Come on, Dr. Wu

Chapter 311 Zone E!
Who wouldn't want to graduate early?

Most doctors nowadays do not think about continuing their studies as long as they can graduate early. In their opinion, theoretical knowledge is not as important as practice. Most importantly, students do not make money.

Of course, Wu Xiaofu doesn’t think so. It is always good to learn more, especially the resources of a good school.

However, for Wu Xiaofu, studying in school now is really meaningless. It would be best if he could graduate early.

To be honest, every time I saw those friends online who had to delay their graduation and looked so worried with their hair falling out, Wu Xiaofu felt distressed. At that time, his biggest wish was not to delay his graduation. Now, not only can he graduate early, but he can graduate two years early.

After this, Wu Xiaofu could also say that he was a doctoral graduate.

"Also, the National Health Commission has approved it. You are still an attending physician. If you tell others about it, people will laugh at you. You will go through the formalities during this period. In a few days, you will take an exam and be promoted directly to associate chief physician."

Deputy Chief Physician!
That's all! Although I started planning for promotion after coming back this time, it was still a pleasant surprise to get Rong Qiao's promise so suddenly.

Since Rong Qiao said so, there must be no problem.

After going through the procedures, I estimate that his professional title will be promoted within next month at the latest.

This is the privilege of technical elites. Cases like Wu Xiaofu actually exist in many hospitals. Some doctors look young, but in order to give them adequate treatment, they are basically given convenience in promotion of professional titles.

It is actually very difficult to go from attending physician to associate chief physician.

Not only has the exam become more difficult, it is also very difficult to get hired in the hospital. Take the current First Affiliated Hospital of Donghai as an example, out of ten deputy directors, probably only two or three are hired, and the others have passed the exam and passed the associate chief physician exam, and their title is still attending physician.

It doesn’t matter who the attending physician is, we will hire as many as we can.

The most important thing is that after being promoted to deputy director, it will be legitimate for others to call him director.

Later, Rong Qiao directly gave Wu Xiaofu a series of salary increases, such as a performance improvement of 2.3. Wu Xiaofu accepted all the offers. He also realized that if he did not accept them, Rong Qiao would not be at ease.

"By the way, Xiaofu, Donghai TV station contacted our hospital and said they are preparing to start filming the second season of The Offer. They want you to be their mentor at that time. Please consider it."

offer2.

The internet has been going crazy these days, all about this matter. Wu Xiaofu naturally knows about it. He is just a mentor, and his work will not be affected except when shooting the scenes.

The protagonists are a few interns, and Wu Xiaofu is really interested in training new talents.

"Okay, I'll think about it."

After returning to the department, Zuo Hui held a small celebration ceremony for Wu Xiaofu, which included a big cake, and then the entire department celebrated for Wu Xiaofu together.

Looking at Zuo Hui, Wu Xiaofu felt a little sad. Zuo Hui has had a hard time recently. Last time, because of the relationship with that leader's family, there was a big fuss, and since then he has made small mistakes repeatedly.

Therefore, he is often said to be old, and even Zuo Hui's condition seems a little unnatural.

When Wu Xiaofu was looking at Zuo Hui, Zuo Hui was also looking at Wu Xiaofu. Zuo Hui knew that Wu Xiaofu could no longer be suppressed and that he could no longer suppress him. So, he simply didn't have the mind to focus on such things now. He just went along with Wu Xiaofu. It would never be wrong to maintain a good relationship with him.

Wu Xiaofu felt Zuo Hui's attitude and was also very surprised. This department director was treating him better and better.

When Wu Xiaofu was not around, it didn't mean that the patients were completely ignored.

When encountering some difficult cases, Feng Lingling and others would send them to Wu Xiaofu and ask for his opinion. If some problems arose during the operation, they would basically turn on the video and deal with them on the spot. Therefore, Wu Xiaofu actually knew a lot about many patients in the group.

Of course, this is also the norm for doctors.

When doctors go on vacation, their phones have to be kept on 24 hours a day, as department matters and patients may come to them at any time. Other jobs may not be fatal, but a doctor's work is often life-threatening, so answering the phone in the middle of the night has become the norm. Although they may complain, no one will actually turn off their phone or anything.

