Come on, Dr. Wu

Chapter 349 Assessment Continues
What the hell!

There is no gallbladder. What's going on? It's possible that the color Doppler ultrasound reported something wrong, but the gallbladder cannot be gone. If the patient had a cholecystectomy before, he would not have said nothing. Moreover, if he had done it, there would be an incision, and it would not have been described in the medical record.

What's going on? Just watching your friends get into trouble.

They finally understood how the zero score came about. There was no gallbladder, so they performed gallbladder surgery. After the stomach was opened, they suddenly discovered that the gallbladder was missing. What should you do at that time? Should you go with the flow and sew up the stomach and say that the operation was successful, or should you just tell the truth?

To be honest, this is a serious medical negligence.

People asked you why you didn't check it carefully before. You didn't even know the gallbladder was that big, but you still performed the surgery. What a quack you are!
It's not possible to just go along with the mistake. The anesthesiologist is the patient's son and is standing next to him. Once the stomach is opened, there is no way he can hide it.

I was really screwed by my brother.

"That's not right. There is no gallbladder. Why would the ultrasound department report a filled gallstone?"

"This is your second mistake. The ultrasound department is an auxiliary department. Can they write the diagnosis on the ultrasound report so decisively?

Moreover, even if someone wrote it, don’t you know what an ultrasound department is? How dare you believe it? You didn’t even write this. Now, think carefully about how this filling-type gallstone came about.”

Yes, they were also careless. However, it cannot be blamed on them. Who made them trust the auxiliary department so much? They could not have thought that a small gallstone would be written wrong, especially when several examinations from other hospitals showed filling-type gallstones. Such a definite diagnosis made them believe it.

There are so many color ultrasound doctors and so many hospitals. It would be okay if one of them made a mistake, but could all of them make mistakes?
"The fact is that before doing the ultrasound, the ultrasound doctors in some hospitals would ask the patient what their condition is, so that they can have a clear direction for the examination. The patient told the ultrasound doctors that they had filling-type gallstones, and then the ultrasound doctors would look at it in that direction.

Well, as expected, at a glance, they are all filling-type gallstones, each one firmer than the other."

such!

Cheng Shi and Jiang Bei had also rotated to the auxiliary departments. Thinking about the situation during the rotation, it seemed to be really like this.

But this pit has caused them a lot of suffering.

Also, what kind of disease is it that makes the ultrasound doctors see it as filling-type gallbladder stones? It is very obvious whether there is a gallbladder or not. If there is no gallbladder, it should be able to be seen somehow.

But now this is what they should think about, and they have to think about it as soon as possible. They have already scored zero points. If they can't get an answer, it will disappoint Wu Xiaofu a lot, and this is not what they want to see.

"Ultrasound uses elastic mechanical waves to form images. In fact, gallbladder agenesis is very similar to filled gallstones. Ultrasound doctors also saw that the patient had no incisions on his abdomen, and the patient also said that he had never had surgery. So they rarely thought that the patient had congenital gallbladder agenesis. Therefore, their first reaction was filled gallstones."

Cheng Shi gave the answer quickly, but he was a little nervous, wondering if this answer would satisfy Wu Xiaofu.

Jiang Bei had a puzzled look on her face, "Is there anyone born without a gallbladder?"

Wu Xiaofu rolled his eyes at Jiang Bei. "It's normal for an undergraduate student not to know. You are a doctoral student. Even if you haven't read the relevant books, you should have at least some impression of it. How can you not know this?"

However, congenital absence of the gallbladder is indeed rare. It is an extremely rare congenital bile duct malformation. The incidence rate reported abroad is 0.010%~0.065%, and the domestic reported incidence rate is slightly higher, but only 0.032%~0.070%. So far, only 400 cases have been discovered worldwide.

These are mainly case reports, and no standardized diagnosis and treatment methods have been established.

It is very easy to misdiagnose clinically and lead to unnecessary surgery, just like Jiang Bei and others. If they were really asked to take over this patient, the surgery might have already been done. After all, there are too few cases of congenital absence of gallbladder, and no matter who it is, the first reaction would not think of congenital absence of gallbladder.

Even many doctors don’t know about congenital gallbladder absence, just like Jiang Bei.

Moreover, during the operation, many people are unaware that the patient does not have a gallbladder and are still focused on finding the gallbladder. This process can easily lead to bile duct damage. Well, the absence of a gallbladder does not mean the absence of a bile duct.

