top student at medical school

Chapter 411: Was it really resolved? (Please subscribe)

"At 6 PM this afternoon, all resident physicians, including the supervising resident, must be in the department's demonstration room! No absences are permitted without a valid reason."

"Only leave requests for reasons of: elective surgery assistant, laboratory experiments scheduled in advance."

"Apart from this, no leave requests will be approved."

"Those who requested leave in advance do not need to return. Please inform each other." Fang Ziye posted a small group announcement.

In this group, there are no professors, no associate professors, not even attending physicians; Fang Ziye is the absolute superior!

After Fang Ziye sent out the message, people immediately began to reply that they had received it.

Fang Ziye did not count or call roll. No one can be on their phone 24/7. At this time, it is the surgery day for other groups, and some people are still on stage.

Unless there are special circumstances, very few modern people, especially young people, do not check their phones between 10 a.m. and 6 p.m.

After Fang Ziye finished distributing the product, he walked to the door and glanced at the product manual left behind by his older brother who had just left.

The products are of standard quality; they must be from a company or manufacturer, have obtained all the necessary registration documents, and have been successfully launched on the market.

Currently, the only supporting evidence for this so-called "epidermal growth factor" is two Chinese-language articles...

Fang Ziye glanced at it a few times and then lost interest.

It definitely has some use!

Even if it is effective, it should be introduced into the department in a reasonable, compliant, and appropriate manner, rather than being replaced by a 'silver ion' dressing instead of the 'epidermal growth factor' spray, which is done in a way that is not entirely in accordance with medical advice.

Immediately afterwards, Fang Ziye threw it into the trash can.

However, something miraculously happened that Fang Ziye never expected.

Around 11 a.m., Yuan Weihong called Fang Ziye again to tell him that the medical insurance bureau's review notification in his OA backend had actually been approved through an 'appeal'.

"Master, I haven't dealt with this at all?" Fang Ziye was eating barbecue rice in his office, while his senior brother Yan Zhiming and Li Yuanpei were eating in the doctor's office.

Fang Ziye led the two of them to review all the medical orders in the group over the past three months, and so far they have only found seven similar medical orders.

However, only the events on April 29th and the most recent one in May were not covered by medical insurance, as there were third-party responsible parties involved. The other five events were not reviewed or reminded by the medical insurance bureau.

"If you didn't handle it, someone else definitely did!"

"If the other party really has enough power, the penalties imposed on our department by the hospital's medical insurance department will be revoked."

"Honesty and responsibility are what people rely on to make a living." Yuan Weihong calmly gave Fang Ziye a relatively vivid lesson.

Fang Ziye placed his phone flat on the table with the speaker on. He was stirring the grilled meat and side dishes with a spoon in his right hand, while holding a bottle of chilled oolong tea in his left hand, which he held about five centimeters from his mouth.

After a full five seconds of frozen silence, Fang Ziye sighed softly: "Master, if I make a big deal out of this now, wouldn't that be making enemies?"

For pharmaceutical companies to survive, they must have sales, and sales staff must generate orders.

New businesses and new products are never easy in the early stages.

If a medical worker tries your medicine and is subsequently penalized, and your company refuses to take action, then this new company can forget about operating.

The fact that you are fined every time you use it, or even once every ten times, proves that your pharmaceutical company has failed to connect with the entire medical system and that this is unreasonable.

Who would dare to use it then?
In such a situation, the company will inevitably need to engage in public relations. Moreover, products that can get into Zhongnan Hospital generally come from companies with decent public relations capabilities.

It's useful, it's just not covered by medical insurance.

But does that mean drugs not covered by medical insurance can't be used by patients covered by medical insurance? Of course not...

Objectively speaking, its main drawback is not that it is useless, but that it is too expensive.

"Ziye, you'll have to experience this for yourself."

"Even your master can't teach you much."

"However, the reason why Master and Professor Deng often encourage you to do more scientific research is because the money earned from scientific research can be put in the open, cleanly paid for, and there is no shame in talking about it."

"However, money obtained through other channels is more or less tainted by corruption. But the existence of such things actually makes sense to some extent."

