Gou is practicing medicine in the clinic

Chapter 114 Finally reached the attending level of drug use
One is a minor ailment, which is the most common cold. After the examination is all right, some medicine is given for the patient to take at home.

The patient is a 35-year-old female. After receiving the medicine, she still hesitated.

"Do you have anything else to do?"

Li Jingsheng asked with concern.

Some patients have diseases that are difficult to talk about, and they will have concerns.

Especially there were two patients present at the scene, and she was a young female patient, so she was even more embarrassed to speak.

"I... usually choose to go to the Kuaikang Clinic for treatment when I am sick. They have quick results, and I can recover the next day after the injection. I also went to the Golden Chamber Clinic once, but the traditional Chinese medicine prescribed there took three days. God, it won’t be better until the fifth day. This is my first time here, and I recently heard from friends that your medical skills and ethics are very good, so I came here to try.”

The meaning of the woman's words is already obvious.

She is most satisfied with Kuaikang Clinic.

Because patients don't understand medicine, they don't know how valuable the human immune system is. Antibiotics for injections really heal quickly.

Especially the combined use of multiple antibiotics.

Of course, Li Jingsheng's current drug efficacy and pharmacokinetics are only at the proficient level, and cannot reach the level of combined drug use.

At least he asked himself that he didn't have the strength.

The Kuaikang clinic has been in operation for many years, but Li Jingsheng doesn't know how Boss Zhao's real medical skills are.

Usually, it is basically a few doctors and nurses hired by Boss Zhao to work.

Boss Zhao is only responsible for signing and directing.

What Li Jingsheng saw the most was Boss Zhao making fun of his little nurse.

If Boss Zhao did some work, he wouldn't be so fat.

Kuaikang Clinic has been focusing on infusion for more than 20 years, and should have accumulated a wealth of experience in the use of various antibiotics.It is not surprising that the level of medication in this area has reached the level of the deputy director.

Even if Boss Zhao and the doctors in the clinic don't understand, they can still spend money to consult the chief doctor of a big hospital.

Under normal circumstances, there are thousands of prescriptions for a thousand diseases, and the medicines for each patient's disease will be different.

Even if it is the same disease, it should be comprehensively considered based on symptoms, age, whether there are underlying diseases, whether it is pregnant or breastfeeding, etc., and then precise medication.

However, one of the biggest advantages of western medicine is the patterning.

What do you mean?

As long as it is a common cold, almost one medicine can solve it.

The most is to make some increase or decrease in dosage according to age and weight.

Even the dosage of the medicine does not need to be too precise, just a rough medicine.

For example, adults take one pill at a time, and children take half of it directly.Basically, as long as there is no problem with intelligence, everyone will take medicine.

Kuaikang Clinic treats all kinds of common headaches and brain fever, and can achieve results in one day. The level of medication should be much better than imagined.

The same patient can use the same antibiotic for one or two colds, but the more times it is used, the worse the effect will be.

Kuaikang Clinic is able to retain so many old customers and guarantee the curative effect all the time, which is very technical.

Li Jingsheng seriously suspected that Boss Zhao was looking for someone to buy the medicine formula.

It is even possible to directly find a chief physician in Hunei with a high level of medication behind the scenes to cooperate.After all, there are many clinics that do this.

This is the core secret of the clinic, and outsiders can only guess like this.

"Doctor Li, don't mind if you say something!"

After the female patient made the foreshadowing, she began to get straight to the point.

Talk very politely.

"You can just say it!"

Li Jingsheng faintly knew what the other party wanted to say.

"You didn't give me an injection, but only prescribed these two boxes of oral medicine. Is the effect guaranteed? I run a shop and have to work every day. If the recovery is too slow after taking the medicine, then I still want to get an injection. I know, You didn’t give me the injection for my own good. I heard that the injection involves the abuse of antibiotics, which will cause some harm to the body. But I have had so many injections in Kuaikang Clinic, and I haven’t seen any problems.”

Women's communication is very direct.

what to say.

This is very good, it can let Li Jingsheng understand the real thoughts and needs of different patients.

"First of all, I have to thank you for your trust in me and for your honesty. I will be responsible for every patient who enters my clinic, and try to choose the most beneficial treatment for the patient. From your previous description of the condition and past medical history Analysis, I must tell you that the frequent use of antibiotics has actually caused a certain degree of damage to your body's immune system and body balance.

