My Medical Skills Give Me Experiences
Chapter 205: Tuya's reform, achalasia treatment
Zhou Can secretly wondered, didn't Du Leng hang out with Wu Baihe in neurosurgery?
Why did you come to the general surgery department?
"I believe that without my introduction, many people have already recognized the young and promising doctor next to me. His name is Du Leng. He graduated from Johns Hopkins University and has received a doctorate degree. He has trained in neurosurgery in this hospital. One year later, he is now preparing to join the general surgery department, and we welcome Dr. Du with the warmest applause."
Xia Huai'an, the head of the department, took the lead in applauding.
Immediately there was warm applause from the audience.
Zhou Can secretly wondered that although the growth cycle of neurosurgery is a bit longer, in terms of future, it is much better than general surgery. Du Leng is out of his mind, or what?
"Please take care of me in the future! Thank you everyone!"
After the applause subsided, Du Leng bowed to everyone.
Being polite and courteous made everyone feel good about him.
"Today I called everyone this morning meeting. First, we welcome Dr. Du, a super talent, to join our general surgery department. Second, we announce that from now on, the hospital will carry out general surgery, digestive surgery, and hepatobiliary surgery in consideration of strategic development. Integration. These departments will be divided into multiple medical teams to carry out diagnosis and treatment competitions. The teams with top results will have the opportunity to be qualified for the construction of sub-departments.”
As soon as the news came out, the doctors of the general surgery department were in high spirits.
Tuya has been working hard in the past ten years, reforming the hospital's internal departments, management system, and talent introduction.
To put it bluntly, digestive surgery is gastrointestinal surgery that is separated from general surgery.
Hepatobiliary surgery is also a sub-department.
At present, the development of these two separated departments is not very good.
The structure of general surgery also urgently needs to be optimized.
That's why there is this reintegration and sub-department construction.
In order to enhance the competitiveness of the department.
It really makes Tuya Hospital a top hospital with the highest comprehensive strength.
It's not like it is now, not up and down, weak in all aspects.
Tuya's current Dean Zhu has great plans and plans, and he is determined to fulfill the great dreams of the previous deans. Build Tuya Hospital into a leading super tertiary hospital in China.
The reform of the talent structure has achieved initial results, and many departments have been replaced with fresh blood, basically all of whom have postgraduate degrees or above.
Those old comrades with low education and mediocre medical skills have either retired.
Either you have already got Attachment 2 or Attachment 3.
Tuya General Institute has realized the young and highly educated talents.
With this foundation, the next step is to optimize the department.
Out of prudent considerations, the weighted departments maintained the status quo first, and the general surgery department, which performed poorly, became the first reformed experimental department.
This reform actually started seven years ago.
Digestive surgery was separated from general surgery to treat gastrointestinal diseases. Then three years ago, another hepatobiliary surgery department was separated from the general surgery department.
The experimental results are somewhat unsatisfactory.
That means it's impossible to do so.
Not only failed to create a powerful department through reform, but seriously weakened the strength of general surgery.
The reform plan formulated by the hospital this time should have absorbed the valuable experience of the previous two reform attempts.
Du Leng must have sensed it. At this juncture, he chose to join the general surgery department and participate in the competition of various groups. I want to use this opportunity of department reform to climb up in one fell swoop.
Under normal circumstances, even if he is a doctor of returnees, if he wants to climb to the position of a subject leader in a department, it will be difficult to succeed within seven or eight years.
Because there are not a few doctoral students in Tuya Hospital.
Even though many of those people are only domestically trained doctoral students, but in terms of educational level, there is no distinction between high and low with foreign doctoral students.
Even if there is a difference, it is also caused by the employer's admiration of foreigners.
At the level of national policy, there is no difference between the two.
"Dr. Du, you can choose from all the medical teams in this department, as well as all the medical teams including digestive surgery and hepatobiliary surgery. This is the introduction of the team leaders and the members of this team."
There are about 130 doctors in the general surgery department, including the digestive surgery department and hepatobiliary surgery department that were separated from the family.
Regular training and internships are not included.
There are nearly 30 chief physicians alone, 29 associate chief physicians, and the rest are attending physicians and residents.
It can be seen from here that chief physicians and deputy chief physicians account for nearly half.
It's not that it's easy to get the titles of senior and deputy senior, but that those who can stay are senior and deputy senior. Attending physicians, residents, regular trainees, interns, and advanced students are the main force in the work.
If these people can't get promoted for a long time, or if they feel that their future is bleak, they may change jobs to other units.
There are not a few people who change careers or are engaged in administrative workers.
Being a doctor is not for everyone.