Although Yuan Weihong did not teach Fang Ziye how to do things, he still objectively sorted out the ins and outs of the matter: "From a personal point of view, most of the doctoral and master's students in medicine are in their late twenties."

"When you see other people your age earning salaries or other things, you always feel a sense of imbalance."

"But compared to myself, I might need financial support from my family..."

"We cannot support such behavior!"

"But we can't completely condemn someone based on their actions."

Fang Ziye certainly doesn't need to go through these shady and forbidden areas. How many drugs does he need to prescribe in clinical practice to earn the reward for publishing scientific research articles?

This year, Yuan Weihong gave Fang Ziye several hundred thousand yuan. If the ratio were still 5:1, Fang Ziye would need to write out a medical bill for one million yuan.

With this time and energy, Fang Ziye would be better off producing more scientific research output. This would not only allow him to accumulate academic influence and achievements, but also earn him money and various awards.

You can receive scholarships while studying, and after you start working, you can receive research breakthrough awards.

After extracting the keywords, Fang Ziye asked again, "Master, do other groups have teachers supporting the use of this?"

Zhongnan Hospital operates on a professor-led system.

In other words, all issues related to medical quality and medical orders within the group are the responsibility of the professor in charge of that group.

If a professor in the group wants to, he can use whatever medication he wants, and the guidelines cannot be applied to the group; only such medications can be used.

If Professor Han Yuanxiao or Professor Dong Yaohui used this medicine and found it effective and worth the price, then there's a reason why it's expensive.

Therefore, Fang Ziye did not have sufficient evidence to question his superiors.

Raising questions, even to prove them false, would waste a great deal of Fang Ziye's time.

And if such a problem occurs—

If the professor needs it, the hospital's medical insurance department will impose a fine, and hospitalization will always involve it, then Fang Ziye will have no choice but to register it with the medical affairs department!

Fang Ziye couldn't stay in the position of chief resident forever without being promoted.

"I haven't heard of that yet. If you need to communicate with your subordinates, please be a little more tactful and mindful of the appropriate level of communication..."

"If it's at the behest of other professors or superiors in other groups, don't confront them directly. You are the chief resident, that's true, but you're not part of any other group's team." Yuan Weihong drew a line for Fang Ziye.

"Okay, thank you for your guidance, Master. I understand."

"What about Yunwen?" Fang Ziye asked Yuan Weihong again.

"Professor Deng has already dealt with this matter. No matter how other things change, the outcome has already been decided in Zhu Yunwen's personal handling of the situation."

"Does Zhu Yunwen still want to argue?"

“If he can’t provide evidence that his superiors ordered him to write the prescription, he will have to bear the responsibility himself. But if he can provide evidence that his superiors ordered him to write the prescription, then the responsibility lies with our superiors.”

"The graduate programs of Wuhan University and Zhongnan Hospital are extremely protective of their own students."

“It’s just protecting our own, not condoning it!” Yuan Weihong said.

The school is indeed very protective of its own students. Even if you are an intern, your department must do a good job of teaching rounds and weekly case discussions. Otherwise, the Second Clinical Department will come and talk to you directly and veto your department's teaching level.

how to say?

In a teaching hospital, you may not have a lot of publications, but if you don't have the teaching qualification certificate recognized by the clinical college, you won't be able to pass the associate professor hurdle, even if you are a god.

Even in Zhongnan Hospital, there are many deputy directors and even chief physicians who are not qualified for the title of associate professor; your presence alone is not an exception.

Fang Ziye gradually calmed down.

After speeding up his eating, he threw the lunchbox into the trash can in the doctor's office.

He then sat down on one side of the oval desk in the office, began to drink water, and quietly considered the current situation.

During his student years, the only pharmaceutical representatives Fang Ziye could come into contact with were those from a company who would come to him, ask him to prescribe certain drugs, and then offer him a rebate of a certain amount of money.

This kind of thing still exists even after volume-based procurement.

As for the deeper levels, Fang Ziye was not qualified to delve into them in the past.

During the final stage of hospitalization, someone spoke privately with Fang Ziye, hoping that he could lead the resident physicians in his department to use their company's drugs.

For example, if two companies sell the same low molecular weight heparin sodium at roughly the same price, and the price difference between them is negligible, then there is competition.

