Chapter 474: People Who Affect the Height of the Structure
Chapter 474 People who influence the height of the pattern (please subscribe)
Author: A lancet
Chapter 474 People who influence the height of the pattern (please subscribe)
Zhou Cheng was really worried about Yang Yifeng. How long had it been since he was doing this?
To be honest, Zhou Cheng did not expect that Zhou Cheng would come to Chen City with the Medical Association and the forensic team to hold a hearing this time.
However, after Zhou Cheng checked some relevant documents, he realized that he had been classified as a member of the medical accident appraisal expert group by the Hunan Medical Association, and these application procedures seemed to be done by Professor Ding Changle or Lei
Professor Zhong, in order to increase his qualifications, he filled in the materials.
Therefore, Zhou Cheng followed.
According to Article 2 of the "Regulations on the Handling of Medical Accidents", medical accidents refer to medical institutions and their medical staff who, during medical activities, violate medical and health management laws, administrative regulations, departmental rules and diagnosis and treatment nursing standards and routines, and cause personal injury to patients due to negligence.
ACCIDENT.
This refers to the personal injury caused to the patient. If the negligence only increases hospitalization expenses, hospital days, and pain, it does not constitute a medical malpractice.
For medical malpractice, a panel of experts from the Medical Association must be invited to conduct a hearing and appraisal of the medical malpractice. Due procedures must be followed.
When a medical accident is suspected, the patient should immediately seal medical records, related drugs, and medical equipment, whether they are paper medical records or electronic medical records, whether they are still hospitalized or have been discharged (or died), they should be sealed as soon as possible, and the evidence should be fixed as soon as possible to avoid
The hospital tampered with medical records to cover up errors in diagnosis and treatment, which put the patient at a disadvantage in providing evidence.
In the case of hospitals and patients, after reporting to the local health committee, the local health committee will organize the local medical association or a higher-level medical association to conduct a medical accident appraisal report. If you are not satisfied, you can apply for a higher-level medical association.
A group of experts came for another hearing and appraisal of medical malpractice.
This time, Zhou Cheng and others came to Chen City because the patient was dissatisfied with the local medical association’s medical malpractice appraisal——
Even if the patient dies, the medical institution only bears minor responsibility.
In fact, three conditions must be met to constitute a medical accident: 1. The medical institution or medical staff is at fault, that is, it violates laws, regulations, and diagnostic and treatment practices; 2. The patient suffers personal injury; 3. The patient's personal injury is caused by these errors
.These three conditions are indispensable.
Although the patient died, according to the appraisal opinion of the local medical association, Chenzhou First People's Hospital had fulfilled its obligation to provide the maximum level of medical care during the patient's treatment, but still failed to rescue him in the end, which did not cause a medical accident.
In the spirit of humanitarianism, it was determined that the hospital had certain responsibilities.
Zhou Cheng continued to look at the patient’s diagnosis and treatment process:
The patient was admitted to the hospital for trauma and underwent surgical treatment in the hospital. After the examination, during the operation, a large-scale myocardial infarction and pulmonary infarction suddenly occurred. The patient died on the operating table at that time.
What the patient means is that they push people to the hospital just to save lives. No matter which aspect, as long as something goes wrong, the hospital is responsible and has not fulfilled its obligation to save lives.
However, the hospital's opinion is that when the patient is admitted, the signs of trauma are obvious, and emergency surgery must be planned as soon as possible, instead of continuing to waste time checking whether there are any hidden risks such as blood clots and blood clot detachment. Otherwise, the patient will undergo the examination during the examination.
While waiting, there is a high possibility of death from shock.
After trauma and during surgery, there is a certain chance of special unforeseen complications such as shock, myocardial infarction, and arrhythmia. These are inherent complications of surgery and operations, and are not due to medical errors on the part of the medical staff.
cause.
This is naturally recorded in the medical records, and the surgical records are also quite complete.
But in fact, after Zhou Cheng read the corresponding emergency rescue procedures, he discovered a problem, that is, this emergency department only called the surgical doctors to the emergency clinic for consultation, and then immediately pushed them to the operating room, without bringing the internal medicine doctors to the emergency room for consultation.
Ask people to come over and take a look.
In fact, if we must follow a particularly strict emergency diagnosis and treatment system, the consultation system is the core system. When encountering a suspicious patient, it is best to call all relevant departments.
