"Okay then!" The man agreed. After searching for a long time, he found out a hundred yuan and paid the fee. "You can't come to hospitals and clinics. You have to spend money as soon as you enter, which is quite a lot. This 100 yuan is enough for me to buy a lot of steamed buns!"
People in some places like to eat white flour steamed buns.
Cheap and hungry.
The surrounding patients and customers couldn't help laughing after hearing this.
Look at the couple.
"Oh, can you please stop saying a few words!"
The woman's face turned red.
Women are usually more concerned with saving face. She felt a little embarrassed when she exposed her family background in public and let everyone know that her family eats white flour buns every day.
"What's the point? We can live a good life now that we have steamed buns every meal! In the past, in my hometown, for which meal were we not allowed to eat chaffy vegetables?"
Men don't care.
These words naturally made everyone laugh again.
The woman wanted to crawl into the cracks in the ground, her face turned red to the root of her neck.
"Many hotels now regard sweet potato rice and rice with bran as high-end food! Eating healthy is very good for the intestines."
Li Jingsheng came to the rescue for this woman.
She married a straight-faced husband, which had both advantages and embarrassing moments.
For example, when speaking in front of others, you don't pay attention to your image and don't take into account her feelings.
Most of these straight men are quite down-to-earth and live a fairly solid life.
I took her to the medical technical room and took an X-ray. Because the resolution was limited, it took a lot of effort to see a slight fracture line.
This was after Li Jingsheng had touched the bones and knew where the fractures were.
Now his small clinic has started the business of manual bone setting and reduction, and you can take an X-ray when you come.
For a one-time charge of 100 yuan, more than 100 patients can help him earn back his capital.
In addition, the clinic's medicine sales business has picked up again in the past two days. By then, he will have some money, and he is going to buy a new X-ray detection equipment while biting his back molars.
The only problem is that the venue is not up to standard.
The advantage of renting in such a busy area is that there is plenty of traffic. The disadvantage is that the rent is extremely expensive and the space is small.
If we can take possession of this building, the venue will definitely be enough.
The rent for renting the first floor would be enough for him to choke. It was unimaginable to rent an entire building.
However, the rent on the second and third floors should be much cheaper.
This building is the landlord's self-built house.
Most of the houses on this street are self-built houses.
Urban villages are like this, with densely packed houses and a good place for migrant workers to live together. Basically all are old houses.
Except for the slightly higher rent on the facade, housing is basically very cheap.
Moreover, compared with the commercial storefronts on the main street outside, the rent of storefronts in this area is not even comparable to that of grandsons.
Li Jingsheng heard that the rent for a two-meter counter in a commercial plaza is 5,000 a month.
The four facades rented by China Construction Bank require an annual rent of 1 million. I don’t know if it’s true or not, but it’s definitely true that the rents for storefronts on the main street are exaggerated.
Although he is ambitious now, he still focuses on stability.
According to the current rate of making money, if we continue to develop for about a year, as long as there are no accidents, we should be able to buy a storefront.
Only then can we truly take root.
The future is very bright, but you just can’t rush, you need to accumulate slowly step by step.
"After the shooting, let's go out and talk!"
Li Jingsheng took the patient out of the medical technology room, while the patient's husband stood guard outside.
The wife entered the medical technology room with a male doctor. It seemed that the husband was somewhat uneasy.
"What's going on? Can it be cured?"
her husband asked expectantly.
"If there is a wrist bone fracture accompanied by joint displacement, you can try manual reduction. After successful reduction, you need to use a splint for four to six weeks."
"How much does it cost?"
"This kind of reset costs at least 350 yuan. Considering that it's not easy for you, I'll give you 300 yuan."
Li Jingsheng really took great care of this family.
When you go to the surgery clinic of the Second Hospital, you don’t even have to think about it.
Many outpatient treatments are not reimbursable.
So there is not much difference between treatment in a clinic and in a hospital.
They only charge 300 yuan, and after deducting the cost of the plywood, they only earn more than 200 yuan in technical fees. If it were a patient with better financial conditions, he would charge at least 400 yuan.
"Can it be less?"
The man obviously regarded this place as a vegetable market.
I can understand that people who repeatedly ask for prices are either really poor or stingy.
