Doctor of Healing

"Can you handle other emergencies?" Director Bai asked a question that he thought was ridiculous.

But at that moment just now, the sixth sense told Director Bai that Ji Xiang would definitely be able to handle it.

"Director Bai..." Ji Xiang shuddered, his thoughts flashed, recalling what he had done, but he couldn't find any flaws, "I'm still a regular training doctor."

"Okay, go back and rest." Director Bai said, "Come to me if you have any clinical problems."

……

……

Ji Xiangpin smacked Director Bai's words, and he was not in a hurry, and he didn't go home directly, but came to the emergency department.

"Teacher Meng, I'm back."

Meng Qingfei was sitting in the consulting room looking at his mobile phone, and Ji Xiang walked in and spoke.

"Oh, I'm back." Meng Qingfei smiled, "Did the operation go well?"

"Successful." Ji Xiang didn't brag, but replied flatly.

"That's good." Meng Qingfei didn't ask further.

"Teacher Meng, I want to ask you a question." Ji Xiang asked the question just now again.

In the dead of night, it's time to speak your mind.

"Oh, I don't know much about the blood bank, but what Director Bai said makes sense." Meng Qingfei said, "I'll give you an example."

"We often encounter rupture of the spleen in the emergency department. When we see it, we quickly send it to the liver and gallbladder to cut the spleen, which can save our lives. Although the operation is not difficult, it is a life. Now the question comes-how much is a spleen rupture operation."

Ji Xiang was taken aback, he had never thought about money.

"350 yuan, this is the price after raising the price 2-3 times under the premise of increasing doctors' income in recent years."

"..." Ji Xiang spread his hands.

In the operating room, he asked the patient whether he needed coils or gel sponges, because the system NPC had mentioned it, so Ji Xiang mechanically remembered it.

Now when it comes to the operation fee for spleen rupture, this topic is very strange.

"350, you go and start...you know the start."

"do not know."

"There is a large hairdressing chain store in our provincial capital. I used to go there, but then I couldn't stand the price increase. It costs 50 yuan to cut a small crew cut, 350 yuan. If you can get a haircut, you can only do a simple female hairstyle."

"A life, and a woman's hairstyle, well, that's how ridiculous it is."

Ji Xiang was speechless.

"I haven't finished talking yet. The 350 yuan needs to be deducted from the operating room equipment, conventional surgical equipment, coal, water, electricity, and electricity. The rest is the labor cost of all the doctors and nurses on the stage."

"In terms of conversion, it is possible that this bunch of people will lose money even if they come to power."

"Losing money?"

"Yes." Meng Qingfei nodded, "Actually, it doesn't matter, according to the regulations, the state will invest, but there is no profit margin for medical staff.

A certain field department can earn so much money by taking so much share of domestic medical care.If you transfer to a private hospital in an all-round way, can you imagine?Do you dare to think? "

"Teacher, do you want to transfer to a private school?" Ji Xiang asked a sharp question.

"I don't want to." Meng Qingfei shook his head, "I have been washed by Liby for countless times over the years."

As he spoke, he pointed to his head.

"Let's just make do with it. Treat illnesses and save people, and earn some money to support the family. It's good."

Chapter 300

"Don't think too much about this kind of thing. If you think about it, you can't understand it. Our medical system is a suture monster. If you want to learn from the United States, you can't be ashamed to play Sheda." Meng Qingfei said, "If you play universal medical insurance, free medical care will go back to three. On the old road 40 years ago, the technical level was inherently low, and it was very scratchy.”

"It's so difficult." Ji Xiang listened in a mixed manner.

"It's okay, as long as you don't want to, just do the job at hand." Meng Qingfei said, "During major surgery, the surgeon's labor fee is 39 yuan per hour, which is still the price after the price increase."

"It's less than 40 yuan an hour, who wants to pay for this surgery, right?"

"Too."

"The inpatient manager of your department pays 20 yuan for a night shift. You have to order meals on duty, and you lose money for each shift. My buddy resigned and went to Shanghai to work in an American-funded hospital."

As he spoke, Meng Qingfei's eyes showed envy.

It is rare for Ji Xiang to see Meng Qingfei express his heart so bluntly, especially the envious expression in his eyes, which is not fake at all, full of overflowing.

