Chapter 38: Outpatient Consultation
Translator: EndlessFantasy Translation Editor: EndlessFantasy Translation
The provincial hospital was a large-scale, tertiary, grade A general hospital that was on an equal footing with Yun Hua Hospital.
In other words, they were both reputable tertiary grade A hospitals.
Hospitals had a siphoning effect[1].
Everyone would think of going to the best hospitals. That also included those who held positions at the top.
So, the premium provincial hospitals would be able to get the best financial support from the province’s health finance departnt. The city’s tertiary grade A hospitals would be able to get the greatest financial support from the city’s Departnt of Health Care Finance. County-level tertiary grade A hospitals would be able to get the greatest financial support from the county’s Departnt of Health Care Finance. If this county-level city had a tertiary grade A hospital…
Under such circumstances, the Matthew Effect[2] was particularly evident in hospitals. The strong would grow stronger, while the weak would grow weaker. Better hospitals would be able to obtain more advanced facilities and keep excellent doctors in their hospitals.
Among the 1,300 tertiary grade A hospitals throughout the entire country, there were only 44 governnt-funded hospitals such as Union, Xiangya, West China Center of dical Sciences, Zhongshan, Fudan, and so on.
Based on that alone, Departnt Director Huo Congjun of Yun Hua’s Ergency Departnt and Chief Physician Qi Zhenhai of a provincial hospital’s Ergency Departnt were among the best in the dical field of Changxi.
Both of them were masters when it ca to determining the degree of burn wounds, and they had ‘communicated’ with each other more than what other people would think.
However, procedures for formal outpatient consultation were complicated, and such events only beca easier to organize if there were unique public incidents, such as factory explosions, or the entire dical cadre was required to perform health care assignnts.
Qi Zhenhai was most eager for such an opportunity. He did a ward round and perford one surgery in the morning before he changed into his outfit for a journey and rushed straight towards Yun Hua Hospital.
He had been slated to beco a chief physician when he was just forty years old. It was a young, early age—one that was full of promise.
He had also dressed himself in a way that made him look younger than he was. While the elder doctors donned white coats and fought to create their own empire, he got into T-shirts and dress pants whenever he left the hospital.
The only thing that worried him was the fact that the number of wrinkles on his face were increasing day by day. His body which slacked off from physical exercise had started packing on pounds. His belly would grow if he was not careful. If he wore the white coat like a departnt director, perhaps he could still try to cover it up. But Qi Zhenhai was not willing to fall to that.
It was too old-fashioned. He would not be able to show his young and promising side.
Currently, what troubled Qi Zhenhai the most was his departnt director.
Hospitals were unlike governnt agencies. The path to promotion was extrely narrow. A departnt director would remain in the sa position until retirent arrived, unless he could get promoted to be the associate hospital director, or get transferred, or perhaps even get poached by other hospitals.
So departnt directors were not willing to leave their positions as departnt directors, even once they have been promoted to beco associate hospital directors. And so, so young and promising departnt directors remain in the sa position for over twenty years, smothering the doctors beneath them to the point of suffocation.
Qi Zhenhai could not afford to wait for the Director of Ergency Departnt to retire. So, he had been aggressively promoting the founding of a Burn Center, thinking of stepping out independently to be his own boss.
This additional challenge was probably the reason his wrinkles ran so deep. Because of that, no one could actually tell that the age difference between him and Huo Congjun were only ten years apart.
“I was thinking of holding another case discussion when I received a consultation call from your Yun Hua Hospital. I have also brought cases from my hospital along with . Let’s have a look together.” Qi Zhenhai was speaking about dical records that had been assigned to the provincial hospital.
The factory explosion incident was a tragedy to the wounded workers and a loss for the factory. For Qi Zhenhai, it was, in fact, a rare opportunity. If he could prove his position in the field of burn wounds, it would be easier for him to establish his Burn Center.
