Gou is practicing medicine in the clinic

"It turns out there is this historical reason, and I can understand the patients' concerns."

Li Jingsheng nodded.

Many patients are very resistant to the treatment plans proposed by doctors due to various concerns or special reasons.

They may even put off treatment.

"Has this patient's coagulation function been checked? I feel that there may be a problem with his coagulation."

Li Jingsheng was able to infer that the patient's coagulation might be abnormal just by reading the patient's information. Director Tian was immediately amazed by his ability.

"The patient's coagulation function has not been tested yet. After confirming the surgical plan, preoperative tests on coagulation can be arranged immediately."

A blood routine can show basic data such as hemolysis, white blood cells, and red blood cells.

However, coagulation function is generally not checked.

Preoperative tests to check coagulation and the presence of infectious diseases are all required.

"Personally, I still feel that colonoscopy is too risky to remove such a large tumor. If there is severe intraoperative bleeding or intestinal perforation, emergency laparotomy will definitely be required."

Li Jingsheng looked at this big business and was greedy, but the risks were also extremely high.

In fact, not to mention the removal of tumors with a diameter of more than three centimeters, even the removal of intestinal polyps of about 2 centimeters is very risky.

However, colonoscopy technology is now becoming more and more perfect through continuous exploration by doctors.

The techniques are becoming more and more abundant.

Various advanced techniques emerge in endlessly.

"Any surgery has risks, let alone resection of such a large tumor. If you are willing to take this job, you can talk directly to the family and the patient himself. I believe they will understand."

Director Tian thinks these can be discussed.

The most important thing is whether Li Jingsheng has the ability to take over this business.

"The nature of the patient's tumor has been pathologically detected as tubular adenocarcinoma, which is a well-differentiated cancer. This is a blessing among misfortunes. At least the degree of malignancy is low. In addition, he is still in the early stage, which is also the result of endoscopic mucosal dissection. It provides a possibility. I think I can try colonoscopy."

Li Jingsheng gritted his teeth and decided to challenge.

Colonoscopy is only the first step, and the real advancement must be toward colonoscopy surgery.

Cutting out some ordinary polyps every day, how high-end is this?

Nowadays, hospitals with a little bit of strength can basically perform colonoscopy surgeries.

Moreover, when the patient had a colonoscopy, polyps were found and they were immediately removed.

Li Jingsheng focuses on high-end products, and must be aiming to cure some malignant tumors or solve problems that other large hospitals are difficult to solve. Only then can he form a real technology monopoly.

Just like his current bone-setting techniques, not to mention being invincible all over the world, at least he has no rivals in Jiangli City.

This has also led to countless patients coming here.

The Second Hospital is the biggest winner. It directly relies on Li Jingsheng's orthopedic surgery techniques to increase the business volume of the orthopedic surgery department by a large level. It also makes orthopedic surgery take great strides towards becoming a first-class department.

It is estimated that within three to five years, orthopedic surgery will become a first-class department comparable to general surgery.

Even better than general surgery.

Li Jingsheng’s Sunshine Clinic also benefited greatly.

At least half of his current personal fame is earned through his bone-setting techniques.

It would be unimaginable if he could also develop an absolute technical advantage in colonoscopy.

Both his personal reputation and his status in the medical community will reach a higher level.

This patient has colon cancer, but there are some favorable conditions. He feels that as long as the patient's money is enough, he can take the risk and challenge it.

The worst outcome is converting from colonoscopy to laparotomy.

After all, the tumor is so large that it is easy to cause intestinal perforation during the resection, which is a great potential risk.

"This is the patient's own phone number. You can contact him directly. You can discuss the price. The patient said that within 50,000 yuan, he is completely acceptable. If there are more, I guess he will not refuse."

Director Tian introduced this business to Li Jingsheng, and he definitely wanted to earn a big red envelope.

As for the operation itself, Director Tian thinks it is not particularly difficult.

Li Jingsheng did not shy away and dialed the patient's phone number on the spot.

"Which one?"

"Is this Mr. Zhao? I'm Dr. Li Jingsheng from Sunshine Medical Team."

Li Jingsheng introduced himself.

"Oh, was it introduced by Director Tian?"

"Yes, yes, yes, Director Tian told me that you want to make an appointment for high-end colonoscopy service. I have already seen your examination information, early-stage colon tubular adenocarcinoma. I heard that you are resistant to traditional laparotomy?"

Li Jingsheng went straight to the point.

"Yes, I hate laparotomy. Can your team solve it for me directly through colonoscopy?"

the patient asked.

"Well... the diameter of your tumor is still quite large, and it has exceeded the size that the colonoscopy can handle. But if you want to use a colonoscopy to solve it, our team is willing to go all out. But you also know, because The tumor is larger and there are relatively high surgical risks, so there is no guarantee that it can be solved through colonoscopy. All we can say is that we are willing to try our best."

Li Jingsheng must clearly explain the risks.

Otherwise, if it fails, he will not be able to explain it to the patients and their families.

To be able to spend tens of thousands for an operation that could have been solved for only seven to eight thousand yuan is definitely not an ordinary family.