"Boss, the ultrasound doctor can't see the arc waves produced by the gallbladder, so he can't diagnose filling gallstones. Shouldn't he write that the gallbladder cannot be explored clearly? Where does this confidence come from?
I think they mistook something for the gallbladder, like a fecal stone in the transverse colon."

Jiang Bei has a high IQ and a good foundation. She quickly put forward her own point of view. Although they did not study ultrasound, they still knew the basic concepts of ultrasound. In Jiang Bei's understanding, there is a difference between having no gallbladder and having filling gallbladder stones.

So, another perspective is given.

Wu Xiaofu nodded and said, "Both of your opinions are correct. In fact, the patient had three outpatient color Doppler ultrasounds. In the first ultrasound, the ultrasound doctor mistook the fecal stones in the transverse colon for gallbladder stones. The next ultrasound doctor was just like Cheng Shi said, too confident, and mistook the absence of gallbladder for filling gallstones.

I gave you this case so that you can pay more attention to it. I have already said it today. Next time, if you see an ultrasound doctor report a filling gallbladder stone, what will be your first reaction? "

"Recheck the CT scan."

Jiang Bei and Cheng Shi said almost in unison that it was fortunately a case analysis. If it was really a real situation, and they were on the operating table with their stomachs opened, this case would have been a shadow in their lives. Although they were not facing the same case now, they should be vigilant in the future.

They are the diagnostic doctors and should never trust the auxiliary departments too much. They still have to make their own judgments and do their own research. If they encounter any doubts, they should not hesitate to conduct further investigations.

Seeing the reactions of the two, Wu Xiaofu was quite satisfied. He nodded and looked to the side.

This is the case with Jiang Bei and Cheng Shi, Xun Qi and others are not much better. Although the idea was proposed by Wu Xiaofu, the cases were found by Lin Dongping and others themselves. The questions asked by Lin Dongping and others are basically the same as Wu Xiaofu's, which are the kind that are very easy to mislead people, but they are rare cases.

Not to mention interns like Xun Qi, even some attending physicians would probably be fooled.

Therefore, this zero score was not unexpected for them. It would have been strange if they could get any points.

Like Jiang Bei and Cheng Shi, Xun Qi and the others were also criticized to the point where they couldn't even raise their heads. However, it was noticeable that there was a bit more composure in their eyes. Having just stepped out of the campus, they were full of high spirits, some were overconfident, and even a little impetuous.

This impetuousness can definitely be washed away with work, but how to wash it away, that is painful memories, those are mistakes and lessons, bad memories for doctors and patients, which make them mature and stable. What Wu Xiaofu and others are doing now is to help them avoid this.

Since they followed them and became their interns, they naturally had to take on some responsibilities. If they could help them avoid future tragedies with the help of a case or an assessment, then it would all be worth it.

Of course, the assessment is definitely not over.

"Okay, you can all gather and go to the clinic."

Go to the clinic! What does that mean? There is also an assessment?

Facing everyone's puzzled looks, Wu Xiaofu smiled and said, "You don't think this is the end of the assessment, do you? This is just an appetizer. We have already communicated with the hospital. You will be working in the convenience clinic today. There will be some teachers who often work in the convenience clinic watching you. At the end of the day, your performance will determine your score."

Appetizers!
They just thought that Wu Xiaofu had problems understanding appetizers, but they felt much more relaxed when they heard it was a convenience clinic.

Unlike specialist clinics, convenience clinics are set up for patients who seek medical treatment for a purpose, or for patients who only have minor problems.

For example, if a patient needs to get some medicine, but cannot get an appointment at a specialist clinic, or has to wait for a long time even if he does, he can come to the convenience clinic and get the medicine directly there. As long as you know what medicine to use and how to take it, with the support of the doctor's previous medical records, the problem can be solved quickly.

For example, if you want to get a check-up, the outpatient clinic of the First Affiliated Hospital is actually not cheap. It is not easy to get an appointment, and it is not cheap. You have to wait a long time to get an outpatient clinic. If you don’t have any tests, you will go to see a doctor. It is very likely that the doctor will prescribe tests for you based on his own experience and ask you to go for the check-up.

Can you feel at peace if you are dismissed in a few minutes? You spent so much money and time to eradicate the problem, not to get a few checkups. Most importantly, even if you get the checkups, you can't come back to see this doctor for a checkup.