But the word "suspicious" is too broad. If every patient is called in this way, it will actually waste medical resources and increase the burden on patients to a certain extent. After all, consultation requires money, even if it is
The other party comes over to take a look and says it's okay, and you have to pay for the consultation.
Besides, I really didn’t have that much time at the time.
However, in the operating room, there is an opportunity to request a supplementary consultation. If someone from the relevant department comes to visit and writes a consultation opinion, then the hospital will not be at fault if the relevant questions are raised again. This is a common practice in surgery.
risks of.
But if there is no such link at present, the patient will cling to this point.
Of course, Zhou Cheng did not have any fixed thinking and concluded that this was definitely the fault of the patient and had nothing to do with the hospital, because the medical records and medical history information were all written by the hospital and clinical medicine, and there may be bias.
Now that I have been recommended to be a member of the medical accident appraisal expert group of the Hunan Medical Association, I must be objective and fair.
Because from the patient's perspective, if they have pre-existing support, then they really don't know how to work hard to protect their rights.
According to the determination of the local medical association, it is actually only determined that the hospital bears part of the responsibility, which is okay and complies with legal regulations and corresponding provisions issued by the Chinese Medical Association.
Moreover, another problem is that in Zhou Cheng's view, this accident can actually be avoided. When Zhou Cheng performed the limb transplant before, he had considered such a situation and installed a filter in advance.
To have such an awareness of risks, there is no guideline to identify the standard diagnosis and treatment procedures for this complex emergency surgery——
The standards for identifying medical malpractice are not based on an individual's technical level, or on the top medical standards in the province and country. If it were so defined, most doctors would be laid off.
Standards include vast medical monographs, textbooks, guides, norms, authoritative documents, etc., as well as some administrative regulations. However, medical knowledge is relatively flexible and is not as simple as black and white. It may be possible to analyze it from all aspects.
One, two, three, four, different analysis angles lead to different conclusions.
In particular, there are many cases of "medical disputes" where the clinical evidence is actually insufficient, and the auxiliary examination results that should be available are lacking, providing a huge space for wrangling.
Therefore, before the appraisal hearing tomorrow, Zhou Cheng has to think carefully about how he should speak tomorrow so that he can be more fair and just and not do anything ambiguous.
"Dong dong dong!" While Zhou Cheng was still thinking like this, there was a knock on the hotel door.
Zhou Cheng went over to open the door, and then saw Jin Kaishi, also a professor of vascular surgery at Shonan University Hospital, stepping in: "Xiao Zhou, I knew you were not asleep yet."
"Professor Jin, sit inside, you haven't rested yet?" Zhou Cheng welcomed Jin Kaishi in and asked Jin Kaishi to drink some mineral water. There was really nothing else to entertain him.
"I'm old and can't sleep well, and I have something to do. I want to talk to Dr. Zhou." Jin Kaishi sat down and looked Zhou Cheng up and down.
"Professor Jin, please give me some advice." Zhou Cheng's attitude immediately improved. He knew that Jin Kaishi must be here for tomorrow's hearing.
Although Zhou Cheng himself is very good at being a doctor, Zhou Cheng also has this kind of self-confidence.
However, this is the first time that I have been determined to deal with medical malpractice, and the experience this time is different from the previous inspection team.
But you must not wrongly blame a good person, and you must not express your opinion casually.
Jin Kaishi said: "Xiao Zhou, let's put aside the relationship between the surgeon and our brother hospital. What we mean is still that it depends on the local diagnosis and treatment level and the upper limit of the services that can be provided."
"Based on this, it is most appropriate to make such a determination."
"Of course, Professor Jin, I think so too." Zhou Cheng nodded quickly.
"Of course, when I say this, I don't mean to scold you for arguing with you at the hearing, but I also know that Dr. Xiao Zhou, you have a solid foundation of medical knowledge, and you must have a lot of reserves when it comes to quoting classics."
"If we take it seriously, I think there are still some problems with the medical admission process this time. That's for sure."
"In fact, the entire operation process may be full of loopholes in your eyes, Dr. Zhou. I don't know if Dr. Zhou can break out of your own fixed thinking." Jin Kaishi spoke slowly.
