My medical skills add experience

Chapter 271 When it's cold, a clean diagnosis

Through chatting, Zhou Can learned that she has rotated in multiple departments, and her surgical ability is no less than that of ordinary residents.And like Zhou Can, he passed the medical license examination this year and became a licensed physician.

Of the 512 students in Class 41, only Zhou Can and Yang Chan successfully stayed and worked in Tuya General Academy.

Both of them performed extremely well, and the official doctors who were transferred to the general hospital after the regular training should have left.

While chatting, she had inquired about Zhou Can's current strength many times.

It's a pity that Zhou Can still refused to reveal too much, which made her very helpless and even a little annoyed.

Women are very curious.

She has heard about Zhou Can's glorious deeds many times, and many chief physicians praised Zhou Can for his excellence when chatting with Director Zhang Bihua.This made her want to know how good Zhou Can is?

After insinuating a few times and failing to find out what to ask, she simply stopped asking.

Anyway, when we arrive at Xinxiang Maternity and Children's Hospital, we will definitely diagnose and treat patients, and Zhou Can's strength will be clear at a glance.

After driving for more than an hour, the bus came to a slow stop.

"Xinxiang Maternity and Children's Hospital is here, get ready to get off!"

The door opened, and everyone got out of the car one after another.

"Director Zhang, I'm looking forward to you!" The reception at Xinxiang Women's and Children's Hospital was very grand.

There are lights and festoons everywhere, and banners are stretched everywhere.

The content is also very eye-catching.

Good news for patients: Welcome Professor Zhang Bihua, an expert in obstetrics and gynecology from Tuya Hospital, to lead an elite team to come to our hospital for consultation!
Welcome all experts to visit our hospital to guide our work!

Tuya Hospital and Xinxiang Women's and Children's Hospital are close.

There are red banners everywhere, full of festiveness.

Dean Tian of Xinxiang Women's and Children's Hospital personally led a team to greet them and gave them the highest standard of reception.

"Experts, elite doctors and nurses, welcome to Xinxiang Maternity and Children's Hospital to carry out expert outpatient activities. You have been exhausted all the way, and you have worked hard!"

Dean Tian and Xinxiang Hospital specially formed a reception team.

First, they were led to familiarize themselves with the environment and had a special breakfast in the hospital cafeteria.Then I came to the hospital's outpatient and inpatient wards to work.

I can feel the desolation and depression of this tertiary hospital.

A characteristic specialized hospital with a history of 70 years is deserted, with only a few dozen patients and their family members waiting in the outpatient hall.

This deserted scene made every doctor and nurse in Tuya Hospital feel special emotion after seeing it.

"I've seen the outpatient clinic and the ward, and it's getting late. Let's go to the outpatient hall and start the consultation!"

Zhang Bihua is a pragmatist.

After breakfast, after checking the situation of Xinxiang Maternity and Children's Hospital, he led everyone to carry out consultation work in the outpatient hall.

Tables are set up along the east side of the hall.

There are nine consultation seats in total.Including director Zhang Bihua, Tuya has eight directors and deputy chief physicians.As for Zhou Can and the others, regular trainees, resident physicians, and attending physicians, there are no special seats.

Not to mention the nurses.

All of them stood behind to assist the director and deputy chief physicians to receive the treatment.

There is one exception, and that is Du Leng.

He has a special seat, "Dr. Du Leng from Johns Hopkins University in the United States, who is good at disease diagnosis in the fields of neurosurgery and nail and breast surgery."

The introduction is very attractive.

As soon as it was put out, it attracted several patients to watch around his table.

Du Leng studied with Director Yang Qing in General Surgery for about two months.Unexpectedly, this guy really dared to brag. After only two months of study, he said that he was good at diseases in the field of nail and breast surgery.

This reminded Zhou Can of the medical beauty institutions outside.

Some so-called plastic surgeons, made up of people with no medical background, dare to use knives on the faces of plastic surgeons, cut their double eyelids, create dimples, etc. after only about a week of study.

It's crazy.

Du Leng is definitely much stronger than those three no personnel.After all, he is a doctoral student who graduated from a famous foreign university.

Whether he is really good at nail and breast surgery is not yet clear.

After a while, you will know what level it is by looking at his specific diagnosis and treatment behavior.

Zhang Bihua was much more famous than Du Leng, and with Yang Chan sitting in the middle seat, four or five patients lined up in front of her table.

"Director Zhang, we also got the news that you will open an expert clinic at Xinxiang Maternal and Children's Hospital today. So we rushed over early and queued up. Your special-needs expert account at Tuya Hospital is really hard to get."

A patient said to Director Zhang Bihua excitedly.

"Hehe, is it? Thank you for your trust and support. Don't worry, everyone, line up and come one by one. I will be here for a day today."

She looked very happy.

Any doctor would be happy to have such a high influence and to be sought after and trusted by patients.

Directors Du Leng and Director Zhang Bihua had patients at their consultation tables, but it was a bit miserable for Zhou Can and the others.

Only two people came to the gastroenterology department of Tuya Hospital.

