My Medical Skills Give Me Experiences Chapter 189

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"When Director Liu was chatting with me, he mentioned you more than once. At the beginning, he promised to accept you as an apprentice and teach you personally. However, when several major departments selected general practitioners, you were selected by the emergency department. You also know that the department The competition among them is very fierce, and the interests are intertwined. Lao Liu is only the deputy chief physician, and he is in the same position, and he has no ability to get you from the emergency department."

The personal relationship between Director Jia and Liu Lao seems to be very good.

Otherwise, it would be impossible for the two of them to talk about these topics.

Mr. Liu's position in general surgery is not bad, but in the whole Tuya Hospital, he may not be ranked well.

These days, doctors with little academic achievements, no matter how rich their experience in diagnosis and treatment, generally do not have a high status.

The status of a doctor is determined by three key elements. First, surgical ability or diagnosis and treatment ability. Can cure diseases, can overcome some intractable diseases, and is very good at a certain field.

Such doctors are often famous doctors and experts in a certain field.

They have great influence and can bring a large number of patients to the hospital.

Such a doctor belongs to the banner of the hospital and has a detached status.

Even if the academics are not good, it still does not affect their status in the hospital and the industry.

The second type is outstanding academic achievements.

There are many important journals and core journal papers published, at least one of which has caused a sensation in the industry. Even lead the industry trend and create a precedent. Or the scientific research achievements are extremely outstanding.

This kind of doctors often hold senior teaching positions in medical schools, and they basically start as third-level professors.

The most common one is also a third-level professor.

As for those who can be mixed into the first-level professors, they are often at the academician level.

Not only do they have a very high status in the hospital, even in academia, they also have a high status in society.

This is also the reason why all doctors spend a lot of time studying academics, whether they are that material or not.

Since ancient times, there has been a law that everything is inferior, and only reading is high.

The same applies to the profession of doctors.

The third type is that the administrative position is high, or there are people on it.

This does not explain.

No matter how good a doctor is, he is still a younger brother in front of such people.

Of course, everyone generally respects each other and lives in harmony.

Mr. Liu's academic achievements are hard to describe in one word, his surgical ability can only be said to be above the standard, and his rich experience in diagnosis and treatment is barely an advantage. It's just that at the level of deputy director, which doctor doesn't have rich experience?

Therefore, Liu Lao's status in the hospital is relatively poor.

It can't be compared with big bosses like Wu Baihe, Yin Hua, and Hu Kan at all.

In his position, it was really powerless to want to transfer away a general practitioner who was selected by the emergency department.

Back in the operating room, Mr. Liu just casually said that he wanted to train Zhou Can himself.

Even Zhou Can didn't dare to take it too seriously.

Unexpectedly, the person who said it always remembered this promise.

"Old Liu invited me to teach you, which can be regarded as indirectly fulfilling the promise he made to you at the beginning. I hope you can understand this."

Director Jia said to him again.

"I understand! Thank you Mr. Liu for always remembering me as a small person. Thank you for willing to teach me yourself."

Zhou Can expressed his attitude very seriously.

"From today onwards, you can follow me no matter whether I am in consultation, performing surgery on patients, or making ward rounds. As long as you have the ability, you can come at any time. If you don't understand, you can ask me directly."

What Director Jia meant was basically to tell Zhou Can that he would lead him with all his strength.

And give Zhou Can the greatest freedom to develop.

This kind of treatment is beyond the imagination of any Gui Peisheng.

For Gui Peisheng, to be appreciated by a chief physician is already a stroke of luck, and the ancestral grave is full of smoke. The probability of being fully cultivated by the chief physician is about the same as buying a lottery ticket.

"Winter Dongdong!"

At this time, a rather young and beautiful female doctor stood at the door and knocked.

"Morning, Director Jia! Is it convenient for you to go to the ward round now?"

The female doctor asked with a smile.

"I'll be there right away! Qiu Hong, I have a new student, his name is Zhou Can, and he is Gui Peisheng who has just transferred to the Department of Gastroenterology. If he doesn't understand anything 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 Qiuhong, and she has been studying with me for almost five years. She has achieved a lot in the fields of gastritis and ulcerative enteritis in digestive surgery. She has achieved the diagnosis of various malignant diseases and the surgical plan of digestive tract diseases. to a considerable level.”

Director Jia was quite satisfied with the female student and gave her a high evaluation.

"Hello, Senior Sister Qiu, please take care of me in the future."

When Zhou Can should be sweet-mouthed, he is never rigid.

A senior sister Qiu, directly exchanged for the happy smile of the female doctor.

"Hehe, you don't recognize students. Director Jia seldom brings regular trainees. You should be the first regular trainee he brought after his re-employment. But I have heard of your name, and it is said that it can be as famous as Dr. Du, a returnee doctor. I look forward to seeing your true strength!"

She smiled and blinked at Zhou Can, and looked at Zhou Can with curious and probing eyes.