"The year before last, he was on duty for a New Year's Eve shift. How much do you think he paid for the night shift?"

"Five thousand." Ji Xiang said.

"Fifty thousand!" Meng Qingfei raised his voice and said.

"..."

"If you want to say how high his level is, why don't I believe it. The main thing is the platform, the platform. The Second Affiliated Hospital is still pretty good, you go to the grassroots to see, even more so." Meng Qingfei said.

Ji Xiang agrees with this.

For the old man who ate grapefruit, Meng Qingfei knew what was going on at a glance, so he took the time to call the patient's family.

This kind of experienced doctor is sinking on the front line, unable to earn money, and can barely maintain a simple life.Meng Qingfei even reported that he had to rely on other jobs to make ends meet.

"Mr. Meng, can't the price be set higher?" Ji Xiang asked.

"The lower the price is, the more it can protect the interests of patients and reflect the public welfare of the hospital." Meng Qingfei said with a smile, "We are a public hospital, and the price directors, health administration, human resources and social security departments set the price .

In other words, a group of laymen are setting prices, but you can't do anything about them. "

Ji Xiang was speechless. He always felt that this kind of system could not last long, but it happened to be the industry he was engaged in, and after so many years, it still stood firm.

"I've researched the details. To put it bluntly, it's the state's investment. But in recent years, the investment has been reduced, so let's just maintain it, and don't want so much." Meng Qingfei said, "The medical insurance will also be empty. These are all related to blood. It’s almost the same station, so don’t be surprised if you see any strange things.”

"If the local finances are good, the income of doctors will be high, and the level of medical care will be more developed. Our side will die sooner or later. If there is no money to invest in medical care, there is no way, right?"

"Now it's boiling frogs in warm water, not only in the medical industry, but also in other industries. I can't see it, but you have to prepare in advance."

As he said that, he was amazed, "Director Bai is really a talented person. In a dead end, Director Bai will not offend anyone. Zhongzheng pushed forward peacefully. Let me tell you, if there is no Director Bai, Professor Deng from the Department of Orthopedics has memorized it."

"Ring ring ring ~~~"

The phone ringing at the nurse's station was so clear in the cold night.

Ji Xiang clearly saw that Meng Qingfei's body trembled, the flesh on his face trembled a few times, and he was obviously taken aback.

Even Ji Xiang could hear the fast thumping sound coming from Meng Qingfei's chest.

The phone ringing in the middle of the night on the emergency night shift really caused Meng Qingfei infinite psychological harm.

Meng Qingfei didn't move, but Ji Xiang saw his ears move twice, like an antenna erected 2-3mm, to listen to the voice of the nurse who answered the phone.

"Brother Meng! The 120 of the Hospital of Traditional Chinese Medicine sent a patient, saying that it was acute myocarditis."

After hearing the diagnosis, Meng Qingfei was not nervous, but relaxed.

"Mr. Meng, acute myocarditis is a very serious disease."

"Damn, it doesn't matter to us whether it's serious or not. I'm most afraid of a big car accident. I have to be rescued. I don't think I can sleep. The person on duty is ten years old.

Besides, acute myocarditis is an internal medicine disease, so I'll just take a close look at the internist in the class and let her deal with it.If it's really troublesome, you can wake her up, it has nothing to do with us. "

As he spoke, he stroked his chin.

"The kind of class that encounters a big car accident in the emergency department, the beard grows an inch."

That's what he said, but Ji Xiang noticed that Meng Qingfei didn't call the Department of Cardiac Surgery and Circulatory Medicine to ask the hospital chief to come down, but got up and "greeted" the patients in the corridor.

"Mr. Meng, why don't you find the hospital manager?" Ji Xiang asked.

"Doctors in lower-level hospitals are unreliable." Meng Qingfei said "arbitrarily", "I have to see with my own eyes."

"Unreliable?"

"About a year ago, it was a similar situation. A patient was referred from a lower-level hospital and said it was a tension pneumothorax. The patient was sent to see that the condition was normal. I was about to be auscultated, and the doctor from the lower-level hospital handed over a 50ml syringe. Let me do the piercing."