Deputy Director Shi and Zhou Can.

"Doctor Zhou, I need your help later."

Deputy Director Shi knew Zhou Can's ability very well, so he asked someone to bring a chair for Zhou Can to sit behind the table with him.

There is a pre-made sign on the table.

Gastroenterology specialist Stevenson.

I asked them to come over to help support the appearance, so the superficial skills were naturally done well.

Words like deputy chief physician will never appear.

Deputy Director Shi didn't have a particularly good title either.

The word "expert" actually needs to be enclosed in double quotation marks.

Of course, it must be much stronger than the Bricks.Deputy Director Shi's surgical ability is very good, and the level of diagnosis and treatment is also above the standard.At most, there are some super-difficult intractable diseases that cannot be solved.

"Director Shi, we don't have any patients here, should we think of a way to take the initiative?" Zhou Can couldn't sit still, and he didn't want to be laughed at by others.

Before coming here, Director Shang explained to him that he should not lose face of the Department of Gastroenterology.

"How to take the initiative? These patients and their family members don't know us at all, even if they take the initiative to look for them with a shy face, it's useless! Just sit here and see the situation! I still don't believe it, I can always get a few in a day. patients. The probability of digestive system diseases is very high, and there is never a shortage of patients.”

Deputy Director Shi didn't care much.

If it is deserted, it will be deserted, and he is happy to be at leisure.

This is different from working in this hospital. Anyway, the consultation fee is paid, and there is no performance commission.

Diagnosing and treating more patients is the same as seeing and treating fewer patients.

"Director Shi, there is a patient here who reported severe pain as soon as menstruation started, and rolled on the bed when it was severe. I asked her to have an ultrasound examination. There were solid masses on both ovaries in the pelvic cavity. I felt that the nature was not good. Okay, can I trouble you to come over and have a look together?"

Director Zhang Bihua obviously encountered a medical condition that he was not sure about.

Deputy Director Shi went over and took a look at the B-ultrasound sheet.

"Multiple solid masses can be seen in the pelvic cavity, with clear boundaries and an oval shape. There are abundant blood flow signals inside and a small amount of ascites. Isn't this an obvious ovarian tumor? What does Director Zhang mean?"

Naturally, Deputy Director Shi would not be so stupid as to think that Zhang Bihua couldn't even diagnose such an obvious disease.

The patient's ovarian tumor is highly likely to be malignant.

As long as this kind of tumor with rich blood flow signal can be seen, special vigilance should be paid.

As for the formation of ascites, it is also related to tumors.

"I always feel that this is not her only cause!" Director Zhang Bihua frowned slightly, thinking hard about other possible causes of the patient.

Experienced doctors can be keenly aware of some diseases lurking in the dark with their rich clinical experience in diagnosis.

Multiple diseases are a nightmare for young novice doctors.

Because it is difficult for them to diagnose all the causes.

When encountering patients with multiple diseases, it is very easy to miss diagnosis, or even misdiagnosis and misjudgment.

Deputy Director Shi turned to look at Zhou Can for help.

In front of so many patients and their families, and in the outer hospital, there were many doctors and nurses from Xinxiang Women's and Children's Hospital watching. He was an 'expert', and he was really embarrassed to ask Zhou Can for help.

Zhou Can took the initiative to stand up and walked over.

Anyway, there is not a single patient at their table.

After roughly reading the patient's information, he looked at the patient, who was 24 and five years old, very young.From the analysis of the patient's temperament, appearance and body shape, this should be a young mother who has given birth.

It is possible that she is still breastfeeding.

"Hello, can I ask you two questions?" Zhou Can asked the female patient.

She and the accompanying family members glanced at Zhou Can, their eyes actually looked down on this young doctor.At the scene, Director Zhang Bihua and this expert surnamed Shi were treating her. How could a young doctor intervene?

Just out of politeness and respect, the female patient nodded reluctantly.

"Okay, just ask!"

"May I ask if you haven't given birth for a long time and are still breastfeeding?"

When Zhou Can asked such a question, the patient was taken aback, expecting a little more from this young doctor.

This young doctor seems to have some skills.

She hadn't told anyone that she was breastfeeding, but the young doctor could easily tell.

"Yes, my child is only [-] months old. Before I was pregnant, I would often have dysmenorrhea. Later, I heard that it would be much better after giving birth. I didn't expect to have dysmenorrhea after giving birth. It seems to be worse than before. It's even more serious."

The female patient said honestly.

"Didn't ovarian tumors be found during pregnancy and birth checks?"

Zhou Can asked again.

"No! At that time, my body should be normal. Because I gave birth in the local county people's hospital, the medical level there is not bad."

Like most patients and family members, she has no idea of ​​the difference between county-level tertiary hospitals and provincial-level tertiary hospitals.

Both seem to be top three hospitals, the scale, the level of doctors, and the level of equipment are not at the same level at all.

To put it bluntly, the chief physician of the County People's Hospital may not be as good as the more powerful attending physician when he is brought to Tuya Hospital.There is a lot of water in it.

The bed size is also completely different.