Unfortunately, she was soon disappointed.

Because Zhou Can looked a little handsome, a little handsome, and he couldn't see any demeanor of a master.

Dressing under the white coat is also very casual.

The lower body is a pair of casual sports pants, and the feet are also casual shoes. Compared with Du Leng's well-dressed clothes, the image gap is quite large.

Du Leng dresses very formally at work every day. Suits, leather shoes, shirts, and ties are almost his standard equipment. The hair is also taken care of meticulously, properly dressed as a social elite.

"Senior Sister Qiu, it's better not to look forward to it, because I'm afraid of disappointing you. Just treat me as an ordinary training student 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 usually have a good face and strong self-esteem. They like to be praised by others, but you are the complete opposite of them. How to keep a low profile. Under Director Jia, Tibetan clumsiness has never been popular, and you must use your real skills. Only in this way, Director Jia can help you point out potential problems."

Qiuhong didn't buy him at all.

This female doctor is not nice.

"Xiao Zhou, you really don't need to deliberately hide your clumsiness. Whether you follow my ward rounds or sit in a doctor's office, as long as you don't stir up disputes between doctors and patients, you can express your opinions and opinions as you like."

Director Jia also told him that there is no need to be too low-key.

"clear!"

Zhou Can is very smart, when to show his skills and when to hide his clumsiness, he has never been embarrassed.

As a newcomer to digestive surgery, as long as he has the opportunity to make contributions, he will definitely seize the opportunity and perform well.

"Let's go, let's go to the ward!"

Director Jia stood up first, and staggered towards the outside.

Qiu Hong naturally stepped forward to help him.

Judging by age, Director Jia must be over sixty years old. But walking needs someone's support, which is really beyond Zhou Can's expectation.

For light manual laborers, even if they are old, it is difficult to tell their real age from their appearance.

The man's forty-one flowers are not called for nothing.

As soon as I walked to the corridor around the corner, I saw a dozen doctors and nurses waiting there.

Many of them are middle-aged and elderly doctors over 50 years old.

It seems that Director Jia is quite popular in digestive surgery.

Zhou Can actually doesn't like this type of ward rounds, because his status is low, and following the director's ward rounds is more like a formality.

After entering the ward, he discovered that Director Jia's rounds were more direct.

He does not check ordinary beds.

Only check key beds.

Go straight to bed No. 3 and stand still.

Lying on the bed was an old man with a sallow complexion, pale lips and sunken eye sockets.

"The patient in the third bed, male, 71 years old, had a history of recurrent abdominal pain for 17 years. About three months ago, the condition began to worsen. Five days ago, the pain was so painful that he fainted many times, and finally four days later after black stools, due to acute The pain was unbearable, so I came to our hospital for treatment."

As soon as the doctor in charge introduced the basic situation of the patient, Zhou Can became interested.

Diagnosing various cases was his favorite.

Pathological diagnosis and tracing, this is one of his best fields.

The history of abdominal pain has been around for nearly 20 years, indicating that the patient must be a chronic disease.

These diseases are generally not fatal.

Many people take medication to relieve symptoms and live with the disease.

In fact, more than 90% of people over the age of 30 in my country have various chronic diseases. It's just because it doesn't affect life, and it won't bring particularly serious consequences, such as unbearable pain, life-threatening and so on. So many people are living with the disease, and never even received any treatment.

Not to mention anything else, just a fungal skin infection is the most common disease among most middle-aged and elderly people.

Such as tinea pedis, tinea capitis, genital itching, beriberi and so on.

As for chronic gastritis, enteritis, diabetes, high blood pressure, asthma, etc., it is also very common.

Tumors and polyps are also chronic diseases.

This patient presented with abdominal pain and recent black stools, suggesting gastrointestinal bleeding.

The lesion is likely to be in the stomach and intestines.

"Six days ago, the patient experienced abdominal pain and various discomforts, nausea, and vomited the contents twice without obvious incentives. There was no coffee-like blood, no obvious abdominal distension, no obvious acid reflux, and no heartburn. Then fainted again, fell After the injury, he became **** incontinence. He passed out about 200 grams of black stool, no convulsions, no foaming at the mouth, and he woke up on his own not long after..."

This case is confusing and challenging.

No wonder Director Jia focused on checking this patient for the first time.

"After that, the patient had melena again, and the stool test was positive for occult blood. It was accompanied by vomiting. The patient's 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 a duodenal ulcer.

Hepatosplenomegaly also needs to be added to the diagnosis.

"When the patient had abdominal pain before, he had taken propantheline and Weishuping intermittently. The symptoms could be effectively relieved after each dose."

Most people with chronic diseases are like this.

Medication works. No one wants to be hospitalized.

Buy some medicine and deal with it.

"The patient was treated in a local hospital eleven years ago, and the diagnosis was a duodenal ulcer, combined with superficial gastritis. He was discharged after treatment."

