Zhang Fan questioned the director of the Department of Gastroenterology, who was sweating whitely.
If Zhang Fan couldn't find out today, he wouldn't be afraid. But today Zhang Fan found out.
The director of the Department of Gastroenterology's heart was as sharp as a willow leaf in the wind, and he said, "It wasn't this great last time. How long has it been since I came here? Why is it so great this time?"
He opened his mouth, not knowing what to say. No matter how you explain it now, it's useless. An orthopedic surgeon can detect your internal diseases, so what else can the internist say?
No matter what people scold you, you have to lower your head and listen. Who told you that you are not good at your business?
"Look, look, in your department, a patient with gastroesophageal shunt disease is seeing a doctor for the first time. He is directly treated with imported omeprazole. Is it very comfortable to get commission? Why not use octreotide?
Look, you give calf blood to a patient with hepatic encephalopathy! "
Zhang Fan took the medical records and patted them. The director's face turned pale. Not a word could come out.
If Zhang Fan had not succeeded in the examination today, it is likely that a doctor would come forward soon and start to quibble about pharmacology for Zhang Fan from the medical records, physiology, and biochemistry.
However, no one dared to do so now, because they discovered that Zhang Fan's internal medicine skills seemed to have suddenly improved.
They can't stand the change anymore, and they can't be fooled by the change anymore.
It is not wrong to say that they are wrong, because the drugs are symptomatic, but it is also wrong to say that they are wrong, because there are cheaper alternative drugs.
In the past, things like this were not easy for Zhang Fan to manage. Even though he is the dean, he is really difficult to manage. As people say, if you line up to be shot, some people will be wronged, but if you shoot every other person, there will definitely be people who slip through the net.
Moreover, doctors' salaries were not high in the past, and the hospital was located on the border. If you were too strict, they would give up their job and go to the south, and you really had no choice.
There is an example of this. It is said that in a border county, a new hospital director confiscated all the rebates on the medicines under the guise of preventing physicians from using medicines indiscriminately. Of course, after confiscating the medicines, it was said that he bought them for his mistress. A mini.
As a result, several departments of the internal medicine department of the county hospital, under the leadership of the department director, directly contacted a private medical group and all of them changed jobs. The dean was too late to cry.
In the border areas, indeed, sometimes talents really are talents. Even if Mr. Nan Guo can block a hole in you, the leader will grit his teeth and say that Mr. Nan Guo is a great talent.
But it's different now. Salaries at Chasu Hospital and public hospitals in Manhua are almost no higher than theirs.
At present, even the Harbor Fishing Village United Hospital in the fishing village, this special hospital, barely has the same salary as Cha Su's.
Therefore, Zhang Fan is already very tough when he speaks and curses. Moreover, Zhang Fan's level of internal medicine was enough to convince them. For technical units, if you have the skills to curse people, you have the confidence, but it may not be enough. If you have money and technology, you will be bold and powerful.
"Come on, tell me about this treatment now. Now tell me how to treat it." After cleaning up the director, Zhang Fan began to ask the doctor in charge of the bedside, and asked the doctor in charge of the bedside to give medical orders on the spot.
Ouyang looked at Zhang Fan, her heart bubbling, "When did this kid have such a high level of internal medicine? He was not as good as me before, but now he is even better than me." After thinking about it, she looked at Ren Korea.
Ren Li smiled slightly, "My digestion is not as good as his!" She whispered to Ouyang Yi.
When Ouyang heard this, he glanced at Ren Li with a look that said, "What's the use of you?"
Then I could only watch Zhang Fan pretending to be 13 quietly.
"Ampicillin, sulbactam, 3.0g a day..." The doctor in charge of the bedside thought for a minute before starting to explain the treatment plan.
After listening, Zhang Fan said: "Ciprofloxacin, metronidazole 500mg, liquid diet, and the doctor's instructions will be changed as the symptoms change. After three days, it is recommended to eat a high-fiber diet and check blood routine regularly. If the white blood cells increase, , it is recommended to review CT!~
Which one do you think is better, mine or yours? "
After the doctor in charge of the bedside told him the medical orders, Zhang Fan immediately put forward his plan and asked the doctor in charge of the bedside without asking anyone else.
The doctor in charge wanted to roll his eyes but didn't dare because his own was really not as good as Zhang Fan's. She wanted to say that Zhang Fan was bullying others, but then she thought about it, he is an orthopedic surgeon, so she could only say: "Well done to the director!"
"Don't be dissatisfied. I haven't read many internal medicine books. Comrade, you should pay attention!"
The doctor in charge of the bed is almost pissed off, but there's nothing he can do about it, they can do whatever they want now!
A surgical director came to the internal medicine department to check the doctor's orders. Really, how awesome is this!
Erosion, ulcers, sinus tracts, fistulas, cavities, and diverticula. When explaining the terminology for the pathology examination back then, Zhang Fan was particularly impressed by this diverticulum.
The explanations of medical school terms are all in English.
First it needs to be translated into Chinese, and then the meaning of this word is explained.
These are all words related to holes. Of course, there are deep holes and there are shallow holes. When he first took the exam, Zhang Fan knew the name of a diverticulum in English, and he was excited to show off his skills. However, after learning the English, he suddenly discovered that he could not write Chinese characters.
Really, at that time, Zhang Fan felt as uncomfortable as a dog. It was as if he wanted to find a favor to thank him for his patronage, but ended up ordering another bottle. Whoever bought it would understand his mood at that time.
