Director Qian called Nong Zhiwen and said that beds were too tight and he would have to wait for another two or three days. He asked Nong Zhiwen to bring his father's medical records to Annex 4 to find him now. He wanted to talk to Nong Zhiwen in detail about him.
Regarding my father's condition, I had to communicate some things in advance so that when the time came to be hospitalized, the surgery could be performed immediately, thus saving time and cost to the maximum extent.
So Nong Zhiwen immediately took the information to Director Qian. After all, Director Qian was the one who performed both surgeries, and he knew his father's condition best.
In the office of the director of the General Surgery Department of the Fourth Affiliated Hospital, Nong Zhiwen met Director Qian. Director Qian politely asked Nong Zhiwen to sit down and poured him a glass of water.
"Small farmers, if you wait patiently, there should be a bed in two days. Your father's current situation is like this. The results of the first two surgeries are very good." Director Qian said sincerely.
"Thank you, Director Qian. Later reexaminations showed no signs of recurrence," Nong Zhiwen said gratefully.
Director Qian thought for a while and said: "Well, as a malignant tumor, the effect of this kind of surgery is very rare and we should cherish it. So this time, in addition to repairing the recurrent laryngeal nerve, more importantly, we will perform some intensive treatment on the tumor. In fact,
Repairing the nerves is secondary, neurological symptoms are life-threatening, and it is crucial to strengthen the treatment of tumors, otherwise all efforts will be easily wasted."
"Director Qian, what do you mean?" Nong Zhiwen understood.
Director Qian paused and said, "This time we need to carry out targeted treatment. The overall cost is estimated to be relatively high, almost more than 50,000 yuan. I don't know how prepared you are?"
More than 50,000 yuan, I only prepared 20,000 yuan, and Director Fang of Sanbo Hospital said that it would not cost much, and the total cost was only more than 20,000 yuan. If you have medical insurance, the out-of-pocket portion may not exceed 10,000 yuan.
"Sanbo Hospital said it was more than 20,000?" Nong Zhiwen said awkwardly.
"Twenty thousand? That's what they told you? It's so irresponsible, really, so irresponsible! No wonder, they didn't do the surgery, they simply repaired your nerves without considering the treatment of the tumor at all.
The most important thing is the treatment of the tumor. If it is not treated properly and thoroughly, if it recurs, all the previous efforts will be wasted, which is really perfunctory."
Director Qian said angrily.
"Well, considering your actual situation, we will help you find a way to save some money, and try to control it to around 50,000. What do you think? The main reason is that you need to use some targeted therapy drugs after the surgery, so that the effect will be good.
You see, the postoperative results are now very good, and there has been no sign of recurrence. It is best to use targeted therapy drugs for a period of time. They are more expensive, but they can send the disease farther away. Targeted drugs are at your own expense and cost.
It's twenty to thirty thousand, and this is the bulk of it. Your father has already spent so much money. Don't care about this little money, and don't lose a big deal for a small amount. Once it relapses, all our previous efforts will be in vain. You should think about it yourself."
"Look, no one can guarantee whether these abnormal signals here are residual tumors, so it's best to use targeted drugs to clean them up."
"You must not go to that Sanbo Hospital again. There is no such thing. It doesn't consider the patient's condition at all. What's the use of doing a simple nerve repair? It's a waste of money."
Director Qian pointed to the picture on the reading light with a patient-centered attitude.
Nong Zhiwen is indeed in a dilemma. Director Qian said the same thing. Now is not the time to save money, but where can we find so much money now? Since this drug is so important, if we don’t use it, I’m sorry to my father. If I want to use it, I really can’t afford it.
This money.
"Well, I have a friend who sells medicines. I'll say hello to him and see if I can sell you this medicine at a cheaper price. I can help you save at least 10,000, but you can't tell others, because doing so
It's illegal, and I can't help it. I won't help ordinary people."
Director Qian said very embarrassedly.
Nong Zhiwen was very grateful at this time: "Thank you, don't worry, I won't talk nonsense."
"Also, you see, there is a small mass on your father's liver. Of course, it is so small now that it is impossible to see what it is with imaging examinations. But based on the medical history, I personally think it still needs to be dealt with, in case it is
It will be too late to deal with bad things when problems arise. I have always advocated nipping bad things in the bud. Of course, different doctors have different opinions on this issue. Most doctors will find it troublesome and will recommend observation.