Why do you say that?
Because the frequency of your colds is increasing year by year, I can definitely tell you that this is not the reason for increasing age.Rather, it is a sign that the body's immune system is compromised and weakening.

In addition, your cold symptoms are also increasing, and the risk of severe illness is rising, which is a huge safety hazard.

If you think about it carefully, have you had a bad cold every time since you caught a cold in the past two years? "

Facing the patient's doubts, Li Jingsheng patiently did ideological work for her.

It's like eating those vegetables with excessive pesticide residues or ham sausage processed from sick and dead pork, I didn't feel at all on the spot.Even after eating ten or eight times, I still don't feel much.

When I feel it, malignant diseases such as kidney disease, cancer, and arteriosclerosis appear.

At this time, you can spend 10,000+, hundreds of thousands to save a life is not bad, many of them are rich and can't be cured.

The same goes for the overuse of antibiotics.

It may be okay to use it ten times or eight times, but after the immune system is destroyed, it is very easy to bring disastrous consequences.

"When you say that, it seems that it is really the case! Then, what should I do in this situation?"

After recalling slightly, the woman found that it was really as Li Jingsheng said.

She was a little scared immediately.

After all, she was only at this age, and if something happened, it would definitely be a disaster for her family.

"The two boxes of medicine prescribed for you are not as effective as the injections, but after taking the medicine, you can take a rest of at most two days and be able to engage in lighter work. I don't think you are a person who does heavy physical work. You are a boss wife. Those jobs, totally fine."

After listening to Li Jingsheng's words, the female patient showed a knowing smile on her face.

Being a proprietress is a very proud thing in the hearts of most people.

Wage earners and bosses, migrant girls and bosses' wives, it must be the later titles that make people feel more honorable and face-saving.

Even if some bosses are heavily in debt and their annual income is negative, and some wage earners have an annual salary of tens of millions, everyone still thinks that the title "boss" sounds better.

"Hehe, then I will try to take the medicine first! I can feel that you are a professional and responsible doctor. Goodbye!"

"It takes a long time for the immune system to recover. If you can persist in a certain amount of exercise every day, coupled with scientific and healthy nutritional intake, I believe that your body will undergo major changes in at most half a year. The infusion itself is not a bad thing, but Try not to use minor illnesses if you can, this is my personal suggestion to you.”

Li Jingsheng added another sentence.

"Ok."

She nodded and left.

Judging from her expression and tone, she trusted Li Jingsheng.

This is very important. Patients trust doctors, and the curative effect is often very ideal.

As long as you don't meet a black-hearted doctor, the ending is probably happy.

If you encounter a black-hearted doctor who tricks patients into various treatments and takes expensive nutritional medicines for the sake of performance, you must be especially cautious.

After seeing off the female patient, Li Jingsheng took care of another patient.

The patient was older, 63 years old, with a severe cough.

With the experience of seeing a tuberculosis patient last time, Li Jingsheng is now particularly vigilant for patients with severe cough.

There are many infectious diseases of the respiratory tract.

Must be protected.

In the future, when his small clinic develops well, he can even consider taking some better measures to try his best to protect other patients from being cross-infected.

After measuring body temperature, blood pressure, heart rate, and auscultating heart and lung sounds, Li Jingsheng combined with the patient's self-reported symptoms and medical history, and made a preliminary diagnosis using proficient internal breath diagnosis.

Out of multiple considerations, he suggested that the patient should have a chest X-ray in a small clinic.

Check your lungs.

Whenever he has the opportunity to use this 'grandfather' machine, Li Jingsheng will try his best to use it.

Get your money back sooner rather than later for a new high-definition device.

Not to mention small clinics, even large hospitals also need to find ways to 'pay back'.

Unnecessary checking, that's over-checking.

Normal examination can provide a basis for diagnosis and avoid misdiagnosis and missed diagnosis, which is very necessary.

In larger hospitals, the department of respiratory medicine will basically have bronchoscopes, invasive ventilators, non-invasive ventilators, ECG monitors and other equipment.When Li Jingsheng used to work in a large hospital, these devices were the 'property' of the department.

It can be used to save patients' lives at critical moments.

If his small clinic makes money and has a stable patient population, he can slowly add these devices.

At that time, small clinics will take off, leaving other clinics behind.They can even start a challenge with the Chengnan Community Health Service Station.

Although the Chengnan Community Health Service Station is just a station, its scale has already reached the level of a community health service center.