Because the examination at the First Affiliated Hospital requires a long waiting time, and if you want to make an appointment with the same doctor next time, even if you can get one, it will be a long time later, and the time cost and expenses are too high.

Therefore, the best way to see a doctor is to go to a convenient clinic first. The doctors here are all experienced and will issue you a check-up list based on your symptoms and other conditions. You can then go for the check-up. After the check-up, they will find relevant doctors and professors based on the problems on your check-up list and then register for treatment.

This way you can spend the least amount of money and time and get the best treatment.

There are also some patients who have chronic diseases or are in the maintenance treatment stage. They need periodic follow-up examinations and medication, so they don't have to see the attending physician every time. They can just go to the convenient clinic for a check-up. If there is a problem, they can make an appointment with the attending physician to adjust the treatment method. If there is no problem, they can just continue to observe.

The word "convenience" is not for nothing. It is to make it easier for patients to see a doctor. Moreover, the registration fee for a convenient clinic is very cheap and there are fewer people queuing. However, many people seem unwilling to come here, or they don't even know about the convenient clinic.

This is also the reason why Xun Qi and others feel at ease. If they are just dealing with these patients, they feel they can handle it with ease.

What's more, there are teachers following them, although they are to monitor them, but if there are really big problems, these teachers cannot just ignore it. After all, it is related to patient safety. In this way, there will be no problem. They are all doctors who have just graduated from school. They still have a strong sense of responsibility towards patients and do not want to have any bad influence on patients due to their lack of experience.

The convenient clinic is located on the first floor of the outpatient department, which is also to ensure that the word "convenience" is carried through to the end.

There are twelve windows in total. Yes, there are twelve windows in the convenience clinic. The twelve doctors have actually all worked in the hospital for at least five years. They are experienced enough to make people believe in them.

When Jiang Bei and the others came over, the people from the medical department led them into the outpatient clinic.

There are eight people, each at a workstation, and no one else can be seen.

The convenience clinic starts at 10:20 and ends at 12:00 in the morning.

Now, let’s begin.

Soon Xun Qi and his colleagues discovered that it was not so easy to run a convenient clinic. You know, whether it is medical students or doctors, they become more specialized as they learn more, and the professions become more and more specialized. In the end, they basically focus on the knowledge of their main profession, and naturally they lack knowledge of other professions. Xun Qi and his colleagues are the same.

But the convenience clinic doesn't care about these things. The patients who come here are of all kinds, with diseases from various departments, and they all need your treatment. Although they are not asked to treat the diseases directly, it is difficult to make the most basic judgment.

Just a few patients had passed by, but they had already begun searching for the deepest memories in their minds.

At Cheng Shi’s convenience clinic.

A patient with a headache came and said that he couldn't get an appointment with a specialist, so he thought that Cheng Shi could prescribe some medicine and do some examinations, and then he could go back and try it first.

This!
Cheng Shi is really not good at treating neurological diseases, let alone using medication. How dare he prescribe it casually? However, if the patient has a request, he has to handle it, or at least give some supporting reasons to refuse.

After hesitating for a moment, Cheng Shi sent a message in the group.

Xun Qi and the others’ cell phones were also placed on the table.

"Have you noticed that the patients coming here are very diverse? We are not general practitioners, so we may make a mistake or treat the wrong condition if we are not careful. So, if we meet someone from the other department, we can recommend them to us. This way, we can reduce the chance of error and satisfy the patients, giving them the most satisfactory treatment."

As soon as these words were spoken, Xun Qi and the others nodded subconsciously. This was a good idea. They had also encountered the same problem as Cheng Shi, and were still hesitating about how to solve it. They couldn't just fool around. This would not only be irresponsible to the patients, but also to their own assessment.

If it is like what Cheng Shi said, it would be much better. Cheng Shi is not good at treating neurological diseases, but Fu Yuanhang and Chao Yuan can. General surgical diseases that Xun Qi and others are not familiar with can also be recommended to Cheng Shi and Jiang Bei. In this way, patients can be diagnosed and treated quickly and well.

It was passed unanimously and officially implemented.

In the distance, Wu Xiaofu and the others saw the situation of the few people and nodded with a smile. To be honest, the performance of Cheng Shi and the others was somewhat beyond their expectations.

"See, they are very adaptable."

(End of this chapter)