But I think we as doctors should consider our patients more and not be afraid of trouble."
Director Qian pointed to the color ultrasound report on the liver. The color ultrasound report considered liver cysts.
"You see, color Doppler ultrasound considers cysts. What does "consider" mean? It means uncertainty. What if? You can't bet on this thing. A few years ago, I had a patient with a similar situation. I suggested early surgery to remove it.
, in fact, it would be fine after surgery. However, he heard that the patient had a cyst and it was fine, so he didn’t do the surgery. After two years, he was diagnosed with liver cancer, which is in the advanced stage and even gods can’t save it.”
Nong Zhiwen thought about it and realized that Director Qian was actually right. No one could guarantee that it was definitely a cyst.
"If we are more proactive, we'd better cut off this tumor and nip it in the bud. Your father is only over 50 years old. The average age of Chinese people is now close to 77 years old. Your father is only over 50 years old. You
Are you going to give up just like that? To be honest, you can earn back the money very quickly, but human health is priceless."
Director Qian said sincerely.
After Director Qian said this, Nong Zhiwen felt really guilty now. He couldn't delay his father because of money matters. The disease had been cured to this extent, was he still short of the last little money? Nong Zhiwen gritted his teeth and decided to think about it again.
Think of ways to.
''You should think about it carefully. If the economy is really tight, and we are more careless and passive, as we are already in our fifties, right, we can simply do nerve repair to improve the symptoms. As for the rest, that's it.
I understand that there is nothing you can do about it. But if you can still find a way to raise some money, I think you should try not to deal with it carelessly, but deal with it seriously. The old man is only over fifty years old, and you are so filial as children, right?
, this small amount of money can be solved by gritting one's teeth, but it saves a life."
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"let me consider it."
Nong Zhiwen hesitated.
"Think about it and try to make a decision before hospitalization. Because your father is my old patient, so I tell you so much. If the treatment is too sloppy, it is a pity that other doctors will not tell you this. Simple
It's great to just take care of your nerves, but you also have to thank the doctor for saving so much money. I said so much, it's a thankless thing, and those who don't understand think that the doctor is doing something wrong."
Director Qian was very eloquent and his tone was sincere, so Nong Zhiwen was hesitant now.
---
Director Fang found it strange why Nong Zhiwen took so long to get the pathology report without replying.
According to the phone number left at that time, Director Fang called Nong Zhiwen, Nong Tiesheng's son, and learned from the other end of the phone that the pathology report was not found, but Director Qian from Appendix 4 had agreed to admit his father to the hospital. Director Fang probably
After understanding the situation, Director Qian over there said that more than 100,000 yuan should be prepared.
Director Fang didn't quite understand why he wanted so much money.
Nong Zhiwen explained: Targeted drugs cost about tens of thousands. Tumors in the liver require surgery, and it is best to do da Vinci robot surgery for better results. If it is ordinary surgery, the tumor is very deep.
If it cannot be cut cleanly, the effect of the surgery will be compromised.
After listening to this, Director Fang almost cursed. Director Qian had a bad reputation in the circle, but it was just a bad reputation. Director Fang had never dealt with him. Now through this patient, he really understood what rat shit in the soup was.
Damn it, didn’t this patient only need to repair the recurrent laryngeal nerve? Why did he also need liver tumors? Isn’t that a cyst? Just regular check-ups, and there’s nothing wrong with it.
Moreover, they also engage in targeted therapy. The drugs for targeted therapy are all self-funded and cost tens of thousands. How can patients from rural areas afford them? This is really a waste of money just to treat the disease.
We must not let Qian do whatever he wants. This patient is very pitiful and must be taken over.
If you had to do this surgery yourself, if there was a rural cooperative medical system, you could have done it for a few thousand yuan. Now you have to pay hundreds of thousands, and most of it is at your own expense. Robot surgery is at your own expense, targeted drugs are at your own expense, and there is a lot of mess.
The project is self-funded.
Director Fang's whole thinking has changed since he improved his level. How can he tolerate such abhorrent behavior if he wants to be the world's top doctor in the future?
"Where were you hospitalized?" Director Fang asked.
Nong Zhiwen said: "Not yet, but there should be beds soon."
"Let me tell you, this problem can be solved with only a few thousand yuan. There is no need to spend hundreds of thousands. Please take the time to come to me and I will have a good chat with you." Director Fang warned.
Nong Zhiwen was confused. Why were the doctors on both sides so different? Who should he believe?