However, due to various reasons, it has not been able to be upgraded to a community health service center.

For the three clinics on this street, this is actually a good thing.

The weaker the official medical institutions, the greater the opportunities for the development of private clinics.

After Li Jingsheng conducted a comprehensive examination on the patient, he was diagnosed and confirmed that there was no pneumonia, and it was likely that bronchitis was induced by long-term smoking and cold exposure.

In the patient's own words, this is an old problem.

Once the disease is diagnosed, the next step is to prescribe treatment.

Considering the age of the patient, Li Jingsheng was particularly cautious when taking medication.

To achieve a good curative effect, it is necessary to use various drugs such as cough relieving, phlegm reducing, asthma relieving, anti-infection and so on.

The efficacy of the proficient level seems a bit insufficient.

Can prescribe, but very reluctantly.

Considering that the patient has a history of hypertension, although the current blood pressure is basically stable, this important factor must be taken into consideration when taking medication.

He started pulling at his hair.

Doctors sometimes give patients medication, which is much more difficult than doing math word problems.

Because all aspects of drug safety and efficacy must be considered.

"The efficacy and pharmacology of the medicine should have been upgraded a long time ago, so I might as well squander it this time."

Li Jingsheng's gaze inadvertently swept across the uncle who was still sitting in the rest area waiting.

This person is poor and poor. I persuaded him to go to a big hospital for treatment yesterday afternoon. Now he is here again. There is only one result. The uncle probably thinks the big hospital is too expensive and gave up.

As for coming to Li Jingsheng's clinic again, he must still want to live.

Li Jingsheng checked him for so long yesterday without charging. The patient is not stupid, so there is naturally a comparison in his mind.

I didn't go to the pharmacy or other clinics, but came all the way here to wait for Li Jingsheng to come back, probably wanting to prescribe some medicine for him to take home and eat.

Not to mention the medication for short bowel syndrome, even the medication for the bronchitis in front of me is laborious.

For ordinary bronchitis patients, Li Jingsheng can basically catch them with his hands.

For such an older person, with a history of smoking for many years, and with high blood pressure, the consideration of medication, blood drug concentration, drug exposure, metabolism time, and the impact on the body after medication are all worth considering.

This kind of clinical medication with considerable risks, the level of senior residents is really not enough.

At least one must have a low seniority attending level to be able to bear this important task.

Li Jingsheng checked his health, the balance was 346.

This is still because Boss Zhao 'poured' at his place two days ago, allowing him to earn an extra 50 points of life.

Successfully diagnosed the tetanus of the old man who scavenged waste, and paid for the old man to be sent to the hospital for treatment, where he earned 100 points of life.

Otherwise, it is impossible to have so many.

Regardless of how he sees patients every day, he can earn some money by touching and setting bones in the second hospital, but the life points gained from routine operations are not much.Just like working part-time, the monthly salary is so much.

It is impossible to skyrocket ten times and twenty times at once.

If you want to earn a "large amount of life", you need to do something "exciting".

Such as rescuing patients, someone sent him a pennant and so on.

He also found a problem. When he was helping bone setting in the Second Hospital, the praise of the patients was not given to him personally, but to the whole bone setting clinic, and occasionally to Dr. Xu.

This made him somewhat depressed.

One praise can get 10 life points, even if you only get three or four praises every day, you can get thirty or forty extra life points.

He also concluded that when he was in the Second Hospital, why did the patients not give him good reviews?

It is understandable that the patient's praise is given to the medical staff in the entire outpatient room.

After all, it was not Li Jingsheng's work alone to heal the patient's bone injury.

As for Li Jingsheng who set the patient's bone back and healed the patient's bone injury, the patient gave Dr. Xu a good review. This is the difference between the leader and the younger brother.

It's like a certain surgical team successfully completed a super-difficult surgical operation.

The winner of the highest honor must be the chief surgeon.

As for the surgical nurses, medical assistants, and anesthesiologists, despite their great efforts, they were all covered by the light of the chief surgeon.

Even if the chief surgeon only completed one-tenth of the operation, which is the most difficult key part.

The highest honor still belongs to the chief surgeon.

When the hospital publicizes, it will also write like this, a certain chief physician led the surgical team to successfully complete a super-difficult so-and-such operation.

When Li Jingsheng set the patient's bone, first of all, the patient went there in the name of Dr. Xu.

