Chapter 271: Cold reception, clean diagnosis
Through casual conversation, Zhou Can learned that she had rotated through multiple departments and her surgical skills were no less than those of ordinary residents. And like Zhou Can, she passed the medical license examination this year and became a practicing physician.
Among the 41 students in Class 512, only Zhou Can and Yang Chan successfully stayed and worked in Tuya Headquarters.
Both of them have performed exceptionally well, and there is no doubt that they will be transferred to become full-time physicians of the main hospital after completing their regular training.
During the chat, she had repeatedly inquired about Zhou Can's current strength.
Unfortunately, Zhou Can was always unwilling to reveal more, which made her feel helpless and even a little angry.
Women are very curious.
She had heard about Zhou Can's glorious deeds many times, and many chief physicians praised Zhou Can for being excellent when chatting with Director Zhang Bihua. This made her want to know even more how excellent Zhou Can was.
After asking several times in an indirect way and failing to get any information out of her, she simply stopped asking.
Anyway, we will definitely treat patients when we get to Xinxiang Maternity and Child Health Hospital, and then Zhou Can’s strength will be clear.
After driving for more than an hour, the bus slowly stopped.
"We've arrived at Xinxiang Women's and Children's Hospital. Get ready to get off!"
The car door opened and everyone got out one after another.
"Director Zhang, we've finally got you here!" The reception at Xinxiang Maternity and Child Health Hospital was very grand.
There were lights and decorations everywhere, and banners were hung all over the ground.
The content is also written in a very eye-catching way.
Good news for patients: We welcome Professor Zhang Bihua, an obstetrician and gynecologist from Tuya Hospital, and her elite team to come to our hospital for consultation!
Experts are welcome to visit our hospital for guidance!
Tuya Hospital and Xinxiang Women's and Children's Hospital are one family.
The red banners hanging everywhere are full of joy.
They were personally welcomed by Director Tian of Xinxiang Maternity and Child Health Hospital, who gave them the highest level of reception.
“Dear experts and elite medical staff, welcome to Xinxiang Women and Children’s Hospital for expert outpatient clinic activities. Thank you for your hard work !”
Director Tian and Xinxiang Hospital formed a special reception team.
First, they were led to familiarize themselves with the environment and had a special breakfast in the hospital cafeteria. Then they went to the outpatient department and inpatient wards of the hospital to carry out their work.
One can feel the coldness and depression of this Grade A hospital.
A specialty hospital with a history of seventy years was surprisingly deserted, with only a few dozen patients and their families waiting for treatment in the outpatient hall.
This deserted scene made every medical staff at Tuya Hospital feel particularly emotional.
"We've already checked the outpatient department and the wards. It's getting late. Let's go to the outpatient hall and start seeing patients!"
Zhang Bihua is a pragmatist.
After breakfast, he took a general look at the situation at Xinxiang Maternal and Child Health Hospital and then led everyone to conduct medical consultations in the outpatient hall.
The tables were lined up on the east side of the hall.
There were nine consultation seats in total. Including Director Zhang Bihua, there were eight chief and deputy chief physicians in Tuya. As for Zhou Can and his fellow trainees, residents, and attending physicians, there were no special seats.
Not to mention the nurses.
They all stood behind and assisted the chief and deputy chief physicians in seeing patients.
There is one exception, and that is Du Leng.
He has a special seat, "Doctor Du Leng from Johns Hopkins University in the United States, specializes in disease diagnosis in the fields of neurosurgery and thyroid and breast surgery."
The introduction is extremely eye-catching.
As soon as it was put on display, it attracted several patients to gather around his table to watch.
Du Leng studied with Director Yang Qing in the Department of General Surgery for about two months. Unexpectedly, this guy was so bold that he said he was good at thyroid and breast surgery after only two months of study.
This made Zhou Can think of the medical beauty institutions outside.
Some so-called plastic surgeons, who have no medical background at all, dare to operate on patients' faces after only a week of training, giving them double eyelids, dimples, etc.
It's really crazy.
Du Leng is definitely better than those "three no" people. After all, he is a doctoral student who graduated from a famous foreign university.
It is not clear whether he is really good at thyroid and breast surgery.
You will know his level by looking at his specific diagnosis and treatment behavior.
Zhang Bihua was much more famous than Du Leng. She sat in the middle seat with Yang Chan, and four or five patients lined up in front of her table.
"Director Zhang, we also got the news that you will open a specialist clinic at Xinxiang Women's and Children's Hospital today. So we rushed here early to line up. Your special expert number at Tuya Hospital is too hard to get."
A patient excitedly said to Director Zhang Bihua.
"Haha, really? Thank you for your trust and support. Don't worry, line up and come one by one. I will be here for the whole day today."
She looked very happy.
Any doctor would be happy to have such a high influence and to be admired and trusted by patients.
Director Du Leng and Director Zhang Bihua had patients visiting their desks, but Zhou Can and his colleagues were in a bit of a bad situation.
There were only two people in total who came to the gastroenterology department of Tuya Hospital.
Deputy Director Shi and Zhou Can.
"Doctor Zhou, I'll need your help for a while."