This middle-aged couple did not look like wealthy people. They were dressed very plainly and their nutritional status was not very good.
"It's already the lowest price, you can consider it. She definitely needs treatment, otherwise the fracture will be aggravated, and the cost of treatment will increase several times. There is also the risk of teratology and disability."
Deception is a compulsory course for doctors.
When Li Jingsheng should be cheating, he would never act like a gentleman.
Rather than waiting until patients have problems and then complaining about them, it is better to make the consequences more serious now and scare them into receiving formal treatment.
"Okay, let's fix it! How many steamed buns will be lost! You bitch, why do you ask me to change the light bulb next time? You have to show off."
The man had a pained expression on his face.
I paid three hundred yuan.
It turned out that his wife dropped the light bulb.
It can be seen that although he cares about money, he loves his wife very much.
At least he paid for the treatment without much hesitation.
Li Jingsheng used rotation, flexion and extension and lifting, pressing and end-squeezing techniques to successfully reset the patient's bones.
I encountered a few minor problems during operation, but finally it didn't overturn on the first day of official listing. After resetting twice, I finally succeeded.
Out of caution, he felt the bone again and examined it.
The displaced bones have returned to their original positions, and the fracture lines have also been closed, making them almost invisible.
After the patient was splinted and the inspection was correct, the business was completed.
"How does it feel?"
The man couldn't wait to ask his wife, and his concerned tone and expression were very helpful to the female patient.
"It was very painful when it was just reset, but I feel much better now. Before treatment, whenever I hung my hand like this, or like this, I would feel pain in waves."
"What now?"
"Of course it doesn't hurt anymore!"
The woman smiled.
"It doesn't hurt as much as before the treatment. Why didn't you tell me earlier?"
The man seemed a little distressed when he heard that his wife had endured pain for so many days.
"I asked several people, and they all said that treatment in a big hospital costs two to three thousand yuan. I didn't think that my family didn't have... money! I didn't expect that I could be cured here for only four hundred yuan. If I had come earlier, I'm definitely feeling better now."
She looked at her healed right hand repeatedly and tried to move it, with a happy expression on her face.
The worry in his eyebrows has also disappeared.
"Speaking of which, we are lucky. This morning I saw a new sign for orthopedics in this clinic. As soon as I asked, I knew that it could probably be cured. Hehe, these three hundred yuan are well spent. Doctor, let's go. !”
"Both, walk slowly! Remember not to use your right hand to lift heavy objects or do strenuous exercise, and then come over for a reexamination after one month. Don't worry, there is no charge for the reexamination. After I check that there is no problem, I will help you remove the splint. "
Li Jingsheng added some additional precautions.
Seeing the couple leaving happily, Li Jingsheng was also very happy.
Isn’t the purpose of studying medicine to help people relieve their illnesses?
If it costs two to three thousand yuan, that woman will definitely not go for the treatment. Now a total of 400 yuan has been spent to cure her, and everyone is happy.
Although Li Jingsheng earned a little less, he was very happy.
If he really encounters a patient who is in particular difficulty, he is willing to help even if he does not make money.
But if you ask him to do charity, if this doesn't make money, and that doesn't make money, then it won't work.
Appropriate and reasonable charges have been a principle he has set since he opened his clinic.
The woman with a very swollen face had already finished her phone call.
It seems that I have been hesitating whether to treat here.
Seeing that the female patient with a fractured and displaced wrist was quickly cured, her confidence in Sunshine Clinic immediately increased.
"Doctor Li, my husband agreed to let me be treated here. Can he be treated now?"
"Can!"
Li Jingsheng’s answer was simple and powerful.
Physicians must have faith.
"Although this is just a minor surgery, it is on the head and face after all. Let me talk to you about the surgical options first. The first one is to make an incision from inside the mouth, separate the abscess and drain it. During this period, you cannot eat. The advantage is that it is not on the face. Surgical scars will be left. The second method is to make an incision from the face, and the abscess also needs to be separated for drainage. You can eat normally, and the postoperative recovery will be faster. The disadvantage is that surgical scars will be left on the face..."
"No need to think about it, I choose the first option."
The woman answered very simply.
Li Jingsheng didn't even wait for him to finish speaking before he chose the first option.
"Okay, I'll get you a surgical risk notification form. Please sign it. Did you bring your ID card? Register it for me."
