Chapter 626: Hospital refusal rules, the benefits of learning some medical knowledge
After being promoted to attending physician, his status in the department will be qualitatively improved.
Although he had proven himself with his ability and was recognized by most people in the department, his title was very low, just a resident doctor, which seriously affected his weight.
Since ancient times, there has been a rule in architecture that only magnificence can bring authority.
A hundred feet forms the shape, a thousand feet forms the momentum.
This is also the reason why the residences of the dignitaries, government offices, and imperial palaces in ancient times all occupied a vast area and looked magnificent.
They have to create an aura of authority in the minds of the common people, and offices and residences are top priority.
The level of civilization in modern society has far surpassed that of ancient times, and it advocates equality for all.
This concept has also been deeply rooted in people's minds.
However, in any unit, the saying that a higher-ranking official can crush someone else still exists.
This is the extension and evolution of magnificence.
Managers can command supervisors, supervisors can command team leaders, and team leaders can command team members, building a pyramid-shaped hierarchy.
With each leap forward, you will gain greater power and a higher status.
Why did so many people oppose Zhou Can's promotion to deputy team leader of the operating room? It was because they felt that Zhou Can was just a resident physician with a lower title than them, but now he was going to be superior to them, so they naturally refused to accept it.
Now that Zhou Can has officially become an attending physician, the residents who used to look up to him now need to look up to him. The attending physicians who used to look down on him now need to look up to him.
To have reached the level of chief physician is already considered to be of some importance, and even the deputy director level has to take his existence seriously.
The human heart is the most complicated.
Why is the job title so important? Because it is valuable.
The larger the institute, the more valuable the title is.
The deputy chief physicians and chief physicians in small hospitals are usually very impressive. They can fool ordinary people, but the experts will just smile knowingly.
Maybe the chief physician of the small hospital would not be convinced after seeing this.
This is very simple. Deputy directors and chief physicians from small hospitals often come to large hospitals for further training.
After the chief physician entered the hospital, his status immediately changed to a trainee.
No matter how much the hospital department where the trainee is training respects the chief physician, the trainee's status and position cannot be changed.
The trainee will then usually be supervised .
When Zhou Can was doing his regular training in internal medicine, he saw a deputy chief physician from a county-level hospital below him. When he came to Tuya for further training, he was scolded by a chief physician and he didn't dare to raise his head.
If it were the deputy chief physician of our hospital, which attending physician would dare to scold him?
Zhou Can followed the nurse who delivered the message to the triage desk.
He recognized the woman who was looking for him at a glance.
“It’s you!”
Zhou Can was a little surprised when he saw the woman.
This young woman was none other than the girl who had asked for leave and whom he had met when he was inspecting the pharmaceutical department two days ago.
Later, Zhou Can put in a call on her behalf and her leave request was approved.
Is she coming to Zhou Can now just to express her gratitude?
Cheng Xiaolu looked at Zhou Can, who was walking towards her in a white coat, with a complicated look in her eyes.
"That day I never thought you were Dr. Zhou Can! Thank you for helping me get the day off."
After she came to the emergency department to inquire, she learned Zhou Can's true identity and was extremely shocked.
Who would have thought that the young man I met that day had such a great background.
Even though she worked in the pharmaceutical department, she had heard of Zhou Can's famous name.
Deputy director of the emergency department, deputy director of the operating room, member of the hospital's quality control department, the youngest and most promising quasi-famous doctor in the hospital, the new boss of the pharmaceutical department...
These identities are really dazzling.
It made her feel terrified.
"It's just a small favor. You're welcome. How is your mother's illness?"
Zhou Can didn't care about asking for leave for her.
For him, this was an act of kindness that couldn't be any smaller.
"My mother had a cerebral hemorrhage, and she has... woooo..." She couldn't help crying out loud, turned her head and secretly wiped away her tears.
"Don't be impatient, sit down and talk slowly!"
Zhou Can moved a high stool without a backrest for her to sit on.
There used to be plastic stools at the triage desk, but now that the hospital security is strong, we dare to replace them with iron stools.
The nurse who delivered the message cleverly poured her a glass of water.
"Thanks."
She nodded her thanks to the nurse.
"My mother is in a coma now. The county hospital can't treat her. I called an ambulance and took her to Tuya Hospital. But the doctors here said they can't do anything."
For such transferred patients, especially those in deep coma, any hospital would feel uncomfortable when accepting them.
Passing the buck and pushing it away is basically a default unspoken rule.
Therefore, before transferring the patient to another hospital, it is best to find someone you know, say hello, ask questions, and then transfer the patient.