"and after?"

"Later? I went straight back. If you were so clear, why didn't you put a syringe in the 120 ambulance by yourself." Meng Qingfei said contemptuously.

"Hahaha." Ji Xiang laughed, what he said was too straightforward, with the taste of a superior doctor.

"Actually, the patient vomited and inhaled after drinking too much. I brought a Heimlich, and it will be fine soon." Meng Qingfei looked at the end of the corridor, and said leisurely, "If the doctor in the lower-level hospital said that the pneumothorax should be opened immediately, and it will be cured immediately." Proper medical malpractice."

"They're cheating, they don't know what to do, and they tricked me into doing it."

Just as he was talking, the siren of the 120 ambulance came.

Out of the corner of Ji Xiang's eyes, he saw that although Meng Qingfei didn't move, his whole demeanor changed, solemn and solemn, and there was a faint sense of austerity in his body, like an autumn soldier on the battlefield.

The flat cart pushes the patient in, followed by doctors and nurses carrying first aid kits.

"What's going on?" Meng Qingfei asked.

"The patient caught a cold 2 weeks ago and has not recovered. This afternoon, he suddenly had severe chest pain. He is considering acute myocarditis!" the 120 emergency doctor said hastily.

The report of the medical history is not bad, and the key points are not wordy at all.

Unfortunately, Meng Qingfei didn't believe it.

The first time he took an EKG, looking at the warm paper spit out from the EKG machine, Meng Qingfei glanced at Doctor 120.

"Let's go back."

"All right?" Doctor 120 was taken aback.

"Of course." Meng Qingfei said, "Heart rate is slightly fast, 112 beats per minute, but it is sinus. The ECG changes of acute myocarditis generally include various arrhythmias, conduction blockage and non-specific ST segment elevation, T wave inversion and QT The interval is extended."

"There are no indicators of acute myocarditis, how did you diagnose it?"

Chapter 301

The 120 emergency doctor was a little ashamed.

"Diagnosing myocarditis just because of a cold that doesn't heal? Go back quickly." Meng Qingfei waved his hand and pushed him away impatiently.

"Doctor Meng." The 120 emergency doctor glanced at Meng Qingfei's badge, and said embarrassedly, "Let me know the result."

After speaking, he left a contact number.

Meng Qingfei didn't refuse. He wrote down the phone call and started the physical examination.

The patient is a 32-year-old male, 176cm, about 65kg.

He complained that he had dinner with his colleagues at 12 o'clock noon, and after drinking half a glass of white wine, he developed chest pain, chest tightness and discomfort, and vomited.

Physical examination: heart rate 102 beats/min, blood pressure 154/103mmHg, and no positive signs were found in other physical examinations.

The patient was in poor spirits lying on the bed. Although his vital signs were stable, he seemed to have a serious problem.

After Meng Qingfei asked about the medical history and had a physical examination, he stood beside the patient and did not speak. Ji Xiang noticed that his right hand fingers were constantly pinching like a fortune teller.

The thumb quickly taps on the other fingers. If the other hand is equipped with a mahogany sword and the mouth is chanting, the taste will come.

Ji Xiang was very curious about what Meng Qingfei was doing.

Although the patient looked uncomfortable, he was not in a hurry, so Ji Xiang didn't go to the operating room of the system.

After calling for other tests, Meng Qingfei briefly left the emergency room and returned to the consulting room to meditate.

"Mr. Meng, can I bother you?" Ji Xiang asked.

"Tell me." Meng Qingfei's fingers were still pointing.

"You are..."

"Differential diagnosis." Meng Qingfei said, "The patient has had chest pain for nearly 12 hours, and the pain is so obvious, there is a high probability that there is an organic problem."

"Differential diagnosis one, aortic dissection.

In general, patients with chest pain accompanied by elevated blood pressure should first rule out aortic dissection.

However, the difference in blood pressure of the left and right upper limbs of the patient is not large, and the dissection pain is generally tearing or knife-like. It can be ruled out by completing the relevant examinations of the abdominal great vessels, and performing a CTA examination of the thoracoabdominal aorta if necessary.

Now that the enhanced CT is off work, I can't check it, so I won't consider it for the time being. "