Moreover, the hospital stipulates that, except in special circumstances, no drug monopoly is allowed.

In other words, in a top-tier hospital like Zhongnan Hospital, commonly used drugs like cefuroxime absolutely cannot be supplied by only one manufacturer!
Fang Ziye had thought about why it was set up this way before, but that wasn't the point.

The key issue to consider now is how to balance the department's medication use with the rational use of medication within our own team.

Yan Zhiming walked out of the doctors' lounge, holding a notebook in his hand.

Five names were recorded above. Three of them belonged to this group.

"Zhu Yunwen, Lan Tianluo, Cao Qiongan."

Fang Ziye glanced at it, his eyes flashing, then his pupils darted around, a hint of doubt in his expression.

What does Yan Zhiming mean by this? Lan Tianluo is involved too? Has this driven him crazy?
Yan Zhiming said, "The patients under Tianluo's care have such medical orders, and the time when they appeared was April 27th of last month."

"However, Lan Tianlu himself said that the patient asked him to prescribe this medicine after seeing other patients with it."

"Lan Tianlu created a new document in the medical record, which is the informed consent form for the out-of-pocket use of this drug."

Fang Ziye's expression finally softened.

Most Chinese people have a herd mentality.

If you're in a hospital ward, and someone else has something that you don't, and that thing is relatively good, you'll naturally wonder: Does the doctor think I don't have enough money and isn't giving me good medicine?

We still have to use it.

"Does anyone else have it?" Fang Ziye pressed.

He didn't personally review all the medical records because it was too time-consuming and laborious. Senior Brother Yan Zhiming and Li Yuanpei could both help, and Fang Ziye didn't mind his fellow students helping him with his work.

There are reciprocal relationships. Last year, even though my senior brothers Wang Yuanqi and Gu Yi didn't get any special treatment from my published articles, Yan Zhiming's name was listed on them.

"No."

Yan Zhiming shook his head: "If only there were. Patients have the absolute right to choose their treatment plan and the right to demand reasonable medications."

"From what I've seen so far, I can't say this drug is bad, nor can I say it's effective; for now, I can only say it's harmless."

"But Jin Huan and Liu Haojiang said that their group uses such drugs occasionally, but it has not become a regular practice."

Xiong Jinhuan is Professor Han Yuanxiao's doctoral student, while Liu Haojiang is the first doctoral student of Associate Professor Chen Fang in Professor Dong Yaohui's group, and is currently a first-year doctoral student.

Professor Dong Yaohui hasn't supervised any doctoral students since Dai Yinsheng graduated, and his senior fellow student Fan Yantong just graduated this year.

Dong Yaohui resigned in June, which may have indicated that he had been considering this move for some time.

"Sigh..." Fang Ziye wished that Zhu Yunwen and Cao Qiongan could find an application form like this, voluntarily requesting the use of 'epidermal growth factor'.

"Ziye, I have something else that is quite important to me."

"Zhu Yunwen said that when the pharmaceutical representative was negotiating with him, he mentioned that this drug was one that he had also authorized to use, and that it was a drug that was routinely used on the surface of damaged wounds in the future."

"He has already discussed it with you, and Zhu Yunwen can be used directly."

“Ziye, as you know, this involves other issues. Zhu Yunwen can’t just ask you directly if he can use it. He might just use it on a whim if he can get something in return.”

"Of course, Zhu Yunwen wasn't making excuses. He already knew he was wrong. His master had punished him by sending him to the laboratory for a year off to reflect on his mistakes."

"But I think we should still pay attention to the issue raised by Zhu Yunwen."

“It is unreasonable for pharmaceutical sales representatives to use our group’s upcoming clinical research for promotional purposes.”

“Okay!” Fang Ziye nodded: “I’ll report this to Master later. Now, let’s check how many times our own group actually used it.”

"You don't need to write down the lists from the other groups. I'll explain them during the meeting later. Those who want to change them can do so, and those who don't, there's nothing we can do about it."

"It's only natural to call Professor Dong Yaohui 'Grandmaster'. It's similar to call Professor Han Yuanxiao 'Uncle-Master'. We're all juniors, so what can we say?"

……

After discovering that three people in his group had prescribed similar drugs, Fang Ziye sent all the statistics to Professor Deng Yong.