Then he expressed his position: "I am not trying to be a lobbyist. To be honest, although our hospital and our sister hospitals seem to be brothers, the internal competition is still quite fierce. If given the opportunity, I definitely hope to be the big brother of the brothers.
Not a brother who is a big brother."
"It's just that we can't do such a thing, we need to be upright."
"Of course, this is also what President Lei Zhong means. I hope that Dr. Zhou can separate your own medical work to a certain extent from the current work of the expert team."
If Zhou Cheng was asked to find faults, Zhou Cheng could even find faults in Professor Jin Kaishi and Professor Lei Zhong. After all, there is no one else with the same perfect skills as him!
Based on this, Zhou Cheng has to jump out of his own perfect thinking, and don't spend money and money.
You can't be serious about it, and if Zhou Cheng cares too much and makes this kind of thing too formatted and standardized, then next time, who will dare to treat patients?
There must be responsibilities and shortcomings for dead people, so why not go wherever you like and push some patients who may have been saved away, causing unnecessary injuries or even death.
Lei Zhong asked Zhou Cheng to practice in order to increase his social experience, not to kill this profession.
Jin Kaishi continued: "Another point we must pay attention to is that we can be more stringent in internal verification, but we must not be too harsh externally. Otherwise, it will make our hospital appear too ostentatious.
"
When Jin Kaishi said this, Zhou Cheng was wondering if Jin Kaishi had really been arranged by people from Chen City No. 1 Hospital. But looking at Jin Kaishi's expression and tone, he didn't
picture.
"Professor Jin, what do you mean? Should we continue to recognize the relevant medical accident appraisal report of the Chen Medical Association?" Zhou Cheng asked.
"Yes and no." Jin Kaishi said.
"Because there are some issues that are actually current and established issues. If the corresponding provisions are not changed, then it is correct."
"But if the provisions are to be changed, then the general environment must change. For example, the average medical level of our country has been improved relatively high, so that we can consider modifying some things to take care of more people."
"We can simply go back to this case..."
After talking for about half an hour, Zhou Chengcai sent Professor Jin Kaishi out of the room.
Then Zhou Cheng stood at the window and looked outside, at a strange city, strange scenery, and the night view of a strange place.
The arrival of Jin Kaishi allowed Zhou Chengcai to once again see clearly that as a professor at the Shonan University Affiliated Hospital, with his vision and heart, if you have to spend every penny, then the premise is to make the whole world a better place.
Otherwise, your personal ideas and abilities will be like dazzling stars at most. Although they are high above, they are out of reach.
Not all patients are lucky enough to meet you, and not everyone can be like you.
You need to open your horizons, because in the future, Zhou Cheng will not only become an expert panel of the Hunan Medical Association, but may also become a member of the expert panel of the Chinese Medical Association when handling medical malpractice dispute appraisals in other top hospitals.
At that time, you need to be more careful. If you don't handle it properly, the impact will be even greater.
Generally speaking, medical accidents involving cross-provincial medical accident identification and the deployment of a team of experts from the Chinese Medical Association are generally news at the meeting, and the results of the treatment will also become a reference for the handling of other similar accidents, and even a reference for revising the French.
If it has such a big impact, it may affect the diagnosis and treatment of a wider range of colleagues.
A single move can affect the whole body. At this time, how to explore and how to coordinate the overall situation is also a question that Zhou Cheng should slowly explore.
Jin Kaishi came over, which was equivalent to a message to Zhou Cheng. From now on, Zhou Cheng will definitely not only live in this one-third of an acre in Hunan Province, but will be like the international Professor Zhang from the Vascular Surgery Department of the Second Affiliated Hospital of Xiangnan University.
Go nationwide and even the world.
Therefore, this medical malpractice appraisal hearing was actually just the first stop for Zhou Cheng to reach such a height, and it was a preliminary resume reserve.
Based on Zhou Cheng's previous resume and reserves, many people no longer simply regard Zhou Cheng as a simple department doctor, but truly regard Zhou Cheng as a heavyweight who may have an impact on the overall pattern.
figure.
At least that's the talent pool.
Zhou Cheng suddenly discovered that he seemed to have grown up a little overnight, had a higher vision, and had more things to think about.
Patients, doctors in lower-level hospitals, the development direction of medicine, and whether the handling of medical accidents can be more standardized, will it chill medical staff, and will it involve the issue of rights protection for patients and their families?