“We can discuss this in private if we still have ti after the consultation.”
Huo Congjin did not seem to be in the mood for politeness.
‘Take a look together? That is probably him trying to show off, right?’
Huo Congjun glanced at Qi Zhenhai out of the corner of his eyes as he thought to himself. ‘Let’s see if you’ll be this eager for our private conversation once I’m done.’
“Let’s head in. It is almost ti.” Huo Congjun was not in the mood to talk. He only announced his arrival before he got back into the eting room.
At that mont, the young doctors of the departnt were arranging chairs. Once they were done, they sat around the room, allowing the chairs around the eting table in the middle of the room to be unoccupied.
Huo Congjun had picked the far corner that faced the door and sat down in a regal air.
The other two chief physicians and four associate chief physicians sat by his sides. The solemn atmosphere generated by a total of seven specialists in the departnt room started clouding up the room.
Qi Zhenhai casually picked a chair in the middle and sat down, completely unbothered by Huo Congjun’s attack. Then he instructed the resident doctor who ca with him to put the dical records right before him. He smiled and asked, “Hasn’t Departnt Director Liu from the People’s Liberation Army General Hospital arrived?”
“Sothing happened to a patient of his. But he’s already on the way.” Doctor Du was in charge of keeping the communication lines opened. He gave them the relevant information.
Qi Zhenhai laughed and said, “Then let’s wait for a while. The factory incident is rather serious. It’ll be like a three-judge trial[3].”
Huo Congjun did not make a sound. The other doctors remained silent. The atmosphere quickly beca awkward.
Qi Zhenhai remained unconcerned as he straightened his clothes a little to cover up his bulging tummy and continued to wait quietly.
Hospitals the likes of Yun Hua and provincial hospitals were not fond of outpatient consultations in the first place. Naturally, no consultation session would be held in festive spirits.
Due to the difference in status of county or city level tertiary grade A hospitals as compared to provincial level tertiary grade A hospitals, outpatient consultations held by county or city level hospitals were actually organized due to their need for assistance, and it was more aningful to them.
Of course, county-level tertiary grade A hospitals were also unwilling to engage in outpatient consultations through conventional ans. They had been privately contacting and roping in foreign aid. If they were going to pay anyway, it would be much easier if fewer procedures stood in the way.
“Opps. Sorry. I’m late, I’m late.” The sound of the doors flying open shattered the tense atmosphere in the office.
The person who ca through the door was an old doctor with a square face. There was an old fashioned stethoscope hanging on his chest, and it seed as if the doctor hung it there like an accessory, sothing like a pocket watch.
Huo Congjun stood up to greet him.
“Departnt Director Liu, have you handled the patient?”
“Declared him dead.”
Departnt Director Liu’s expression did not change.
Ling Ran sat in a small corner as he turned his head over and took a glance at Departnt Director Liu.
People dying in a big hospital was a normal occurrence. Only a handful of modern people would have their lives end quietly and peacefully in their own hos. They would usually only completely give up on hope for living after all treatnts from hospitals failed.
However, Departnt Director Liu’s casual manner of speech when it ca to death was still rather uncommon, even by modern standards.
Among the doctors who were sitting in a circle with their backs facing the office table, the expressions of the attending physicians were the calst. On the other hand, the expressions of the young resident doctors varied widely. So of them were familiar with Departnt Director Liu’s words, and those were the senior resident doctors. Others were unaccustod to Departnt Director Liu’s words—junior resident doctors who had just completed their housemanships. There were even so who were not even concerned with the conversation in the middle of the eting room.
“Everyone is here. Let us begin then.” Huo Congjun returned to his seat and opened up the dical records.
After years of improvent, the consultation system had beco much more organized.
Especially when it concerned outpatient consultation. Its ticulousness was uncannily similar to the country’s military education and training[5]. Its importance was also equal to the country’s military education and training. Both were equally troubleso and appeared to be useful, but was in truth, completely useless. Nevertheless, the higher-ups still loved checking on how doctors conducted these outpatient consultations.