"Boss, have you heard?"

"What did you hear?"

"The hepatobiliary surgery department in our hospital is very popular now. I heard that the hospital is planning to open an E-area. Isn't it graduation season? There is a notice on the hospital's official website, recruiting people, especially our hepatobiliary surgery department has the most people."

We need to open a new department!

Not to mention, Wu Xiaofu had never heard of this matter.

"Just open it, it has nothing to do with us."

"Boss, why isn't it big? If it was the old one, it would be fine, but if we open a new section now, don't you want to be the head of the new section?"

Department Director!
Wu Xiaofu paused when he heard this. To be honest, if Yuna hadn't reminded him, Wu Xiaofu really hadn't thought about this matter. After all, he also subconsciously felt that it was too early for him to become a department director.

But that was based on seniority. If it was based on ability, Wu Xiaofu suddenly felt that he was good enough.

"Okay, these are issues that the dean should consider. Why are you worrying so much? Just focus on taking care of the patients."

Yuna was a little disappointed when she saw Wu Xiaofu's expressionless face. This boss was not proactive at all.

No, she must do a good job of intelligence work later. If Wu Xiaofu had not won the World Surgery Competition Championship and made such great contributions to the First Affiliated Hospital, Yuna would definitely not have had too many ideas. But now Wu Xiaofu has both the merits and the strength, and has been leading a team for some time. Why can't he become a department director?

The boss is not in a hurry, they must be more proactive.

Everyone knows that rising water lifts all boats. The higher the boss goes, the faster they can go.

In the ward.

"The patient is a 16-year-old male who was admitted to the hospital two days ago due to 'recurrent fatigue, yellowing of the skin and sclera for more than a year.'

Height: 165 cm; Weight: 55 kg; BMI: 20.2.

The patient developed chills, fever, nasal congestion and runny nose after catching a cold one year ago. His condition improved after treatment, but he gradually developed yellow skin and upper abdominal distension and pain, accompanied by nausea and vomiting, and vomited gastric contents.

The patient was then taken to a local hospital for examination and was diagnosed with acute icteric hepatitis. He was given liver protection and jaundice treatment and was discharged after his condition improved slightly.

The patient was treated with drugs such as polyene phosphatidylcholine, ursodeoxycholic acid, and compound glycyrrhizin outside the hospital, but the effect was poor. Jaundice persisted and the TBIL level was 50-100 μmol/L.

Two months ago, the local hospital considered the patient's clinical diagnosis to be 'autoimmune hepatitis' and added prednisone 2 mg/qd and azathioprine 30 mg/qd. The patient's family reported that the patient's symptoms had not changed significantly, but there was thickening of facial hair and pigmentation.

One week ago, the patient experienced nausea, vomiting, severe abdominal pain, and vomited coffee-colored gastric contents twice, about 1 ml each time. The abdominal plain film taken at the local hospital showed: colon gas expansion, a large amount of gas and feces were seen inside, and the diagnosis was considered to be "incomplete intestinal obstruction, emergency ulcer bleeding". Prednisone was discontinued, and symptomatic treatment such as fasting, liver protection, stomach protection, and anti-infection was given. The patient was discharged voluntarily. (Supplementary medical history: urine porphyrin negative)
The patient visited the emergency department of our hospital 2 days ago. The whole abdominal CT showed: a small amount of pelvic effusion, slight gas expansion in the transverse colon and ascending colon, slightly blurred ileocecal structure, unclear appendix, possible fecal stone shadows in the cavity, and multiple adjacent superior mesenteric lymph nodes. The density of the liver parenchyma was slightly reduced, mild fatty liver was possible, bile stratification, and spleen enlargement.

......"

Feng Lingling's voice echoed beside the patient's bed. Today was Wednesday and Wu Xiaofu had just returned, so the whole team was doing rounds. Wu Xiaofu was in the lead, with Chen Zhendong and Zhang Xuewen next to him, and behind them were Feng Lingling, Yuna and the others.

Whoever has the patient is responsible for him/her. When the new patient is undergoing ward rounds, the attending physician will introduce the detailed condition.

Well, the kind that doesn't even look at the medical records, just speaks without thinking.