Fang Ziye also sent out Lan Tianluo's special case without avoiding any appearance of impropriety.

In official business, Fang Ziye could not show favoritism towards Yuan Weihong's junior brother, so he simply concealed the matter.

If Deng Yong feels that Lan Tianluo also has problems, then they can discuss it in more detail later.

However, whether Deng Yong didn't see it, or felt that the matter could be let go, or didn't want to reply, Fang Ziye never received a response.

Fang Ziye couldn't possibly take the initiative to call and urge them.

At 3:20 p.m. that day, after Fang Ziye had organized, filed and signed all the discharge medical records, two unexpected guests appeared in the department.

One was the young man who had sent Fang Ziye the "materials" that morning, and the other was a middle-aged man who appeared to be of a higher rank. When they were at the office door, the young man said to the middle-aged man next to him, "Mr. He, this is Professor Fang. Our product was used in the trauma surgery department and was found by the medical insurance bureau, which specifically named and warned us."

"The issues with the other teachers have been resolved, but the influence of the other teacher still cannot be suppressed or reversed."

Upon hearing this, the two entered, expertly closed the office door, and were about to lock it from the inside.

Upon seeing this, Fang Ziye sprang up from his chair and began unbuttoning his white coat, revealing his powerful muscles!

With a tense expression: "What do you want?"

As everyone knows, once they take off their white coats, they become ordinary citizens of China and can legitimately defend themselves!
Under such circumstances, even if a video is filmed and uploaded online, it won't be widely disseminated...

Mr. He was overweight, while the young man was thin as a rake, wore glasses, and had a "rogue" style but also looked somewhat cultured.

They didn't seem particularly strong in combat, and Fang Ziye felt he could handle two people at the same time!

At the same time, just to be on the safe side, Fang Ziye planned to start making phone calls to recruit more people.

Next door, most of the people in my group hadn't left; they were all resting in the doctors' lounge.

Seeing that Fang Ziye was about to make a phone call, General Manager He immediately said, "Teacher Fang, don't misunderstand. We are all good friends. We are not the patient's family members, nor are we here to cause trouble."

"Professor Fang, I'm really sorry. I've been wanting to have a meal with you for a while, but you've been too busy and we haven't had a chance to meet."

"So, Xiao Dong only talked to some of the younger colleagues in the department."

"Actually, Professor Fang, you may not be very familiar with our products. We really do make products in a down-to-earth way. Our products have undergone many clinical trials and have been certified by many clinical doctors before they were able to be launched on the market."

"There are quite a few positive reviews now..."

Fang Ziye raised his hand to interrupt, pointing to the office door: "Um, excuse me, the hospital's regulations are posted at the door."

"Pharmaceutical representatives are prohibited from entering the hospital's office area."

"Please have some self-respect. Besides, even if you want to chat, this isn't the place for that. I'm a bit busy right now." Fang Ziye's tone was somewhat cold.

Even the person addressed as "General Manager He" could understand: "Teacher Fang, don't be angry, is this alright?"

"I'll just say a few words."

"Four sentences at most, then I'll leave."

Then, without waiting for Fang Ziye to speak, General Manager He said directly, "Teacher Fang, your punishment has been finalized, so it's not easy to correct it for the time being, but our company is willing to provide some reasonable compensation."

"We can discuss the compensation plan in person."

"Secondly, Dr. Fang, please don't make things difficult for the other doctors in the department. Being a doctor is very hard work. You've been through it yourself, so you should know how hard everyone works and be more understanding."

"Thirdly: I sincerely hope that you, Professor Fang, can have a meal with us, just to make friends."

"Fourth, Mr. Fang, actually our company has always hoped to win people over with quality and virtue, so we have never told you, Mr. Fang, that Chen Guangbai is actually our boss."

Upon hearing this, Fang Ziye's eyes flickered slightly.

"Excuse me, but no matter who you mentioned, please leave, okay?"

"This is the office."

Upon hearing this, and seeing that Fang Ziye seemed rather unyielding, the two could only walk towards the door for the time being.

The moment the two left the office, Fang Ziye's expression changed.