The pressure is high, the work and rest are irregular, and the risks are extremely high. Even if you are making a baby with your wife at night, when you receive a call from the hospital to rescue a patient, you have to put on your clothes and rush over immediately, not even a minute later.
Because every second counts to save the patient.
There are countless invisible risks in the process of surgery, diagnosis, and treatment, and a mistake may become a hatred of all bones.
For example, Dr. Xu is the best example.
An operation mistake directly reduced him from a top surgeon to an unknown attending physician in the emergency department.
If it weren't for his inner strength, he might have given up his career as a doctor long ago.
That kind of psychological gap is really not something ordinary people can bear.
"I'll just choose Director Yang Qing's group!"
Du Leng did not ask Director Yang, the leader of this group, whether he would agree.
After directly choosing this group, he was full of confidence and did not need to ask Yang Qing for his opinion. The other party will not only accept him, but also should feel very happy.
Zhou Can has also been in the regular training for more than a month, and has a little understanding of the various groups in the department.
Director Yang Qing is extremely powerful among the many chief physicians in the general surgery department, ranking among the top three regardless of academic or surgical ability.
In terms of comprehensive strength, Yang Qing's group is the strongest in general surgery.
Du Leng just casually glanced at the group list, and chose to join Yang Qing's group. It shows that before he came, he already had a good understanding of the strength of the various teams in the general surgery department.
"Welcome Dr. Du to join this group! Welcome!"
Yang Qing is a young chief physician in his early fifties.
For the vast majority of doctors in Tuya, becoming a chief physician at the age of forty-five is definitely smoke from the ancestral grave. It is still a very lucky thing to be rated as a chief physician before the age of fifty-five.
If you are over fifty-five years old and have not yet been evaluated, the pressure will be great.
Because most male doctors retire at the age of 60, a few experts and professors can delay their retirement until the age of 65.
Director Yang Qing is only in his fifties and has such a strong strength, and he has great hopes of competing for the position of department leader in the future.
In the personal introduction, Director Yang Qing specializes in the two major surgical fields of pancreas and breast.
He is one of the few chief physicians who can focus on two fields at the same time.
Du Leng walked over quickly and shook hands with Yang Qing.
At the juncture of the department's upcoming reform, Yang Qing and the members of the group are very happy to have such an outstanding talent join the group.
Not to mention anything else, just because Du Leng can produce four or five SCI-level papers a year is enough to make him popular.
Last year, Tuyap Surgery published 38 SCI papers.
So many chief and deputy chief physicians have only published 38 SCI theories in total, which shows how difficult it is.
Many chief physicians may not be able to produce a single SCI-level medical theory in a year.
Du Leng was able to publish several SCI papers in his first year of work, and his academic strength is so strong that he stands out from the crowd in Tuya.
This is also his biggest advantage and bright spot.
"We take the treatment group as the unit and compete for a period of about one month. Including the correct rate of outpatient and emergency diagnosis, the length of hospital stay of inpatients in the group, the cure rate, satisfaction rate, accident rate, mortality rate and other comprehensive dimensions to score .The one with the highest ranking will have the opportunity to form a sub-department at that time."
Department Director Xia Huaian announced the competition rules.
The length of hospital stay is an important criterion for judging the diagnosis and treatment capabilities of the medical team. Only by quickly and accurately finding out the cause, and quickly arranging the operation, and then ensuring the success of the operation, as well as the postoperative care and medication are in place, the patient can be discharged in a very short time.
On the contrary, poor operation, inaccurate medication, or even misdiagnosis may lead to prolonged hospitalization of patients.
"Director Xia, the number and types of patients received are determined by the physicians in the group. Some groups will receive more patients with a single type, which will have a great advantage. It must be a big advantage for the competition. Kind of unfair."
There was a protest.
All fools know that as long as there is a famous doctor in this group, they will have a great advantage.
Because many patients are registered with famous doctors.
For example, Yang Qing is good at treating diseases of the pancreas and breast, and most of the people who see him are from these two categories.
"There is nothing unfair. This competition is to identify in which areas each group is excellent in diagnosis and treatment. Then launch the strongest group to build the corresponding sub-department. From now on, the doctors in that group only need to devote all their energy to research The diagnosis and treatment of diseases in this field can make the department more competitive."
The cases of general surgery are inherently complicated.
The purpose of comprehensively building multiple sub-departments proposed this time seems to dismember the entire general surgery department.
In fact, it proposes a new purpose, and professional things are left to professional people to do.
Subdividing departments is not only conducive to accurate registration and consultation for patients, but also conducive to the areas of diseases that doctors are good at treating.