Otherwise, if you take the patient to a big hospital and he/she is "euphemistically" refused to be admitted, you will be in a dilemma.
The patients also suffered during the transfer.
Even some patients who are already in critical condition may not be able to withstand the bumps on the road and may die directly.
"Where is the person now?"
"Right over there!"
She stood up and pointed to a place not far away where she could see an old man with a cane standing by a flat bed, with a nurse and a doctor accompanying him.
The doctor was squeezing the ball rhythmically.
In this case, either the patient has lost his spontaneous breathing or his blood oxygen level is seriously lower than normal.
In any case, if the patient needs to be squeezed during transfer, it means that the patient's condition is more serious than expected. If he is hospitalized, he must have been put on a ventilator.
The doctors at Tuya Hospital are experienced and have high medical skills. If they dare not even accept a patient, there must be huge risks.
The current medical environment is very poor and no one wants to get involved.
Therefore, in order to protect themselves, doctors can only try to do less.
Pushing away a patient will not affect their income and job promotion, but accepting a patient with a kind heart may be bitten by the "venomous snake". When young doctors and nurses in the hospital first started working, many of them were innocent and kind.
As a result, after experiencing the story of the farmer and the snake several times, they had to put away the overflowing kindness in their hearts.
"Which departments did you ask?"
Zhou Can stood up and walked towards the patient, and she followed closely behind him.
"I have asked the neurosurgery department, neurology department, emergency department, and critical care medicine department. They all said that it is difficult to treat. I have no other choice, so I came to you for help."
It's very difficult to cure, which implies that there's nothing we can do about it here, and you should look for someone else who can help you.
I asked all four departments and the answers were surprisingly consistent.
Zhou Can's heart sank to the bottom.
I'm afraid he can't help this poor filial girl.
The doctors and nurses who were accompanying the ambulance did not greet Zhou Can when they saw him coming. They were just the medical staff accompanying the ambulance, and their mission was to deliver the patient to the destination.
Now Tuya Hospital refuses to accept patients. They cannot just abandon the patients and leave, and they are very angry.
Naturally, it was impossible to give Zhou Can a good face.
“Is the patient still breathing on his own?”
“Weaker.”
The male doctor who followed the car replied coldly.
Zhou Can listened to the patient's heart rate and heart and lung sounds, and then measured his pulse.
Under normal circumstances, heart rate and pulse are consistent.
But this is only limited to the same quantity.
The meanings of the two inspections are completely different.
Heart rate is the frequency of heart beats, usually calculated as 60-second statistics. By checking the heart rate, you can understand the patient's heart condition.
An experienced and skilled cardiothoracic surgeon like Zhou Can can hear a lot of deep information in the process of auscultating the heart rate.
For example, whether the heart rhythm is normal.
Slow beats, premature beats, septal defects, tricuspid valve, mitral valve regurgitation or insufficiency, etc. can all be heard.
The pulse can help us understand the heart's pumping of blood and the patient's body blood circulation.
For example, by measuring the pulse and touching the carotid artery, one can infer the blood supply to the head.
Of course, this kind of examination is only an initial diagnosis and can only provide doctors with a preliminary diagnostic direction.
After checking the heart rate and pulse and listening to the heart and lung sounds, Zhou Can opened the patient's eyelids to check.
The pupils are not dilated and have a poor light reflex.
"When did she become ill?"
Zhou Can asked the sixty-year-old man with a cane.
Cheng Xiaolu told him that her father had an accident on a construction site and was disabled in his legs.
Now it looks like one trouser leg is empty.
However, this old man's amputation should not be a high amputation.
Can feel the thighs still there.
"Dad, this is Director Zhou. He can help mom get hospitalized."
Cheng Xiaolu spoke to her father in dialect.
What this means is that the father should cooperate with the doctor's questions.
"On the night of the 16th, when I got up in the middle of the night to urinate, I found that the old woman was not in a good condition. Her mouth was a little crooked. I didn't pay much attention to it at the time, thinking it was just a normal situation after falling asleep. Later, around five o'clock in the morning, I found that her mouth was even more crooked, her eyes were wide open, she couldn't speak, couldn't move, and she didn't respond when I called her..."
The old man recounted what happened at that time.
Therefore, it is useful to learn some medical knowledge.
At the critical moment, you may be able to save yourself or your family.
If the old man had some medical knowledge, he would have immediately been alert to the possibility that his wife had a stroke when he noticed that the corner of her mouth was crooked.