Chen Guangbai is no insignificant name. His subordinates have caused many medical workers to lose their families and lives.

The son of the old Chinese medicine doctor, Teacher Chen, whom I've heard of many times in Enshi, is Chen Guangbai.

Then, Fang Ziye's expression began to relax.

After all, this isn't Eunseol, this is Hanseol.

No matter how big Mr. Chen's company becomes, there are several strong competitors in Zhongnan Hospital, and it is impossible for him to monopolize the place.

Any opening will be exploited by other companies, which will then squeeze Mr. Chen's company out of Zhongnan Hospital and even the entire city of Wuhan!

Therefore, relatively speaking, this place is safe.

However, no matter what, I must be extra careful about this matter and absolutely cannot be careless.

……

The time finally came to six o'clock in the evening.

Fang Ziye also spent his first day shift of the inpatient rotation smoothly in the department, without any emergency cases.

"Most of the people have arrived, and those who haven't arrived have basically all asked for leave."

"Start taking orders now!"

"Meetings are meetings, personal relationships are personal relationships. If you haven't eaten, just say so, and I'll order you all boxed lunches. Of course, even after I've treated you to boxed lunches, those who need to work still need to work, those who need to attend meetings still need to attend meetings, and those who need to be criticized still need to be criticized!"

"Jinhuan, Yuanpei, and Brother Haojiang, please take the count. I'll now begin today's topic."

As Fang Ziye spoke, he unfolded his PowerPoint presentation.

book.

"Trauma surgery medical orders implementation system and medical insurance management system."

"Zhu Yunwen, Lan Tianluo, you two stand up and listen!" Fang Ziye immediately targeted his two junior brothers as his first target.

Lan Tianluo was completely bewildered, but he knew that Fang Ziye was using him as a scapegoat. What else could he do?
Be a good chicken.

I walked to the last row of the demonstration room and stood on either side.

"Before we officially begin, I want to make a statement: if you guys treat me like a brother, I will definitely treat you with enthusiasm, so that everyone can benefit from it."

"But if you insist on treating me like a traitor, then I'm sorry, but none of us will have an easy time from now on."

"Those who know Fang Ziye know that he is not a petty person, but those who know Fang Ziye also know that he is not a spineless coward."

"Everyone here is a smart person, so I'll stop here for now."

"Now, let's officially begin our learning meeting."

"The principles of perioperative treatment and medication regimens in trauma surgery is a very broad topic, and today we will only choose one aspect to study..."

Fang Ziye has also started to resort to other methods.

Punishment, making an example of someone to scare others, and demonstrations are fundamental, but the means of expression are still to teach people something, some fundamental principles.

I can't just tell you outright, "Don't mess things up for me."

As a superior, your job is to teach your subordinates how to prescribe medication properly and why it should be done this way, using the guise of learning to correct any malpractices.

After speaking for about half an hour, Fang Ziye said...

"Okay, that's all for the first half. I might have been a bit harsh earlier, please understand. Your Ye-ge and Xiao Ye haven't been in a good mood lately."

"I finally made it through almost three months as a chief resident, and I thought three months had passed, but it turns out I still owe three months. I just can't feel good about it." Fang Ziye jokingly recounted his struggles!
It's all because of your crazy actions, guys! My chief residentship has been extended from one year to a year and a half!

You guys are so kind!

Few people could accept what Fang Ziye said.

Yan Zhiming decisively said, "We're all adults, so we won't call anyone by name."

"You all know in your hearts who Ziye was implicated by."

"Let me just say this: while Ziye was fighting for his brothers in front of everyone, you guys stabbed him in the back. That's worse than eating human blood!"

"What kind of opportunity is an emergency trauma center? Does it really have to be discussed openly?"

"Is this really just a coincidence? Can you guys use your brains for a second?"

“In previous years, the orthopedics department would recruit a maximum of two people and five subspecialty divisions per year.”

"Starting next year, the orthopedics department will likely recruit two to three trauma surgeons annually on a regular basis!"

“If you can’t even understand this, then your path has come to an end.”

"I haven't talked to you about these things before, but I hope you can use your brains and think about how to improve yourselves, instead of thinking about crooked ways!"

Yan Zhiming's words were a bit harsh.