Secondly, when he set his bones, Dr. Xu guided the whole process.

After the patient is cured, the object of thanks must be Dr. Xu.As for Li Jingsheng, the patient would think like this: Damn, this novice doctor used him as a guinea pig for practice. Fortunately, Dr. Xu was on the sidelines to check, and there was no major problem. I was scared to death when I set the bone just now.

It will take time to change this situation.

When Li Jingsheng learned the bone-setting technique and was able to stand alone, he was no longer a 'student', but a new famous doctor in the manipulative restoration clinic.

It shouldn't be too long before that day comes.

……

Li Jingsheng looked at the two medical skills under the prescription.

42.5/100 for proficiency in drug efficacy and 39/100 for proficiency in pharmacokinetics.

These two medical skills are used very frequently, but unfortunately their proficiency improvement speed is not satisfactory.

In fact, it is very difficult to improve the proficiency of all medical skills.

Just look at the age of those experts.

Why are few young doctors able to become medical experts?It is because of the accumulation of experience that the improvement of medical proficiency is an extremely slow process.

Most of the young deputy chief physicians and chief physicians in the hospital are academic.

The real level of clinical medical skills is actually not good.

After he made up his mind, he didn't hesitate much. He spent 58 points of life to upgrade the efficacy of the medicine to the proficient level, and spent 61 points of life to upgrade the medicine to the proficient level.

So far, his medication level has leapt up by a notch.

From the resident level, directly jumped to the attending level.

Although it is only at the level of a junior attending physician, this strength can completely sweep the entire old street in the south of the city.Even in terms of medication, I can already wrestle with several old doctors in the community health service station.

Of course, he upgraded his prescription medicine skills to treat patients, not to show off his strength, so naturally he would not be bored and go to the community health service station to "kick the hall" if he had nothing to do.

He felt a new pharmacokinetics.

As expected of a proficient level, when I was at the proficient level before, I made great breakthroughs in the effects, properties, and methods of medication.

At this moment, he found that he has a new understanding of the therapeutic effects and adverse reactions of various drugs.

What kind of effect can be achieved after medication, what beneficial changes can be made to the patient's physiology, and even the entire biochemical function and pathological process, have a clearer and more comprehensive understanding.

Then there is a clearer and more intuitive comprehensive understanding of the side effects, toxic reactions, sequelae, secondary reactions, etc. of the drug.

After experiencing the proficient level of pharmacodynamic medicine, he even became more confident. He felt that he could stand upright and face the huge community health service with his left foot on the Kuaikang Clinic and his right foot on the Golden Chamber Clinic. stand up.

Because the patient was still waiting for him to prescribe a prescription for treatment, he only had a rough experience of proficient pharmacokinetics.

He found that in addition to improving the clearance half-life and clearance rate of the drug, the biggest gain should be the improvement of the two major capabilities of blood drug concentration and drug exposure.

The improvement of these two major abilities also gave him a preliminary level of combined drug use.

It can be safe, efficient and more accurate.

After upgrading the medicinal effect and pharmacokinetics, his HP is only 227 points left.

He wanted to save up to upgrade to the rank of doctor, which is the foundation of all medical skills and is extremely important.

However, if you want to increase the level of a doctor, you need more than 300 health points.

And he didn't dare to use up all of them at once, lest he would encounter an emergency and be unable to improve his key medical skills.

Sunshine Clinic can have today's situation, he has made countless efforts and hardships.

But it only takes one big mistake to ruin the situation.

Therefore, he must ensure that the family has sufficient surplus food at all times, so that he will not panic when something happens.

Especially now, there are at least seven or eight patients who receive consultations every day, and sometimes as many as a dozen. God knows when he will be lucky and pick up a bad patient.

Also, I am currently learning the remaining advanced bone setting techniques.

After learning it, if you want to use it immediately to make a name for yourself and make money in a small clinic, at least you have to upgrade to the proficient level to be barely enough.

If you want to reach the township level, the proficiency level is definitely not enough.

This is also the reason why he wants to upgrade the doctor level as soon as possible.

Thinking of this, I suddenly felt that two to three hundred points of health were too little, far from enough.

Pennant oh pennant, let’s have more!
Li Jingsheng prayed silently, if he could get a few more pennants and dozens of praises, his troubles would be solved.

Unfortunately, so far, only Sister Huan has given him a pennant.

(End of this chapter)