If a doctor cannot even understand the condition of his own patients clearly, how can he guarantee the safety of his patients' lives? Even if you have too many patients, that is your own business. You must do what you should do.

This was a patient who had just been admitted to the hospital two days ago. Wu Xiaofu had never met him before and knew nothing about his condition. So when Feng Lingling explained his condition, she had to be more detailed.

While Feng Lingling was explaining the patient's condition, Wu Xiaofu was watching the patient's examination.

"What about the diagnosis?"

"Incomplete intestinal obstruction, autoimmune liver disease? Others include stress ulcers and splenomegaly."

Wu Xiaofu nodded. Actually, the latter ones were all internal medicine diseases, which were the work of the Department of Gastroenterology. The reason why they were transferred to the Department of Hepatobiliary Surgery was because of the intestinal obstruction, which required emergency surgical treatment. The main diagnosis was generally based on which department the patient was transferred to.

This is not only the reason why the patient's condition is more urgent, but also the reason why medical insurance reimburses and pays, the latter being the main reason.

Now payment is made based on a single disease type, which is the so-called principal diagnosis payment.

Just like this patient, if the main diagnosis is changed to several other diagnoses, then the set of examinations and operations they performed may not be reported.

"What are you going to do next?"

"The patient's obstruction cannot be relieved by medication now, and it will not work over time. It is easy to develop into a complete intestinal obstruction, so I suggest surgery to relieve the obstruction first."

Surgery to relieve the obstruction!

Wu Xiaofu frowned and came to the patient, who was actually just a sixteen-year-old child.

For underage children like this, it is best not to have surgery if possible.

Of course, if surgery is really necessary, you should not hesitate, but the most important thing is that surgery can really solve the problem completely.

What causes intestinal obstruction? In fact, children of this age rarely suffer from intestinal obstruction unless there is a particularly clear cause. If the root cause cannot be found out, surgery will be performed directly. After the surgery, it is very likely that the patient will experience obstruction again not long after the surgery.

What should I do then? Another surgery!

The doctor can perform the operation, but the patient’s body may not be able to withstand it, and the patient’s family may not be able to accept it. It may even lead to another lawsuit. Therefore, such things that easily cause disputes should be avoided as much as possible.

Surgery is always the last resort. Sharpening the knife does not delay the chopping of wood. We still have to find out the cause of the disease first.

"Have you considered the cause of the patient's obstruction?"

"The indigestion caused by liver disease and the patient's stress ulcers still have a high chance of developing obstruction."

This is purely empirical judgment. In medicine, old doctors like to use empirical judgment when treating patients. However, one characteristic of modern medicine is that it is evidence-based. What does it mean? Anything written must be supported by evidence.

Experience is not sufficient evidence.

He shook his head. "Not necessarily. The obstruction is not that serious. There is no need to rush for surgery. Let's do a liver biopsy."

Liver biopsy!

Everyone was shocked when they heard this, not to mention Chen Zhendong and his friends, even the patient's family members were excited. What does liver biopsy mean? It is not ten years ago now, and people still have some basic medical knowledge.

This is to take liver tissue for examination.

"Doctor Wu, what's going on? We're going to remove his liver. He's so young..."

The patient's family members were crying at this time, and Wu Xiaofu could only comfort them in a low voice.

"A liver biopsy is actually just a puncture, making a small incision and taking a small piece of liver tissue. It does not cause much damage to the child. With his recovery ability, he will recover in a few days. The child is so young and has no history of liver disease. You have no family history of genetic diseases, so what is the cause of the liver disease?
A liver biopsy is the quickest way to determine the cause of a child’s illness.”

At this time, Chen Zhendong and the others also calmed down and looked at Wu Xiaofu, "Do you suspect that you have a hidden disease?"

Hidden diseases are actually diseases whose causes are difficult to identify.

For example, genetic diseases, unidentified diseases, etc.

"Well, it's best to do a genetic test as well. For patients with unexplained abnormal liver function, a liver biopsy and pathological histological examination can help clarify the diagnosis and further narrow the scope of differential diagnosis. Molecular and genetic testing is even more important for diagnosing inherited metabolic liver diseases."