Even if a clinic performs minor surgeries, as long as it is not a black clinic, it must be registered.
In fact, clinics and hospital outpatient clinics are of the same nature.
Any surgery has risks, even if it is a first-level surgery, you still need to sign a risk notification form.
After everything was settled, the patient was brought into the treatment room.
Fortunately, the Sunshine Clinic now has three people. He and Tang Ping go in for surgery, while Xiao Gao sells medicine and receives other customers and patients outside.
At this moment, there are some people buying medicine.
Intermittently, some people bought and left, and after a while new customers came in.
Now these people can be received by Xiao Gao alone.
…
In the treatment room, Tang Ping had already laid out the sheets and completed the disinfection.
Although it is impossible to control the sterility of laminar flow operating rooms, for the sake of surgical safety, it is still necessary to temporarily ensure that the surgical environment in the treatment room meets ordinary surgical standards.
Even in large hospitals, many outpatient operating rooms cannot meet sterile conditions.
It is similar to Li Jingsheng's treatment room, with at most all kinds of equipment and supporting facilities.
For example, if a patient suddenly suffers cardiac and respiratory arrest, corresponding rescue operations can be carried out immediately.
"I'll prepare the local anesthetic!"
Li Jingsheng said to Tang Ping.
"good!"
She didn't know what her boss wanted to do.
Li Jingsheng took a bottle of epinephrine and mixed a small amount with the local anesthetic.
Tang Ping's eyes brightened slightly, and she looked at the boss in shock.
"Your medication level seems to have improved again!"
At this moment, she admired Li Jingsheng from the bottom of her heart.
"It was basically an incision inside her mouth, mixed in with epinephrine to reduce the bleeding."
Li Jingsheng's drug efficacy and pharmacokinetics levels have been improved to the Xiaocheng level, which is a real senior doctor-level drug use level.
There are indeed more cows now than before.
When using medicines in outpatient clinics, whether prescribing medicines for patients or using medicines for surgery, they can be used accurately as they wish.
And there are a variety of medication options.
In terms of combined medication, it is also the first step to make it easy to use.
The main purpose of mixing a small amount of epinephrine into the local anesthetic is to reduce bleeding in the surgical field and make the surgical field clear.
In addition, it can also reduce the absorption of local anesthetics and reduce the toxic and side effects of local anesthetics.
There are many benefits.
He didn't dare to play like this before.
In the past, patients were given medication with caution, caution, and caution.
It seems casual now, but it is because I have a high enough level that I can do it with ease.
"I heard that your medical skills here are very high, so I came here specifically to seek medical treatment. You must help me do a good job!"
The patient heard the conversation between the two and interjected.
"I will definitely do my best to give you the best possible operation. We are going to start anesthesia next, so please try not to talk anymore."
Li Jingsheng said to her.
"Sister Tang, push the suction machine over. We will definitely be suctioning phlegm, pus, and blood in a while."
This suction machine was also bought by Li Jingsheng while clenching his back molars.
It has been left in the treatment room to gather dust.
It cannot be used more than three times.
If the surgical business develops in the future, it will be useful.
Before taking local anesthesia, Li Jingsheng still maintained a cautious behavior.
Do a skin test first.
Only after there is no problem will the intraoral injection begin.
"Sister Tang, when you encounter patients with internal abscesses, you should try to avoid injecting in the abscess area."
"I know! Our director taught me specifically before. In fact, if conditions permit, superficial injection can also be done, or injection can be done from the outside."
Tang Ping lifted her pretty eyebrows.
The expression on his face cannot be seen clearly because he is wearing a mask.
But you can see her pride in her eyes.
Her level is not low. She can even teach Li Jingsheng about nursing knowledge.
"Ha, I forgot that you used to be an excellent nurse in the compound."
Li Jingsheng laughed twice.
After the local anesthetic took effect, he took out a flat hook, one each with Tang Ping, and worked together to open the patient's mouth.
If there are enough manpower, a specialized medical assistant will be needed to retract the hook.
Now this work can only be done by Tang Ping, a delicate female nurse.
Retracting a hook is actually a manual job, usually done by young male interns and trained doctors.
In the absence of these two types of novices, resident doctors are promoted.
The newcomers who had just entered the operating room felt very happy to have the opportunity to retract the hook.