Generally speaking, the earlier a serious disease such as myocardial infarction, cerebral infarction, cerebral hemorrhage, aortic dissection is discovered, the better. Timely medical treatment can sometimes minimize the loss.
So as not to cause irreversible consequences.
For example, in myocardial infarction, if the ischemia time exceeds three minutes, irreversible damage will occur, and a large number of myocardial cells will begin to die due to ischemia and hypoxia.
If the patient can be sent to the hospital in time and be rescued by professional doctors immediately, and emergency thrombolytic drugs or interventional thrombectomy can be used to restore blood circulation in the shortest time possible, the patient's damage can be minimized.
The prognosis is often good.
But if it's delayed too long, it's hard to say.
Even if the patient's life is saved, follow-up treatment is often very troublesome. The massive death of myocardial cells can cause the heart to contract weakly and symptoms such as heart failure occur.
Not to mention stroke.
The brain is much more fragile than the pericardium.
When teaching, many doctors directly say that the brain is tofu brain.
This metaphor is not an exaggeration.
"I've seen the situation, it's not good. Have you filmed it in the outer courtyard?"
Zhou Can said to the girl and the old man.
"Yes, the films and examination data are all here."
Cheng Xiaolu quickly handed the examination report to Zhou Can.
Before transferring to another hospital, you must remember to bring all the examination materials with you. There are many examinations that do not need to be repeated if they are still within the validity period.
It can save time, examination costs, and patients will suffer less.
And get the fastest diagnosis and treatment.
Of course, there is a prerequisite, that is, you must meet a reliable doctor.
If you are unlucky enough to encounter an unethical doctor who only pursues performance without regard for the interests of the patient, and performs an examination that has already been done on the patient again, this is quite tragic.
Zhou Can once treated a patient with a difficult disease. The patient underwent a total of 17 MRI and CT examinations.
Although there are reasons for the incident, the doctor's unethical behavior is unquestionable.
The patient insisted that he had a brain problem, but the doctor examined him and found that there was nothing wrong.
The patient and his family did not believe the doctor's diagnosis.
Therefore, in order to convince the patient and his family, the doctor performed so many MRI and CT scans.
It must be mentioned that these examinations were not performed in one hospital, but in seven hospitals in total.
The cheapest head MRI costs more than 600 yuan, and the higher the accuracy, the more expensive it is.
The inspection fee alone is already tens of thousands.
The most expensive MRI scan at Tuya is 5,000 yuan per scan. It is very difficult to apply and you need to wait in line.
Specially used to diagnose some extremely difficult cases.
Those below the level of associate chief physician cannot issue such examination applications.
Applications for this type of examination are generally issued by special needs experts.
If the chief physician of a department needs it, they can prescribe it, but they have to wait in line and it needs to be reviewed by the Medical Department.
But how many hospitals can achieve Tuya’s level?
The management of many hospitals is quite chaotic. The leaders above don’t care whether the cat is black or white, as long as it can catch mice, it is a good cat.
What does it mean to be able to catch a mouse?
It can help the hospital generate revenue and win reputation for the hospital.
It is recommended that if you encounter a difficult case, you can first make an appointment with a general physician and do the necessary examinations. If the general physician cannot find the cause of the disease, it does not matter, and there is no need to scold the general physician in person for his poor medical skills.
Keep these for examinations and make an appointment with a special specialist.
You should see a specialist based on the type of disease you have.
You must understand what areas of disease the specialist specializes in. If you have a bowel disease and you make an appointment with a neurologist, the result will definitely not be satisfactory.
Let’s talk about the benefits of making an appointment with a general physician first and then an appointment with a special specialist.
Save time and registration fees.
Most of the special needs specialists charge 300 yuan, or even 700 or 800 yuan per appointment. You didn't do any examinations, but directly made an appointment with a special needs specialist.
Experts are also human beings, and they will ask you to do the necessary examinations.
Many test results cannot be obtained on the same day.
Then you can only wait until the next day, or even the third day.
After getting the test results, I went to see the specialist for a follow-up visit, but the appointment I made the first time had expired.
You have to make an appointment again, and the key is that you may not be able to get it.
So the first time you make an appointment with a general doctor for a few dollars, and do all the necessary tests. It doesn't matter if the general doctor can't find the cause of the disease, take the test results to make an appointment with a specialist, and generally they can give you a diagnosis on the same day.
Then he was successfully admitted to the hospital.
Save time, effort and money.
Zhou Can took the patient's examination records from Cheng Xiaolu and reviewed them so that he could have a clearer idea of what was going on.