After all, it involved hundreds of thousands of dollars, so Nong Zhiwen decided to wait for a while and wait until he found out more about it. He decided to take the time to find Director Fang and listen to Director Fang's opinion.
To be honest, when it comes to treating diseases, the information between doctors and patients is asymmetric. Doctors have an overwhelming advantage, while patients have almost zero knowledge and can only follow the doctor's arrangements. That is, the doctor is equivalent to having absolute power.
Power, if doctors do not have self-restraint or external restraint, it is easy to over-medicalize, especially when driven by economic interests.
Director Qian’s teacher was the famous Director Tang. Director Tang was well-known in the industry at that time, but until his retirement there was no complaint or any medical dispute. It is said that the patient’s family would send a pennant to thank him if he was cured to death.
That kind of.
After retiring, Director Tang was hired by a private hospital with a high salary to serve as the chief specialist. He continued to use his remaining energy and attracted a large number of patients with his personal charm. The income generated by one person accounted for 80% of that hospital.
After the boss saw this situation, he directly sent Director Tang of Stock Latang to join the company and built a hospital specifically for him to give full play to his expertise. Sure enough, the retired Director Tang kept pace with the times and used the power of the Internet to transform himself
Become an Internet celebrity doctor, attract huge traffic, and make the hospital a lot of money.
Director Tang was originally a general surgeon, but doctors at that time were a bit more sophisticated. He did all kinds of orthopedics and urological surgeries, so retiring to a private hospital was a great way to do all kinds of surgeries.
Now the owner of a private hospital has set up a specialized oncology hospital for him, and he has become an oncologist. I heard that the hospital is now full of patients.
Of course, Director Qian is not as powerful as his master, Director Tang, but he can still be regarded as the true successor of Director Tang, and he has some skills. As his name suggests, this guy is all about making money.
The annual revenue of the general surgery department where he works is extremely high, ranking first in the Nandu Medical University Affiliated Hospital every year in terms of turnover and surgical volume. Therefore, he receives the certificate of outstanding department director every year.
Because the revenue of the department is high, the bonuses for the doctors in the department are also very high. Although he has a bad reputation in the circle, none of the doctors in the department have anything bad to say about him. Anyone who can't get along with money will earn more than any other attending physician in their department.
The sub-high and the high.
From the leaders to the doctors and nurses, everyone likes Director Qian. He is a capable person.
Director Qian would never accept a patient like Nong Tiesheng who only spent 20,000 yuan for a recurrent laryngeal nerve repair in a hospital. Every bed he had had to create maximum economic value.
Moreover, Nong Tiesheng's case is a bit special. The recurrent laryngeal nerve injury was caused by Director Qian himself during surgery. A long section was accidentally cut off at that time.
Because it was my first time to use the Da Vinci surgical robot to perform a radical thyroidectomy on a patient, I was not skilled at it. I did it very reluctantly and accidentally cut off the recurrent laryngeal nerve. However, Director Qian was not afraid. He wrote very carefully on the record in his hand.
It was clear that the tumor invaded the left recurrent laryngeal nerve, and segmental resection was performed.
In this case, if a direct anastomosis is performed, the two broken ends cannot be brought together at all, so direct anastomosis is impossible. If a section of nerve is used to bridge the anastomosis, the defect will be too long, and the postoperative effect will not be good because of the distance required to bridge.
It's really too long.
As for the third method, another nerve is used to connect this nerve. It seems that the nerve suitable for nerve transposition has been cut off at that time. Now no suitable nerve transposition can be found. Even if a suitable nerve is found, the main nerve is not the laryngeal nerve.
The mother vagus nerve of the recurrent nerve has different functional areas in the brain. After anastomosis of the nerve, a series of exercises are required.
Director Qian knew that this case could not be solved at all, so he did not want to repair the recurrent laryngeal nerve for Nong Tiesheng at that time.
Director Qian originally thought that the matter would be over after a long delay, but he did not expect that Nong Zhiwen and his father actually went to Sanbo Hospital to see a doctor, and they also saw Yang Ping. This was troublesome. Who is Yang Ping?
Director Qian doesn't know what level he is at. When Yang Ping comes on stage and performs an operation, nothing can be hidden in front of him.
So Director Qian had to admit the patient first, but he couldn't occupy a bed in vain, so Director Qian followed his own principles and issued a large order for Nong Zhiwen's treatment plan worth RMB 100,000.