Doctor Du stood up and switched on the projector. Then he began reading the powerpoint slides.
Huo Congjun turned his chair around. His eyelids slid down while he listened. He appeared to be asleep, but was not. He paid no mind to how he appeared to others.
Qi Zhenhai was fueled with excitent. His eyes were wide open. He was relentlessly criticizing certain aspects of the dical cases in his heart.
Departnt Director Liu perford the routine. His eyes seed to be both focused and unfocused, and his mind wandered. He seed to be unconcerned, since this had nothing to do with him.
“So, this is the situation. The burn areas of the two critical patients were pretty substantial. But basically, everything is under control. The lesson of the day is to not repeat the sa thing.”
Huo Congjun sounded as if he was giving out dical advice to the doctors working under him.
That attitude established the tone for the outpatient consultation on that day.
Qi Zhenhai could not help but feel a little disappointed. How was he going to show off his talents if there were no critical cases?
“We still can’t let down our guard when it cos to patients with 80% burns.”
Departnt Director Liu paused for a mont before he gave his comnt.
“Soone must be with the patients at all tis. I suggest delegating so manpower into that.”
“We have assigned Doctor Du to this case…” Huo Congjun said.
“Too old, he won’t keep up,” Departnt Director Liu said bluntly.
“For a burn patient, complications can happen at any mont. To have burns on 80% of their bodies—heart failure, renal failure, shock, toxemia, anything can happen to the patients. Assign a younger attending physician, and it’ll be best if he can keep his eyes on them twenty-four seven. Assign the person on duty for a full month. See if we can save both of them.”
The factory explosion was the focal point of the entire city. The doctors needed to be handling the cases cautiously and take everything that could happen to the patients into consideration. Finances should be their secondary concern.
Huo Congjun was taken aback for two seconds before he nodded and said, “Alright, we shall see to it.”
Huo Congjun and Qi Zhenhai were both experts in the Ergency Departnt. They both achieved greatness when it ca to burn wounds. However, when it ca to handling details, they were no match to Departnt Director Liu, who had firmly sat on the throne in the Trauma and Burn Surgery Departnt for many years.
Departnt Director Liu was very indifferent.
“As more patients give up their lives for our learning, our thods grow more innovative. Today, I discovered the pulmonary embolism[6] far too late. Otherwise, I would have straightaway applied heparin, regardless of the potential outcos… forget it, let’s not talk about it now. Let’s only talk about it again during the autopsy. Hmm, old Huo, if there’s nothing left, I’ll head back now, alright?”
“Don’t mind it. It’s not easy to co over here. Let’s talk about another dical case.” Huo Congjun let out a deliberate cough. Doctor Du picked up the remote control and started playing a video.
On the big screen, Ling Ran plunged his hand into a patient’s abdon.
Note:
1. Siphon effect: An effect where atmospheric pressure pushes the liquid up, and gravity pulls the liquid down. In the text, it ans that the strong attraction of the host city (where there are hospitals) attract investnt from other places, thus slowing down the developnt of other areas.
2. Matthew Effect: An effect where the rich get richer, and the poor get poorer.
3. Three-judge trial: A scenario where highest-ranking chiefs of three departnts were handling the sa case at the sa ti and the sa location. Known as public security, procuratorial, and court based on today’s departnt. It usually is held to handle significant cases, or conventional and sensitive parts, such as a case in a royal family.
4. Military education and training: Is a fundantal form of higher learning covering defense education as required by The Military Service Law of the People’s Republic of China and The Decisions of the Central Committee of the Communist Party about Education System Reform.
5. Pulmonary embolism: Is a blockage of an artery in the lungs by a substance that has moved from elsewhere in the body through the bloodstream. Symptoms are like shortness of breath, chest pains, coughing up blood.
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