medical simulator

Zhou Cheng smiled and didn't answer any more. Even though the patient's words were impolite, he didn't care.

As a relatively high-quality boy, if you become better yourself, you will naturally get some better resources. This is a matter of course. If you don’t meet them, it can only prove that you are not good enough for the time being.

"..."

After the ward rounds all the way, Lu Bin asked Qin Ming to make arrangements for tomorrow's operation.

Then he personally led Zhou Cheng to the office in the director's office. Inside, there was a chair for one person, a computer for one person and a desk for one person.

The top is very empty, there is a whole set of tea sets, and the drawer is full of peace.

"Doctor Xiao Zhou, I didn't know that you don't smoke before, so I prepared some gifts casually, but don't worry, I will take this away and replace it with tea in a few days." Lu Bin hurriedly explained, but also He deliberately showed this thing to Zhou Cheng, wondering if it was to show his sincerity.

Zhou Cheng doesn't smoke, but he drinks alcohol, but he doesn't like alcohol.

Drinking tea was the best alternative that Lu Bin could think of.

Zhou Chengcheng said: "Director Lu, don't bother, I'll just drink water."

Lu Bin smiled: "Tea is water, and drinking tea can also nourish your health. You should always have your own hobbies. Doctor Zhou, don't refuse anymore."

"In addition, Doctor Zhou, your current job number is temporarily set to 5555, and the initial password is 8888."

"Under the job number, the current authority matches that of the director. You can check all the medical records in our department, you can have the consultation authority of all departments, and you have the authority to use except a few controlled drugs and antibiotics."

"Then, your work account does not set up sub-accounts to write medical records for the time being, but the daily performance of our hospital corresponds to that of normal employees..."

Zhou Cheng's eyelids twitched when he heard this, and he said, "Director Lu, isn't this in compliance with the rules?"

Lu Bin shook his head: "Doctor Zhou, I have already asked the health committee of our city. This is a benefit given by our city's health system in order to introduce experts to guide us. The performance coefficient is the most Basic 1.0, not much, but a heart."

"Doctor Zhou don't want to refuse. At present, in Changshi No. 1.8 Hospital, an associate professor at the Affiliated Hospital of Shonan University has a performance coefficient of [-], but he is a deputy senior professional title. Doctor Zhou?"

"So, even if we want to pay you more for your hard work, we are embarrassed. We also know that your other money is not easy to take, and we will not take it."

Lu Bin said this very directly.

Zhou Cheng's coming here was not even transferred from the Hunan Health Commission, nor from Shanghai, but if he came from the Huaguo Health Commission, he was transferred from there.

As for the specific reason, Mr. Zeng once hinted that it was because the things Zhou Cheng participated in were different from ordinary people, so his file is no longer in the provincial capital.

It's hard for Zhou Cheng to refer to what this sentence means, but it sounds really awesome!

Moreover, when he visited An Ruo's father, An Nan, the day before yesterday, Zhou Cheng also learned that the reason why Zhou Cheng was arranged to come to a prefecture-level city was not a county-level hospital, nor a provincial-level hospital. curated.

It's not that such a decision was made casually.

"Director Lu, I came to the department mainly to learn from each other." Zhou Chengcheng said back to Lu Bin.

"Dr. Zhou is polite. In fact, we are all orthopedic trauma surgeons. We all know that minimally invasive fracture surgery is definitely the trend of the times. Dr. Zhou's coming to our place really showed us a bright way." Lu Bin is very sincere and authentic.

Minimally invasive fracture surgery is a new type of operation. The patient is very large. Once the operation is performed and the postoperative effect is good, there will be a siphon effect. What is the bonus in the department?

Possibly much higher than before.

It is precisely because of this that the department readily agrees to all the conveniences for Zhou Cheng, and even the entire Department of Orthopedics will benefit, and the average salary of the hospital will also increase, and this is a long-term effect.

Most people who give people jobs are happy.

When Zhou Cheng heard Lu Bin say this, his mind sank a little, and he said: "Director Lu, I saw in the department today that there is not a single postoperative patient in our group, and basically all of them are fracture cases. This is different from the cases in our place. The structure doesn't quite fit, does it?"

This must have been arranged by Lu Bin. Such an arrangement is very bad, unreal, and unrealistic.

Lu Bin's expression flashed slightly, and he said, "Doctor Xiao Zhou, indeed, there are a lot of fracture cases gathered in our group, but most of them are here because of the reputation. After all, the current minimally invasive fracture surgery is very popular on the Internet."

"You also know that everyone has a love for beauty, and it's not easy for us to refuse patients. Since there is a request, there is no reason why we shouldn't."

If you want to learn, you must have the resources to learn, so Lu Bin arranged for this to divide all fracture patients into one group, which is Zhou Cheng's group.

Zhou Cheng felt a bit pained, Director Lu, what are you thinking about.

Trauma surgery is not just about fractures. If you put all your energy on this, after ten years, if minimally invasive fracture treatment has been widely promoted, will you die?

Eat the near-term effect, which is extremely short-term goal.