Many of the county people's hospitals have five or six hundred beds, which has just reached the minimum threshold for a top-tier hospital.Provincial tertiary hospitals often have more than [-] beds, and the most may even have over [-] beds.

Director Shi didn't know why Zhou Can asked the patient these things?Director Zhang Bihua's eyes lit up slightly, as if he understood Zhou Can's diagnosis.

In other words, Zhou Can's questioning of patients gave her some inspiration.

"Have you experienced nausea, vomiting, loss of appetite and other symptoms recently?" Zhou Can asked again.

The patient did not report these situations to Zhang Bihua.

However, Zhou Can noticed that the patient might have these symptoms based on some clues.

"Well...it seems to be true. Didn't I miss a lot of work because of my maternity leave some time ago. After returning to work at the company, I often choose to work overtime in order to deal with some backlog of work. My appetite becomes poor, sometimes I even felt nauseous and nauseated, and I thought it was because of working too much overtime, so I didn't care about it."

She was surprised to find that this young doctor was really amazing.

All the things she asked about actually happened to her.

"Is it convenient for me to give you a simple physical examination? I need to press your upper abdomen and other parts without lifting your clothes." Zhou Can said to her.

"Ok!"

She nodded shyly.

When female patients are palpated by male doctors, they feel somewhat uncomfortable.

For example, when doing an electrocardiogram, they have to take off their underwear, and they will feel very embarrassed when facing a male doctor.

As for finger examinations of some private parts, male doctors tend to avoid suspicion and let some experienced female doctors or nurses perform them on their behalf.

This is why obstetrics and gynecology prefer to recruit female doctors.

There will be many inconvenient scenes for male doctors in the process of diagnosis and treatment of female patients.

The hospital's regulations are that when examining a female patient, only one female medical staff should be present.But in practice, even so, there are often male doctors who are beaten by their family members during the examination of female patients.

As a result, when male doctors receive female patients, they usually take the male family members out of the consulting room as a precautionary measure.

Because after they had been beaten once or twice, they were really scared of being beaten.

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 the clothes.

"If it hurts, just tell me."

He reminded the female patient.

In fact, when doing this kind of pressure check, it is best to have direct skin contact.A layer of clothing, even if the clothing 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 for her was to test for tenderness.

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 cried out in pain.

"This part is the stomach, which is highly consistent with my deduction."

Zhou Can got the answer he wanted and stopped the press test.

"Director Zhang, Director Shi, I suspect that the patient's ovarian tumor is not the primary tumor, but a tumor formed after metastasis. It is recommended to check the patient with a gastroscope or something."

Zhou Can finished his diagnosis and gave his own advice.

Yang Chan watched Zhou Can diagnose this female patient all the time, and she was shocked to find that the gap between herself and Zhou Can was unimaginable.

Since Zhou Can came over to ask the patient the first question, Zhou Can was very targeted.

Recalling carefully, every question Zhou Can asked revolved around the primary lesion.

This kind of efficient diagnosis is often not necessarily achieved by many chief physicians.

As for novice doctors like Yang Chan, they often ask all the items that need to be filled in the medical records, and check everything that needs to be checked.Don't care if it's the right way, after checking and asking, then come to diagnose slowly.

This kind of dogmatic and rigid examination is not only reflected in her alone, but in almost all novice doctors.

Many patients now go to large hospitals for inpatient stays, and they will be distressed to find that even if the injured hand or foot is injured, the doctor will ask the patient to do an electrocardiogram and various routine examinations.

The euphemistic name is to avoid risks, or it is stipulated by the hospital.

In fact, it's just because it makes it easier to complete the inspection tasks assigned by the hospital in various departments.Those expensive inspection equipment, as well as the medical staff in the biochemical room, can't be kept idle all the time, right?
Every time the inspection equipment is used, it can create benefits for the hospital.

The same goes for biochemical tests.

At the same time, it can also avoid the occurrence of some medical accidents and potential safety hazards in queuing.
As for the high cost of patients, isn't there still medical insurance that can reimburse them!
Because it takes a lot of time for patients to do these checks, it's not a big deal.I haven't seen many shops. In order to create a hot business atmosphere, will you find ways to increase popularity, and even spend money to hire childcare to line up?
The popularity of the hospital is high, and the patients who come to seek treatment will subconsciously think that there are so many patients in this hospital, and the medical level must be good.

Doctors like Zhou Can can directly point to the lesion without requiring patients to run off their legs to do various miscellaneous examinations. On the contrary, they are the kind of doctors that modern hospitals do not welcome.

Because it cannot bring benefits to the hospital!

Of course, if you are an expert, that's another matter.

Experts must be different, do the least amount of examinations, spend the least amount of time, let patients take the least amount of medicine, and suffer the least amount of pain. Only in this way can the high level of experts be reflected.

This also indirectly caused a phenomenon, no matter whether it is a serious illness or a minor illness, as long as you can get an expert number, you will never get a resident doctor outpatient number that costs a few dollars.

Do a few unnecessary inspections less, and the money for the expert account will be returned.

"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, a little bit of excitement, and admiration.

(End of this chapter)