After working around it for a long time, I realized that it was just a hard job with no technical content.
The only advantage is the opportunity to go on stage and watch the surgeon's surgical process up close.
Li Jingsheng chose to perform incision and drainage from the lowest point of the swollen area.
This is a hunting mistake that many newbies make.
The textbook says that incision and drainage should be done from the highest point of the swollen area.
That means making an incision from the outside of the mouth to select the highest location of the abscess.
If the incision is made from inside the mouth, choose the lowest position.
Li Jingsheng currently has only one incision technique that has reached entry level or above, and that is the skin incision technique.
It is currently at proficiency level 18/100.
Not even reaching the mastery level.
He seemed a little hesitant when he cut the knife.
The nerves and blood vessels in the mandible are very dense, and if the force of the incision is not properly controlled, if the nerves and blood vessels are damaged, the patient's oral function will be damaged, and even some facial functions may be lost.
For example, some women like plastic surgery and end up with zombie faces, unable to smile anymore.
If he misses when cutting the knife, it may also lead to the same consequences.
After thinking about it, he decided to upgrade the skin incision method to another level.
At least upgrade its proficiency to the master level to be safe.
The current health balance is 127.
Decisively spending 82 health points, temporarily upgraded the skin incision method to the proficiency level.
This is a real level of treatment by a junior doctor.
It can cut the intestines competently, and it is easy to cut a superficial cavity in the mouth.
With the upgrade of this incision technique, Li Jingsheng's use of this incision technique immediately reached a new level.
Concentrate and carefully cut open the lower part of the abscess.
A hole appeared instantly.
He was pleasantly surprised to find that the touch feedback from the tip of the knife was quite clear. This is a feeling I've never had before.
"This...could it be the feeling of a knife?"
I always thought that I had to reach the level of deputy director to have knife sense.
Unexpectedly, as long as you reach the attending level, you will be able to initially possess the knife sense.
He could clearly feel how deep the cut was with one stroke.
The skilled skin incision method can control the angle of the knife more accurately, and the cut will be a straight line.
Rather than a jagged wound.
Novice doctors with low incision skills will easily produce uneven wounds.
Better ones will have wavy wounds.
These are all manifestations of relatively low proficiency in incision surgery.
Surgical technology requires a lot of experience. The older the doctor, the more popular he is.
Because some doctors have completed five to six thousand operations by the time they are in their seventies. You can imagine how rich their experience they are.
A tumor can be determined by just touching it through the skin.
Incision is one of the most important surgical techniques and is the basis of all anatomy.
Including separation procedures advanced from incision, which are also based on incision.
Li Jingsheng found that after the skin incision method was upgraded to the master level, not only the depth of the incision could be grasped more accurately, but the cut line was also straighter.
It's almost like holding a ruler and drawing a straight line.
In addition, he was extremely happy to have feedback from the knife feel.
He didn't cut through the abscess directly.
This kind of abscess incision and drainage surgery must not be done all at once. Even the chief physician would never dare to be so aggressive.
They are cut layer by layer.
Avoid surgical accidents to the greatest extent.
"The feel and feel of the knife are so silky!"
It felt like he was stripping off his clothes.
At this point, yellow pus can already be seen, just beneath the tissue layer.
I don’t know whether it was because his medication level had improved and he used epinephrine mixed with local anesthesia, or because he had become proficient in skin incision methods, and the amount of surgical bleeding was very small.
So little that he couldn't believe that he could be so awesome.
I heard that among the best surgeons, the total blood loss during a major operation does not exceed 50ml.
This is something that is unthinkable.
However, Li Jingsheng now dares to think about it and believes that this legend is true.
Maybe one day, he can reach this supreme state.
"Sister Tang, is it okay for you to pull the hook?"
"I'm fine, I can hold on."
She is a woman after all, and her strength and endurance are not as strong as those of a man.
Now it can be seen that she is gritting her teeth and persisting.
Li Jingsheng took the suction gun with one hand and cut open the last layer of tissue in the abscess layer, and a large amount of pus immediately poured out.
But it was quickly sucked away.
The whole operation is coordinated perfectly.
It felt like he was learning from Zhou Botong's left and right hand fighting skills.
With senior management in charge
(End of chapter)