After Zhou Cheng came down, besides leading the team to solve the real problems faced by prefecture-level city hospitals, he still had to do something of his own, so he said, "Director Lu, it's common sense for patients to love beauty, but , as doctors, we should not make decisions for patients, so as to avoid more twists and turns."

"In the future, let's try our best to enrich the number of diseases. Small incision open reduction and internal fixation, it is not difficult, it is not easy to say, that's the thing."

Lu Bin was taken aback, thought for a while, and then nodded: "I'll listen to Dr. Zhou's arrangement, so how many surgeries would it be more appropriate for us to arrange tomorrow?"

"In the past, we usually arranged up to five fracture surgeries a day!" Lu Bin made a deal for Zhou.

Zhou Cheng pondered for a moment, and said, "Then arrange five sets, Director Lu."

"In addition, Director Lu, I don't know how our hospital used to choose treatment methods for some simple fracture operations. However, as far as our existing patients are concerned, I care about it. Some Fracture patients do not need surgery."

"Director Lu, what do you think?" Zhou Cheng was not afraid of offending anyone, so he directly hit him in the head.

Lu Bin, you transferred the patient to the group yourself, and I won’t talk about the matter of attracting the patient. However, for these fractures, whether to undergo surgery or not, whether to listen to you or to me, this question, Let's clarify first.

Indeed, the current situation is not very good. Under the new situation, the salaries of many medical workers have been seriously affected in the past period of time, so they are not very optimistic.

Zhou Cheng agrees with the idea of ​​increasing income by increasing the number of operations.

However, Zhou Cheng still had to figure out who the Director Lu Bin wanted to be based on.

It is true that some fractures require surgery for ordinary doctors, but for Yu Zhou Cheng, Zhou Cheng thinks that they can be treated by manipulative reduction.

Simple, convenient and effective.

Only by knowing Lu Bin's bottom line can Zhou Cheng make good plans for the next step. If Lu Bin only wants to make money, then he will look for another opportunity and find someone to do things.

If Lu Bin has ideas, then he doesn't mind developing some other ideas.

It's not about fighting for power, but leading a group is to have the appearance of leading a group.

Lu Bin's expression flickered for a while, Zhou Cheng was coming, he had a detailed understanding of Zhou Cheng, and then gritted his teeth and said: "Doctor Zhou, this is up to you to arrange and plan, I told you when I took over the shift." .”

"Which group are you in, Dr. Zhou, your decision-making power should take precedence over the current group director. I will not break my promise."

Lu Bin has a thin body and dull skin, and he looks like a veteran village cadre. It can also be seen that he has read a lot of books.

Zhou Cheng heard the words and said, "Thank you Director Lu for your love and respect."

"The reason why I ask this question is actually based on the following considerations."

"I have read it in detail. Some of the current policies, the state strongly advocates reducing the proportion of medicines and consumption, and increasing the proportion of pure operations in medical expenses. Then, there must be profound intentions."

"Before I came here, I had done in-depth research on the current performance policies of Chinese medicine hospitals. I found that, at present, the operating performance of the operation fee within the department can get 60.00% five, and then according to the different evaluations between departments , there is still a fluctuation of 5.00% to [-]%!"

"Is that right?"

Lu Bin nodded and said, "Yes, it is because of this that we have had a lot of fluctuations in the past few months, so the department is now in a period of seeking change."

Income is directly linked to life, and the performance he got last month was only [-].

The director of the department, 1.0, the highest performance coefficient, whether the salary is high, high enough but not high enough, mainly depends on the money that can be obtained during the residency period, their performance coefficient is only 6000, and it is issued , more than [-]!

They are all at a crucial stage of raising their families.

Zhou Cheng said: "Indeed, we are now in a contingency period. During the contingency period, we must seek changes. Recklessly increasing the number of cases is one of the methods. However, Director Lu, you must pay attention to this point, that is the single-disease model."

"Single disease is paid according to the type of disease, and the medical insurance covers the bottom line. This is a relatively large welfare policy for us."

"This is the first. Second, the proportion of pure operations is not only on the operating table, but also off the operating table. Our orthopedics department can perform far more operations than other departments."

"Third, the manual reduction of fractures includes two types of prying reduction and traction reduction. The closed reduction method is also a pure operation."

"In addition, some of the current diseases in our trauma surgery are not in the field of single diseases, that is, more serious trauma patients. These cases cannot be lost."

"Debridement and suture, tendon suture, etc., seem to be nothing, but in fact, these patients account for the most operations, and there are almost no built-ins..."

"And based on my current understanding of the department, the solution I can think of is."

"Let's reset the manipulation of simple fractures first, and do it well first. Then, Director Lu, you will find that when we further refer to the minimally invasive fracture treatment of complex fractures, we will get twice the result with half the effort."

"In addition, Director Lu, if there are patients with severed limb replantation and severed finger replantation, what do you think should be done?"

Zhou Cheng didn't mean that he didn't like Lu Bin's thoughts and ideas.