Actually, it's not very appropriate for someone to say something like that!
Currently, Han Yuanxiao holds the power to manage personnel in the ward, while Lu Zhefu, Han Yuanxiao's student and Yan Zhiming's classmate, has not yet spoken.

Many people lowered their heads.

Cao Qiongan, who was not an orthopedic surgeon, said in a low voice, "Didn't they say that everything was resolved?"

"That means your problem has been solved!!" Yan Zhiming glanced at him.

In this whole affair, only Cao Qiongan acted as if nothing had happened; the others...

Fang Ziye and Zhu Yunwen are both truly at a disadvantage!
Professor Han's group and Professor Dong's group may have encountered similar problems, and although they were alerted, no special measures were taken.

That's why the hospital singled out Fang Ziye to make an example of him on another platform.

Cao Qiongan lowered her head and did not argue.

At least the higher-ups aren't pursuing the matter, so Cao Qiongan has no other problems.

He's a gastrointestinal surgeon; he should just stay in his department for the rest of May and then go back to his own specialty.

As for whether Fang Ziye will be punished or not, there's nothing he can do about it.
……

It was around seven o'clock.

Fang Ziye then received a relatively confidential message.

In fact, the fact that this drug was approved by medical insurance had already appeared in March, but at that time the medical insurance department only sent an OA message to individuals and did not publish it on the surface.

However, this kind of thing has always been kept secret, so Fang Ziye didn't have the authority to find out even if he wanted to.

Once it erupts, it will be Fang Ziye's whole mess!

Chief Resident, what a terrible traitor.

Fang Ziye glanced at the message and continued his lecture: "The postoperative medical instructions are based on these principles, which are mainly about pain relief, anti-infection, anticoagulation, rehabilitation, nutrition, and so on. Let's learn about them one by one..."

Around eight o'clock.

Fang Ziye then said, "That concludes our lesson for today."

"Starting today, I am announcing a new rule."

"Perhaps my residency was too tiring, and the workload was too heavy. I may have misallocated the tasks before."

"To reduce your burden, emergency surgery shifts will be canceled from now on. I will handle all emergency surgeries myself. You only need to do regular ward shifts and complete the elective surgeries within your group. That will be considered fulfilling your ward care duties."

After saying that, Fang Ziye also looked at Li Yuanpei and Liu Haojiang: "The duties of the supervising chief resident have also been narrowed from running around to consultations to being in charge of revising the medical orders and medical records of the group."

"No need for a consultation, I'll come myself!"

"From now on, you don't need to wait for emergency surgery calls anymore."

"That's it!" Fang Ziye said, closing the laptop lid and stuffing it into his bag. He then turned around and said arrogantly and coldly, "Lan Tianluo, turn off the computer, pack up the classroom, and then go home!"

Resident physicians are only authorized to write medical records and assist with elective surgeries.

To obtain emergency room operation privileges, authorization from the chief resident is required.

Of course Fang Ziye wants to take it back!

Fang Ziye took responsibility and made these minor procedures and consultations more open, but others stabbed him in the back. Fang Ziye still had to continue to work hard without complaint.
SM?

To hell with what people say!

At least, if his fellow disciples in his own group did something awful, Fang Ziye could hit them, scold them, or, if all else failed, complain to their master.

The junior students from other groups who did these things could only keep it to themselves.

To criticize someone else's students is to criticize that other professor for not doing their job and failing to fulfill their duties as a teacher!
Alright, then I won't trouble your students.

Emergency care, emergency consultation, and consultation are powers and conveniences granted to chief resident doctors by the hospital. Chief resident doctors have the authority to assign corresponding tasks.

In the demonstration room, many people looked at each other and fell silent.

However, Yan Zhiming and Li Yuanpei silently got up and left first...

This matter would certainly have been resolved at other levels, but for Fang Ziye, it was only resolved at this time.

Xiong Jinhuan had a bitter smile on his face at this moment, as he had a bitter experience he could not express.

He's numb.

Professor Han Yuanxiao went to so much trouble to find Fang Ziye a mentor, and he lost the opportunity!
However, that very evening, Xiong Jinhuan discovered that Fang Ziye had practically tricked her into opening her mouth...

(End of this chapter)