"The patient's current body temperature is 36.8 degrees, pulse rate is 76/min, blood pressure is 120/80hg..."

The doctor in charge of the bed explained the patient's basic situation, past medical history, and treatment history.

Zhou Can stood at the end of the bed, watching from a distance with several residents and Gui Peisheng. In fact, he really wanted to have a look at the patient's examination report, and then make a comprehensive diagnosis.

Now, I can only listen to Director Jia's opinion.

Director Jia finally diagnosed the patient with duodenal ulcer and arranged for surgery.

For many gastrointestinal bleeding diseases, surgical treatment is the only cure.

"The patient in the 13th bed, male, 45 years old, felt discomfort in the upper abdomen, felt nausea and stuffy, suddenly vomited a lot of blood two hours ago, accompanied by food residues in the stomach..."

This bed patient is another dangerous case.

Basically, those admitted to the hospital are all such acute and severe patients.

At first glance, Zhou Can felt that this person was pale, dark yellow, and had a typical anemic appearance.

And there is likely to be liver disease.

Especially the palm of the patient is obviously the palm of the liver.

This hospitalization should belong to acute upper gastrointestinal bleeding.

The patient's current blood pressure is very low. It should be related to vomiting blood.

Definitely need to arrange surgery as soon as possible.

After checking two patients in a row, Zhou Can had a general understanding of digestive surgery.

The amount of surgery here is very large. It seems that in the next two months, as long as Director Jia is really willing to delegate power to him. You can definitely earn a lot of surgical experience points.

You don't have to think about presiding over the operation alone, but you can work hard to participate in an important part of the operation.

At that time, Director Jia will be by his side to guide him, and he will be able to quickly accumulate experience in digestive surgery.

After checking the ward, Director Jia gave guiding opinions to those key patients.

For example, medication guidance, temporary treatment guidance, and then check the operation arrangements of these patients.

For emergency patients, those whose life is in danger, priority should be given to surgery.

I thought that Director Jia would take them into the operating room for surgery immediately, but I didn't expect Director Jia to take Zhou Can and Qiu Hong to the outpatient clinic directly.

Sitting with the chief physician was something Zhou Can wanted but could not have before.

Because his dual certificates have not yet been obtained, it is impossible for the superior doctor to bring someone like him to the consultation.

Unless he begged with a dead face, the superior doctor would consider taking him once or twice.

It's different now. Director Jia agreed with him in a private conversation that Zhou Can can follow him every day for consultations and operations.

It seems that Zhou Can's pathological diagnosis experience value can finally rise a wave.

His pathological diagnosis is currently level 4, which is the lower level of the attending doctor.

This level is definitely incomparable with the chief physician.

But it is much better than the average resident doctor.

The three of them came to the outpatient room, and they entered Room 1 of the Special Needs Specialist Clinic.

Good guy, it seems that Director Jia's status in digestive surgery is much higher than he imagined!

During the ward rounds just now, listening to Director Jia's diagnosis of those patients and the treatment plan given by him, you can also get a glimpse of Director Jia's strength.

When other doctors make ward rounds, they seldom use an affirmative tone when explaining treatment plans to patients.

When Director Jia faced the patient's inquiry, he gave an affirmative answer very confidently.

"We can cure your disease, and the recurrence rate will not exceed 1%."

"Your disease can be cured, don't worry, I have done many cases, and there is no cure."

Look, this is the confidence Director Jia showed when he spoke.

After hearing this, the patient seemed to have taken a reassurance.

If there is no real ability in hand, which doctor dares to say such affirmative words to patients and their families?

"Xiao Zhou, the volume of outpatient consultations is very large. Every patient who comes to seek treatment has different demands and conditions. You must listen carefully and think carefully. I ask."

Director Jia was afraid that he was too young and would ask all kinds of unfashionable questions when he was treating patients.

"Okay, understand!"

Zhou Can seemed a little absent-minded. UU reading www.uukanshu.com

Because during the rounds just now, the patient in the third bed gave him a very deep impression.

Although he did not check the specific examination report of that patient, Zhou Can has recently supplemented his basic medical knowledge in many fields. These include immunology and digestion.

Director Jia diagnosed the patient with duodenal ulcer, which was consistent with the diagnosis of the receiving doctor.

However, Zhou Can felt that the patient's disease might not be as simple as it appeared on the surface.

This is related to Zhou Can's three-month work in the Department of Critical Care Medicine.

He can come into contact with a large number of terminal cancer patients every day.

That patient gave him intuitions in many ways that it looked like cancer, not a simple ulcer.

To provide you with the fastest update of my medical skills that can add experience points to the great **** Jiangbian Yuweng, so that you can check the fastest update of this book next time, please be sure to save the bookmark!

Chapter 189 The three elements that determine the status of a doctor, Director Jia has gone wrong? Read for free.

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