"Don't worry about unfair competition. Even if a certain group of yours has only received one patient this month, if you cure that patient, you still have a chance to win. This time, the evaluation is not only based on quantity, but also on quality .”
After Xia Huai'an said this, everyone felt a lot more at ease.
Each treatment group has its own characteristics, and everyone is full of confidence in their own strength.
"Also, if you feel that your team is not strong enough, you can also take the initiative to apply to join other strong teams. In short, the purpose of competition is to survive the fittest and make the strong stronger. Spur weak doctors, and doctors who are fooling around Progress. If you don’t make progress, you may be eliminated.”
Jian Feng pointed directly at those doctors who were dawdling.
Including some of the chief physicians and deputy chief physicians, there are many people who dawdle.
Many doctors feel that their lives are complete after they are promoted to sub-high or full-level high, and they don't want to work so hard anymore.
Start lying flat.
The efficiency of diagnosis and treatment in hospitals has also plummeted.
This reform is to make those dawdling people have nowhere to hide.
This will undoubtedly touch the interests of some people. Therefore, the hospital management is very cautious about this pilot reform, and it is only piloted in general surgery. If successful, advance to each department.
It is equivalent to boiling frogs in warm water, and weed out those clinicians who dawdle.
If all the doctors who are dawdling are attacked at the beginning, and they unite to protest, it will make it difficult to continue the reform.
A hospital is not a hospital for a certain individual, but a relatively democratic unit.
"The meeting is over!"
Xia Huaian announced the competition rules and left the meeting room first.
The other doctors did not leave in a hurry, but talked about it one after another. The formation of the group, the search for the search to rely on.
"Director Liu, there are only a few members in our team, do you want to find a strong team to join?"
Song Ze asked worriedly.
Everyone knows that as long as he wins the competition this time, he may become the head of the sub-department. Other doctors in the group can also ascend to heaven with chickens and dogs.
Director Jia is 59 years old and is about to retire soon.
In the past few years, he has been attacking the senior professional title, but the hope is slim. It is inevitable that these doctors who follow him are worried about their future.
"I'm quite old, even if I'm a good person, I can't be a big house. I don't want to be inferior to others and look at people's faces. You are still young. If you don't have confidence in this group, you can try to join other groups."
Director Jia has two attending physicians and three residents.
Including him, there are only six people in total.
If they are regarded as interns and regular trainees, the number will be more.
"I'm used to being with Director Jia. Taking this opportunity to fight hard, I might be able to gather strength for the title of deputy senior professional. Even if our team ranks really low in the competition, it is impossible for the hospital to fire us gone."
He Hansheng's position is quite firm.
This is to prepare to follow Deputy Director Liu to the end.
Song Ze proposed to join other groups at this time, but he was actually afraid of losing the opportunity.
Joining in advance, that group won, and he is the hero. In the future, it will be particularly passive to wait until the sub-departments are built before joining.
"Anyway, I was brought out by Dr. He and Director Liu ~www.wuxiaspot.com~ I'm not going anywhere."
A resident physician followed suit.
Song Ze and the other two residents remained silent.
When faced with major interest choices, human nature will become extremely realistic.
"It's still the same sentence, as long as you have a suitable group willing to accept, you can join other groups at any time. I don't have any opinions."
After Deputy Director Liu finished speaking, he left directly.
Song Ze's eyeballs wandered around, apparently planning to find another way out.
Zhou Can was originally just a regular trainee, and he didn't care about the reform of general surgery. What he wanted was to return to the emergency department to develop after the regular training.
No matter how much noise there is here, it's none of his business.
Back in the doctor's office, he continued to check the unfinished cases, and then went round with the attending physician He Hansheng.
At 9 o'clock in the morning, Deputy Director Liu will start the first operation.
Zhou Can took an intern to send the patient undergoing cardioplasty surgery to the operating room.
This patient had severe dysphagia and food regurgitation. After diagnosis, it was diagnosed as achalasia.
After the patient received medical treatment, the effect was not good.
Then, under the doctor's advice, go to the surgery for surgery. But he was unwilling to undergo esophageal dilatation surgery, so Deputy Director Liu prescribed cardioplasty surgery for him to treat his symptoms.
This operation is now rarely performed.
Because most of them are treated by esophageal muscular incision.
Cardioplasty is generally used for achalasia of the cardia. The effect of medical treatment is not good, and the dilation and flexion of the esophagus are obvious. Or combined with other pathological changes, such as supradiaphragmatic diverticulum, hiatal hernia, or suspected cancer.
It was Zhou Can's first time participating in this kind of surgery, and he was quite looking forward to it.
Learn it, and it will definitely come in handy in the future.
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