Deputy Director Shi knew Zhou Can's abilities very well, so he specially had someone bring a chair and let Zhou Can sit behind the table with him.
There was a pre-made sign on the table.
Gastroenterologist Stilson.
They were invited here to help keep up appearances, so naturally they did a lot of superficial work.
The words "associate chief physician" will never appear.
Deputy Director Shi doesn’t have any particularly impressive title.
The word "expert" actually needs to be put in double quotation marks.
Of course, he is definitely much better than the experts. Deputy Director Shi's surgical skills are very good, and his diagnosis and treatment level is also above the standard. At most, he can't handle some extremely difficult and complicated diseases.
"Director Shi, we don't have any patients here. Can we think of some way to take the initiative? " Zhou Can couldn't sit still and didn't want to be laughed at by others.
Before coming, Director Shang told him not to bring shame to the Department of Gastroenterology.
"How can we take the initiative? These patients and their families don't know us at all. It's useless even if we take the initiative to find them! Let's sit here and wait and see! I don't believe that we can always get a few patients in a whole day. The probability of digestive system diseases is very high, and there is never a shortage of patients."
Deputy Director Shi didn't care much.
It's quiet, so he's happy to be free.
This is different from working in our hospital. You just pay the consultation fee and there is no performance commission or anything like that.
Treating more patients is the same as treating fewer patients.
"Director Shi, there is a patient here who complained that she had severe pain whenever her period came. In severe cases, she rolled over on the bed. I asked her to do an ultrasound examination, and it showed that there were solid masses on both ovaries in the pelvic cavity. I think the nature of the tumor is not good. Could you come over and take a look?"
Director Zhang Bihua had obviously encountered a condition that was difficult to diagnose.
Deputy Director Shi walked over, took the ultrasound report and took a look at it.
"There are multiple solid masses in the pelvic cavity with clear boundaries and oval shapes. There are abundant blood flow signals inside, and a small amount of ascites can be seen. Isn't this an obvious ovarian tumor? What does Director Zhang mean?"
Deputy Director Shi certainly wouldn't be so stupid as to think that Zhang Bihua couldn't even diagnose such an obvious disease.
The patient's ovarian tumor is very likely to be malignant.
As long as this type of tumor shows abundant blood flow signals, you should be particularly vigilant.
As for the formation of ascites, it is also related to tumors.
"I always feel that this is not the only cause of her illness!" Director Zhang Bihua frowned slightly, thinking hard about other possible causes of the patient's illness.
Experienced doctors can use their rich clinical experience to keenly detect some diseases lurking in the dark during diagnosis.
Treating multiple diseases is a nightmare for young novice doctors.
Because it is difficult for them to diagnose all the causes of the disease.
When encountering patients with multiple diseases, it is very easy to miss the diagnosis or even misdiagnose and misjudge.
Deputy Director Shi turned and looked at Zhou Can for help.
In front of so many patients and their families, and in another hospital, with many doctors and nurses from Xinxiang Women's and Children's Hospital watching, he, as an "expert", was too embarrassed to ask Zhou Can for help.
Zhou Can stood up and walked over.
Anyway, there was no patient seeking treatment at their table.
After roughly reading the patient's information, he looked at the patient, who was about 24 or 25 years old, very young. Judging from the patient's temperament, face and body shape, this should be a young mother who has given birth.
Maybe it's possible even while you're breastfeeding.
"Hello, can I ask you two questions?" Zhou Can asked the female patient.
She and her family members looked at Zhou Can twice, their eyes actually looked down on this young doctor. Director Zhang Bihua and the expert surnamed Shi were examining her, so how could a young doctor get involved?
Just out of politeness and respect, the female patient nodded reluctantly.
"Sure, go ahead and ask!"
"Excuse me, have you recently given birth and are you still breastfeeding?"
When Zhou Can asked this, the patient was stunned and became more expectant of this young doctor.
This young doctor seems to have some skills.
She had not told anyone that she was breastfeeding, but the young doctor could easily tell.
"Yes, my child is only eleven months old. Before I got pregnant, I often had dysmenorrhea. Later, I heard that it would be much better after giving birth. I didn't expect that I still had dysmenorrhea after giving birth, and it seemed to be even worse than before."
The female patient said honestly.
"Didn't you find any ovarian tumor during the pregnancy and prenatal checkups?"
Zhou Can asked again.
"No! My body should have been normal at that time. Because I gave birth in the local county people's hospital, the medical level there is not bad."
Like most patients and their families, she had no idea the difference between county-level tertiary hospitals and provincial-level tertiary hospitals.
Although both of them seem to be Grade 3A hospitals, their scale, physician level, and equipment grade are not at the same level at all.
To put it bluntly, if the chief physician of the county people's hospital is transferred to Tuya Hospital, he may not be as good as the more capable attending physician. There is a lot of water in this.
The bed sizes are also completely different.
Many county people's hospitals have 500 to 600 beds, just reaching the minimum threshold for a Class 3A hospital. A Class 3A provincial hospital often has more than 3,000 beds, and the largest may even have more than 10,000 beds.
Director Shi didn't know why Zhou Can asked the patient these questions, but Director Zhang Bihua's eyes lit up slightly, as if she knew Zhou Can's diagnostic thinking.