Zhang Fan was so forced that he almost used Pinyin! Really, it’s a joke for a college student to use pinyin when taking an exam and say it’s all wrong.
Diverticulum, what on earth is this thing? The explanation in many textbooks is: a hernia inside the intestine.
This thing is meant to bully people. If you explain it to a student who has no clinical experience, it is the same as not explaining it at all. It is very discouraging. Because if a noun is not understood, a new noun is formed.
Therefore, it is difficult to learn medicine by yourself. Sometimes, if you learn incorrectly, you will be in trouble.
Back then, Zhang Fan and the others had just finished studying pathophysiology. When they coughed and diagnosed themselves, they thought, Cancer! Just like how everyone treats mother-in-law's disease now, it scares them to death.
In fact, it would be much simpler if Zhang Fan explained this diverticulum now. In fact, it was just a dent in the underwear of the intestines, just like a toothpick guy put a tent on his underwear after having a morning erection.
If it is not broken, the dimples formed by the underwear are diverticula; if it is broken, it is a sinus tract. Of course, this thing needs to be thin. If it is thick, it is not a diverticulum, but a hernia.
What is a hernia? It means that your own organs push out your own tissue into an abnormal depression. It does not count if it breaks, whether it breaks your own or someone else's, it does not count.
A hernia occurs when one's own organs are ruptured. For example, when the spermatic cord brings the intestines and ruptures the groin and femoral muscle layer, it is a hernia.
If the top is not broken, a hole will appear, which is a diverticulum.
If you still don’t understand, there is a more classic explanation. A beautiful woman wears two layers of socks. White stockings are attached to the toes, and black stockings are put on the outside.
Of course, the big toe of this beauty is relatively long. If the white stockings are not broken but the black stockings are broken, it is a hernia. When the white stockings are broken but the black stockings are not broken, it is an ulcer. When the white stockings and black stockings are both broken and the thumb is exposed, this is called sinus tract.
As for the diverticulum, the white stockings and black stockings were not broken by the little finger, but it formed a nest.
The ones that go outward from the intestine toward the muscle layer are called diverticula, and the ones that protrude toward the inside of the lumen are polyps.
If you memorize this thing according to its literal meaning, it seems very simple to separate them one by one, but similar nouns put together can often confuse students.
There must be your own methods for this. For example, Zhang Fan understands polyps as standing up to urinate in the intestines and having a stick. Diverticulum means squatting to urinate, and there are slits.
Really, this is not driving, this is medical textbooks driving medical students to a dead end.
Many people say that surgeons drive badly. In fact, this has its roots. If you go to medical school and listen to the lectures of those old professors, especially the closer to clinical subjects, the worse the driving.
The more female teachers are, and the older they are, the more aggressive they drive.
It is very strange that the male teachers in the medical school were very coquettish when they were young, but as they get older, they all look like moral gentlemen. As for the female teachers, when they were young, they were all as cold as ice, and they would avoid even the word "fart" when they opened and closed their mouths. But as they got older, they started to let themselves go after they learned how to make soy sauce.
After checking the ward, Zhang Fan dismissed the team of doctors and said to Ouyang, "Ouyang, let's organize a meeting between the director and the dean."
"OK!"
Then, the director of the Department of Gastroenterology and several deputy deans in charge of the Department of Internal Medicine were gathered in the office of the director of the Department of Gastroenterology for a meeting.
Zhang Fan sat on the director's chair.
Lao Ju also came because he is a respiratory medicine specialist.
Of course, when he came, he had an expression like "We're breathing fine, why did you ask me to do it?"
"From now on, gastroenterology can no longer regulate prescriptions. Now that the income has been raised, I didn't say anything before. From now on, not a single prescription can be regulated."
After Zhang Fan and others were all gone, he started talking.
The director of the Department of Gastroenterology turned green, but today his underwear was pierced by Zhang Fan, and he was too embarrassed to speak.
What is Tongfang?
In fact, after the doctor issues a prescription, the patient takes the prescription to the pharmacy to get the medicine.
Then, at the end of the month, the drug dealer goes to the pharmacy department to start counting prescriptions one by one.
Let the director of the pharmacy department count who has prescribed how many bottles of medicine, and then pay the doctor accordingly.
Of course, the director of the pharmacy department can't escape either. When calculating how much a prescription costs, it's all clearly marked.
"What, you're not happy?" Zhang Fan looked at the director of the Department of Gastroenterology.
"No, it's not that I'm not happy, it's just that we only have a gastroenterology department and I can't tell the doctors below."
"I'm still brave. The gastroenterologists in the department are not as good as one orthopedic surgeon, so I'm embarrassed to mention it. I'm here to give everyone a break. Today is the gastroenterology department, but today is not the end, but the beginning. Please finish the finishing touches as soon as possible. Let bygones be bygones in the past, and show no mercy in the future.
Also, the Department of Gastroenterology has carried out a one-month skills training, and for those who do not pass the second-level or even third-level outpatient clinics, the laboratory salary subsidy will be cancelled! "
These words are fatal.
"Are other internal medicine departments also started?" Ouyang asked.
"First internal medicine, then surgery. One department after another, until all hospitals are unified. European Hospital, this is to save them instead of harming them!"
"Okay, I support Zhang Yuan!"
"I support it too!" After Ouyang said, Ren Li was the first to support.
The other deans also supported it, especially Lao Ju, who looked like he should have done it a long time ago.
Yan Xiaoyu looked at the team and felt upset.
If this unified formula is not the country, which president would dare to break it?
But, today, Zhang Fan made it clear.
This is awesome.