Wu Xiaofu told Feng Lingling that she was the attending physician and these were things that Feng Lingling had to discuss with the patient's family.

Wu Xiaofu will give the direction of diagnosis, but he will not interfere with how the follow-up will proceed or how Feng Lingling will talk to her family. If things don't go well later, he will step in later.

After the ward rounds, Feng Lingling did not delay and went straight to the patient's family to have a conversation.

She had finally figured it out. She had been thinking too simply before. If there really was some genetic liver disease and she had hastily performed the surgery, then if there were problems later, it would not be as simple as just delaying the treatment.

"Doctor Feng, I'd better think about it first."

The patient's family has always found it difficult to make a decision. Although Wu Xiaofu has a great reputation, this involves a liver biopsy and a genetic test. Feng Lingling had previously said that surgery was needed to relieve the obstruction. Now that she has another idea, who should she listen to?

Especially the genetic test, which is really not cheap and cannot be reimbursed.

After thinking about it, the patient's family made a few phone calls.

Wu Xiaofu was holding a pre-operative discussion with Yuna and others in the office. A lot of surgeries had been piled up during this period, and Wu Xiaofu wanted to have them all done as soon as possible.

Bang bang bang!
Wu Xiaofu looked at the door that was pushed open. It was an acquaintance.

Director Fang of Group B is the deputy director of the department. He is a senior chief physician and has rich experience.

"Director Fang, how come you have time to come here? Do you have something to talk to me about?"

Director Fang looked at Wu Xiaofu and smiled.

"Xiao Wu, there is a patient in your group, Fang Wenfan, who is a relative of mine. His mother called me just now and said that you asked him to do a liver biopsy and genetic testing. I looked at his medical records and examinations, and I wanted to come and talk to you."

Ah!
Everyone's brows furrowed when they heard Director Fang call Wu Xiaofu Xiaowu. Who else in the entire hospital is so low in emotional intelligence to call Wu Xiaofu Xiaowu directly?

Those who have a good relationship with him, such as Rong Qiao and Yu Shifu, all call Wu Xiaofu Xiaofu.

Those with average relationship always call Dr. Wu when they meet, and they have to call him "boss".

They are all team leaders. Wu Xiaofu's status and position are different now. It's okay to call him Xiao Wu in private, but it would be inappropriate if there were other people present. Fortunately, there were no patients, otherwise, I don't know what people would think when they heard that he was a junior.

Moreover, intervening in the conditions of patients in other groups is against the rules.

However, since they are relatives, it is understandable. However, judging from what Director Fang said, he seems to be questioning Wu Xiaofu's diagnosis and treatment methods.

Just now, Wu Xiaofu had emphasized Fang Wenfan's condition again, and they had also reacted at this time. Not to mention, after Wu Xiaofu's analysis, it might really be some tricky liver genetic disease.

However, no one was in a hurry to speak. After all, he was a senior and they still had to respect him and listen to what he had to say first.

"Director Fang, please give me a call and I'll come to see you. Why are you making this trip in person? Come, take a seat first and we'll talk."

Wu Xiaofu, on the other hand, showed no sign of being surprised. Everyone has relatives. It's understandable.

Director Fang was also very satisfied when he saw Wu Xiaofu's attitude.

"Xiao Wu, I looked at Fang Wenfan's medical records and examinations. There is no history of genetic diseases in his family. He was admitted to the hospital this time because of intestinal obstruction. The child's mother also said that the child has had poor immunity since childhood.

In my opinion, it is an autoimmune liver disease that is causing the recurring jaundice. I think that after the intestinal obstruction is relieved, the immunity should be strengthened. Not to mention the high cost of liver biopsy and genetic testing, I don't think it is necessary.

Xiao Wu, I know you're worried, but how high is the chance? It doesn't seem likely at all. Also, I don't think intestinal obstruction requires surgery. Just refer the case to me. I'll give him some medication and it should be fine."

After these words were spoken, before Wu Xiaofu could say anything, Feng Lingling's face had already turned dark.

What do you mean!
It means that she doesn't know how to relieve the obstruction with drugs and only knows how to do surgery. Director Fang has simply condemned her whole organization.

(End of this chapter)