In other words, Zhou Can's questions to the patients gave her some inspiration.
"Have you had symptoms such as nausea, vomiting, and loss of appetite recently?" Zhou Can asked again.
The patient did not report these situations to Zhang Bihua.
However, based on some clues, Zhou Can realized that the patient was likely to have these symptoms.
"Hmm...it seems so. I missed a lot of work because of maternity leave. After returning to work, I often chose to work overtime to finish some backlogs. My appetite has worsened, and sometimes I even feel nauseous and want to vomit. I thought it was because of working too much overtime, so I didn't pay much attention to it."
She was surprised to find that this young doctor was amazing.
All the things she asked about had actually happened to her.
"Would it be convenient for me to do a simple physical examination on you? I need to press your upper abdomen and other parts, but you don't need to lift up your clothes." Zhou Can said to her.
"Um!"
She nodded shyly.
Female patients may feel somewhat uncomfortable when being palpated by male doctors.
For example, when doing an electrocardiogram, they have to take off their underwear and face a male doctor, so they will feel very embarrassed.
As for digital examination of some private parts, male doctors often avoid it and let some experienced female doctors or nurses perform it instead.
This is also the reason why obstetrics and gynecology prefers to recruit female doctors.
There are many inconveniences when male doctors treat female patients.
The hospital's regulations state that only one female medical staff member is required to be present when examining female patients. However, in practice, even so, male doctors are often beaten by family members during the examination of female patients.
So much so that when male doctors see female patients, they usually ask the male family members to leave the consulting room as a precaution.
Because after being beaten once or twice, they were really scared.
As long as the male family members don’t see it, some unnecessary contradictions and conflicts can be avoided.
Zhou Can walked up to the female patient and pressed her abdomen through her clothes.
"If it hurts, tell me."
He reminded the female patient.
In fact, when doing this kind of compression examination, it is best to have direct skin contact. A layer of clothing, even if it is very thin, will reduce the doctor's sense of touch and miss some possible tumors or masses.
The main purpose of Zhou Can's examination of her was a tenderness test.
It is also a test often done by doctors.
“Ah…it hurts, it hurts!”
When Zhou Can pressed on the left upper abdomen, she suddenly screamed in pain.
"This part is the stomach, which is highly consistent with my inference."
Zhou Can got the answer he wanted and stopped the pressing test.
"Director Zhang, Director Shi, I suspect that the patient's ovarian tumor is not a primary lesion, but a tumor formed after metastasis. I suggest that the patient undergo a gastroscopy or something."
Zhou Can finished his diagnosis and gave his own suggestions.
Yang Chan was watching Zhou Can diagnose the female patient and was shocked to find that the gap between herself and Zhou Can was unimaginable.
From the moment Zhou Can came over and asked the patient the first question, he was very targeted.
Recalling carefully, every question Zhou Can asked revolved around the primary lesion.
Many chief physicians are often not able to make such an efficient diagnosis.
As for novice doctors like Yang Chan, they usually ask all the questions that need to be filled in the medical record and check everything that needs to be checked. No matter if it is the right way or not, after checking and asking, they will slowly make a diagnosis.
This dogmatic and rigid examination is not only reflected in her, but in almost all novice doctors.
Many patients who go to large hospitals for hospitalization will be distressed to find that even if the injury is to the hands or feet, the doctors will ask the patients to undergo an electrocardiogram and various routine examinations.
It is euphemistically said that it is for risk avoidance, or that it is a hospital regulation.
In fact, it was just because it would be easier to complete the inspection tasks assigned by the hospital. Those expensive inspection equipment and the medical staff in the biochemical laboratory couldn't be left idle all the time, right?
Every time the inspection equipment is used, it can create benefits for the hospital.
The same is true for biochemical tests.
At the same time, it can also avoid some medical accidents and eliminate potential safety hazards. It is a win-win situation. Why not do it?
As for the high expenses for patients, don’t they have medical insurance to reimburse them?
Because these tests take up a lot of patients' time, it's not a big deal. Haven't you seen many shops trying to increase popularity in order to create a hot business atmosphere, and even spend money to hire people to queue up?
The hospital is very popular, and patients who come for treatment will subconsciously think that since this hospital has so many patients, the medical level must be good.
Doctors like Zhou Can, who can directly point out the location of the lesion and do not require patients to run around for various miscellaneous examinations, are the kind of doctors that are not welcome in modern hospitals.
Because it can't bring any benefits to the hospital!
Of course, if it is an expert, that’s a different matter.
Experts must be different from others, perform the least examinations, spend the least time, let patients take the least medicine, and suffer the least pain, so as to reflect the high level of the experts.
This has also indirectly led to a phenomenon that no matter whether the illness is serious or minor, as long as you can see a specialist, you will never see a resident physician who costs a few dollars.
If you do fewer unnecessary examinations, the money you spent on the expert appointment will be recovered.
"Doctor Zhou suspects that the patient's primary lesion may be in the stomach?"
Zhang Bihua looked at Zhou Can with a strange look.
It was a look of interest, with a little excitement and admiration.