Li Jingsheng would never dare to offend such an employer.

"I have heard of some of the names of your Sunshine Medical Team. Two of my friends said that your team is very professional. I am very anxious now. Do you think the surgery can be arranged tomorrow?"

The patient had actually heard of the reputation of Sunshine Medical Team, which made Li Jingsheng quite surprised, and at the same time he was a little bit happy and proud. The team has persisted for nearly two months and has served many big bosses.

Li Jingsheng took all the colonoscopies that other doctors were unable to perform.

And hand over satisfactory answers to patients.

The team's reputation is also building up bit by bit.

"It's a bit hasty to arrange the operation tomorrow, the day after tomorrow! Before that, our team needs to make two preparations to ensure your safety. In case the tumor is too large during the operation and the colon is perforated after resection. At this time, surgery must be performed Abdominal rotation is a traditional surgery. There are also some accidents that may occur during the surgery, so you must be prepared for the worst.

Especially your coagulation function, this needs to be checked carefully.

Based on my experience, looking at some of your examination data, as well as your personal symptoms, conditions, and medical history, I am a little worried that there is a problem with your coagulation function. "

Li Jingsheng also had something to say.

Communicate very openly with patients.

"Yes, I like your down-to-earth style of doing things. Just follow your arrangements."

The patient was surprisingly cheerful.

Li Jingsheng didn't know how to answer the call.

"Mr. Zhao, there is one more thing that I need to discuss with you beforehand."

"Please speak."

Mr. Zhao's attitude towards him seemed to have suddenly become much more polite.

I don’t know if it was because of Li Jingsheng’s frank communication that he gained Mr. Zhao’s favor.

"Although your colon tumor has been pathologically tested, when pathological specimens are taken, only a few epidermal cells are usually taken before surgery. Therefore, no one can predict the final nature of the tumor.

Even for colon tubular adenocarcinoma, there are three types: poorly differentiated, moderately differentiated, and well-differentiated adenocarcinoma.

If it is a highly differentiated adenocarcinoma, the prognosis will be more optimistic.

If it is poorly differentiated tubular adenocarcinoma, which has a higher degree of malignancy, no one can predict what the endpoint will be after surgery. "

Li Jingsheng must put the ugly words first.

This is the experience he gained from opening a clinic.

Just like estimating the total treatment cost for a patient, he always likes to estimate a little more.

In this way, even if it is really higher than expected, the patient can still accept it.

At the end of the treatment, the total cost is less than estimated, and the patient will be happy.

However, the total estimated cost for the patient was one thousand yuan. However, after two thousand yuan of treatment and the patient was still not cured, the patient might smash his clinic and call him a shady doctor.

"It's okay, just give me a free hand and treat it. No matter how bad the outcome is, I'm prepared for it."

Mr. Zhao answered very simply.

It even tastes like an understatement.

Colon cancer can be divided into adenocarcinoma, adenosquamous carcinoma, undifferentiated carcinoma, etc.

Adenocarcinomas are generally less malignant.

Undifferentiated carcinoma is extremely malignant and its prognosis is generally not optimistic.

This cancer is prone to recurrence and metastasis, especially lymphatic metastasis, which gives many doctors a headache.

It takes away many lives every year.

Tubular adenocarcinoma of the colon is the most feared of encountering poorly differentiated cancer.

It is far from the normal glandular structure and is even diffusely infiltrative. Its tubular structure is not obvious, so the prognosis is very poor.

"Thank you, Mr. Zhao, for your trust. Let's talk about the cost. If it is found that there is no problem with coagulation, we can give you 50,000 yuan. If it is found that there is a problem with coagulation, it will probably cost 70,000 yuan, or even higher."

Li Jingsheng gritted his teeth and reported a sky-high surgery fee.

High-end customers are generally insensitive to fees.

This patient's surgery is high risk and he must be overpaid.

No doctor can guarantee that he will never fail.

Li Jingsheng can't guarantee it either. As long as the operation fails, there is a high probability that the family will have to be compensated by then.

Since the risk is high, it is natural to ensure that the profit is high enough.

"Seventy thousand is seventy thousand. It's no problem. As long as I perform the surgery well, I'll give you a red envelope of twenty thousand after recovery. It's no problem. Compared with life, tens of thousands more doesn't really matter."

Mr. Zhao is too proud.

This was agreed upon by both parties.

Li Jingsheng asked Mr. Zhao to go to the People's Hospital to draw blood for a coagulation test, so he didn't mention it.

It was a rare visit to Director Tian, ​​and he took the opportunity to ask Director Tian some difficult questions about colonoscopy and digestive tract diseases.

Director Tian has been deeply involved in the field of digestive tract for many years, and is especially good at gastrointestinal diseases.

The application of basic medical knowledge is simply perfect.

The clinical experience is extremely rich.

Director Tian's biggest shortcoming may be that his medical skills in the gastrointestinal field are relatively balanced and he does not have a particular disease.

The two chatted for a long time. Director Tian thought of something and said to him.

"Dr. Li, look at this patient's condition. Do you think it can be solved through gastrointestinal endoscopy?"

He pulled up a patient's information from the computer. (End of chapter)