
"Xiao Zhou, the outpatient clinic has a large number of patients. Every patient who comes here has different demands and conditions. You must listen carefully and think carefully. If you have any questions, you can ask me after the patient leaves."
Director Jia was afraid that he was too young and would ask all kinds of inappropriate questions when he was treating patients.
"Okay, got it!"
Zhou Can seemed a little absent-minded.
Because when he was making rounds just now, the patient in bed 3 left a deep impression on him.
Although he did not look at the specific examination report of the patient, Zhou Can has recently made up for the basic medical knowledge in many fields, including immunology and digestion.
Director Jia diagnosed the patient with duodenal ulcer, which was consistent with the diagnosis of the attending doctor.
However, Zhou Can felt that the patient's illness might not be as simple as it seemed.
This is related to the fact that Zhou Can worked in the Department of Critical Care Medicine for three months.
He comes into contact with a large number of terminally ill cancer patients every day.
In many ways, the patient gave him the feeling that it was cancer rather than a simple ulcer.