Rather, before this, everyone was used to the old-fashioned way of treatment, thinking that surgery is surgery, and orthopedics is just putting steel plates, and then the cost of the steel plates is used to subsidize the department's income.

But in fact, this is not the case. It is impossible for any change to have too much impact on the real pure technology.

Lu Bin was thoughtful, and then said: "Doctor Zhou, according to your thinking, I probably understand what it means, but if this is the case, how can we have so many diseases?"

"Precise, individualized, and refined treatment is the source of our disease. When we don't need to find the source of the disease by ourselves, it is the best time for our development."

"As far as I know, at present, the Orthopedics and Traditional Chinese Medicine Hospital in Chang City are comparable in strength to Chang City No. [-] Hospital, and the director of trauma surgery at Chang City No. [-] Hospital is a Ph. Hospitals are currently at a disadvantage."

"Moreover, Changshi No. [-] Hospital will soon become a prefecture-level city hospital affiliated to the Medical College of Shonan University."

"However, as far as I know, a better point is that at present, the 120 system in Changzhou still gives priority to sending emergency patients to us, so these emergency patients are a good source of illness for us."

"We are not worried, there is no source of disease."

"..."

Listening to Zhou Cheng's analysis, Lu Bin opened his mouth slightly. He really didn't expect how long it took Zhou Cheng to analyze the routine in such a deep way?

Zhou Cheng, what are you doing this week?

Zhou Cheng continued: "The current medical insurance policy is 90.00% [-]% and [-]% reimbursement for drugs that are purely operated, inspected, and popularized."

"The patient's cost is small. To a certain extent, it may even be less than 2000 yuan, and more complicated fractures can be treated, perhaps even less."

"In this way, the willingness to treat will also be strengthened. After the consumption of medical expenses is reduced, the willingness to see a doctor and the average health level of the general public can be improved."

Zhou Cheng has thought about such a thing, so, why, Minister Gu, let him come to the prefecture-level city hospital, presumably, Zhou Cheng thinks.

Mr. Zeng and Mr. Gui Yuanping never treated him as a very pure doctor.

These two teachers are all national scholars.

Academicians have the right to advise on higher-level decision-making, and they have a higher vision.

Go to the medical country.

Chinese medicine doctor.

Go to the doctor to treat the disease.

This sentence is just twelve words, but the connotation expressed cannot be simply carried by twelve words. Even, for thousands of years, no one has been able to truly carry it.

Whether it is writing a book, benefiting one party, a miracle doctor helping the world, or other things.

They're all talking about medicine.

Rather than discussing medicine, medicine is a discipline, whether it is modern medicine or traditional medicine, since it is a discipline, it must be systematized.

Presumably, this is the reason why the two teachers let themselves down!

Chapter 3 and Chapter [-] Tool Man's skill pack!

"Doctor Zhou, what do you mean? We should consider the business model, reduce the cost to a certain extent, and earn the difference between the full payment for a single disease?" As the director, Lu Bin is quite sensitive.

You dare not say this kind of thing in front of outsiders, and you need to be extra cautious when saying these things to the nursing team.

Even more so in front of patients.

Lu Bin knew that the most basic purpose of the arrival of Zhou Cheng and others was to continuously sink medical resources and gradually adjust the medical technology level of prefecture-level city hospitals and county-level city hospitals.

On the other hand, it is to help prefecture-level city hospitals to explore the benefits of reform to a certain extent.

Zhou Cheng thought for a while, nodded, but shook his head again: "Director Lu, this is probably the way of thinking, and it's not wrong. But the words of saving costs and earning the price difference are not used properly."

"Under the policy of paying for a single disease, the reason for the centralized procurement is actually to leave a relatively large space, which is to refine the treatment plan, not to leave this space."

After Zhou Cheng said this, he pondered for a while, and then slowly said: "As far as fractures are concerned, there is actually a limit to the peak that can be achieved at the purely technical level. Even minimally invasive fixation of fractures can only reduce the fracture. The damage caused by the small exposed wound."

"It will not substantially promote the growth of fractures, etc., and can achieve the degree of fixation, but if the fractures want to heal, under normal circumstances, the effect can be achieved."

"However, the main purpose of minimally invasive internal fixation devices and ordinary traditional internal fixation devices is just fixation. From another perspective, it is just a substitute for plaster external fixation."

"Solving fixed problems."

"Fixation is only one link in the principles of fracture treatment." Giving a man a fish is worse than teaching him how to fish. Zhou Cheng clicked here to see how much Lu Bin can figure out.

The reason why Zhou Cheng said this is because his current skill level is very high, and the skills are very comprehensive. After the skills are comprehensive and the level is high, the understanding of a disease is the key to his improvement.

Fixation, reduction, and rehabilitation have always been the third most common fractures.

Why did he try his best to promote manual reduction of fractures?That's because most fracture reductions are actually variants of manual reduction—

Whether it is open reduction or closed reduction, manual reduction is the key, and it is the basic component. Whether the reduction is done well or not will greatly affect the prognosis of fracture treatment.