Doctor Song, are you married?
Chapter 61 What checks do 61 need to do?
Chapter 61 61. What checks need to be done?
Song Qi was also satisfied with this arrangement.
After all, circumcision is only a small part of his long career, and he cannot stay in such a small operation for too long, as he still has a lot to learn.
In the vast sea of medicine and vast knowledge, how could he stay for a foreskin?
Only by following a big man like Shan Weihao can we get in touch with more patients and more complicated cases.
Since Shan Weihao came to the District Traditional Chinese Medicine and Western Medicine, the number of patients in the expert clinic has increased day by day. Some nearby patients, who originally went to the People's Hospital, now also come to the Traditional Chinese and Western Medicine.
In short, the current Chinese and Western medicine is not a little more lively than before.
Working as an assistant to the director basically involves taking medical history, writing medical records, and doing physical examinations.It will be tiring, but you will definitely learn something.
As soon as I sat down in the expert clinic, before I had time to drink my saliva, Wang Jian, the chief physician of internal medicine, brought a patient over.
"Director Shan, there is a patient here. I have seen it several times. I feel very special. I originally wanted to transfer him to the People's Hospital. I didn't expect you to be here, so I was transferred to you. Please take a look." He pointed to the man behind him, and handed over the outpatient medical records.
As a physician, Wang Jian has the basic qualities of all physicians, for example, he speaks slowly, with a gentle voice and a gentle attitude.
The patient was a young man in his thirties, with a strong body and a dark complexion. He was wearing a camouflage military uniform with three or five mud spots scattered on it.
Seeing this attire, Song Qi guessed that this person was most likely a migrant worker on a nearby construction site.
There are several construction sites near the traditional Chinese and Western medicine in the district, and migrant workers usually come to see the doctor.
Trauma is the majority. Working on a construction site, being photographed by a shovel, or being hit by scaffolding are very common. When such patients arrive in the hospital, they will leave after being bandaged. The workers’ wages are not high, and they cannot afford high medical expenses. Therefore, as long as it is not life-threatening, they will basically choose to heal on their own.
There are also a small number of patients with serious conditions. The traditional Chinese and Western medicine in the district has no ability to diagnose and treat them. Basically, they will be transferred to higher-level hospitals. Most of them will not be referred.
Clearly, this patient falls into neither of these categories.
"What kind of special method?" Shan Weihao looked through the medical records and asked.
"In the past two years, the patient has fainted several times without warning, and each time it resolves on its own. At first, the patient thought it was fatigue and didn't care. But recently, the frequency of syncope is a bit high, so the family members became nervous and came to the hospital many times, but they couldn't find any problems." Wang Jian said slowly.
"Director, please take a good look at my husband. He is the pillar of our family. If he falls down, our family will be over."
Just after Wang Jiang finished speaking, a middle-aged woman standing behind the patient spoke.
The woman looked to be about the same age as the man, with a dark face, messy hair tied behind her head, and eager eyes.
The man patted the back of her hand: "How can it be so serious, I think it must be because I have been too tired recently, just rest and rest, you have to come and see, how much will it cost?"
The woman wiped the corners of her eyes: "You have to watch it even if you spend money, this time you have to listen to me"
Another poor family who can't afford to get sick.
Shan Weihao was used to such situations. After reading the patient's medical records, he didn't say anything, but handed them to Song Qi.
Song Qi looked it up and found that the doctor has been visiting frequently recently. The patient is usually in good health, has no medical history or genetic history, blood pressure, blood sugar and blood lipids are not high, and there are not many auxiliary examinations. He has only had a few electrocardiograms, and all of them are normal.
"Xiao Song, tell me, what differential diagnosis does this patient need?" Seeing that Song Qi had read the medical records, Shan Weihao asked.
Sure enough, it was still the fate of being asked.
In fact, Song Qi had been prepared for a long time. From the first time he saw the patient, he was thinking about this problem.
"First of all, consider the three-high problem, but I just read his medical records, it seems that the patient has no history of three-high, the next thing to consider is syncope caused by cervical spine problems, whether there is otolithiasis, and another thing that needs to be ruled out is cerebrovascular problems."
Song Qi's answer was quite satisfactory.
"Doctor Wang, do you have anything to add?" After hearing Song Qi's answer, Shan Weihaoming turned to Wang Jian again.
"Xiao Song's knowledge is quite comprehensive, and I have nothing to add."
Although Wang Jian is a physician, he has also heard some anecdotes about Song Qi, and knows that he is a celebrity in front of the leader, so he said it cautiously.
"What tests does the patient need?" Shan Weihao asked again.
Wang Jian smiled awkwardly, "Director, are you testing me?"
"Let's discuss and discuss." Shan Weihao smiled, "This case is quite special, and everyone can just brainstorm."
Wang Jian didn't speak anymore. Even if he was the attending doctor, he still couldn't escape the fate of being asked by the director anytime and anywhere.
"Do an MRI of the head and neck to rule out cervical spondylosis and cerebrovascular problems, and then it's best to do an angiography. As for the diagnosis of otolithiasis, it's best to do a vestibular function test and a balance function test. Hearing test, and it's best to do a high-resolution CT of the temporal bone."
Wang Jian is very familiar with auxiliary examinations. Physicians have no income from surgery, and rely on drug income and commissions from auxiliary examinations. Among their small income, commissions from auxiliary examinations account for more than half.
"How much will it cost for such a set?" Shan Weihao asked again.
"No matter what, it will cost a few thousand dollars, and angiography will cost three to five thousand dollars. However, to check the cause, isn't it just like this to rule out one by one." Wang Jian smiled again.Gentle and gentle look.
Today's medicine has become an auxiliary examination medicine. Once you enter the hospital and check it from head to toe, a few thousand yuan is considered a small amount.This is one of the reasons why many people are afraid of going to the hospital.
"A few thousand, this is just a preliminary examination, not including treatment." Shan Weihao also smiled.Don't mean it.
"Doctor, it's going to be so expensive for a check-up." Hearing such an expensive fee, the patient's family members were also anxious.
"Song Qi, tell me what you think." Shan Weihao looked at Song Qi.
"The patient is a manual laborer. He has no bad habits such as looking down at books and mobile phones for a long time, and he has no history of head and neck trauma. I touched his back just now and there is no stiffness that is common in cervical spondylosis. It is probably not cervical spondylosis, so neck CT can not be done for the time being. As for the several examinations of otolithiasis, we can do it ourselves. The rest is brain magnetic resonance and angiography. Have a carotid ultrasound? Do further examinations based on the results?" Song Qi thought about it comprehensively, and then replied.
"How much does this arterial B-ultrasound cost?"
Xu Shi was frightened by the previous several thousand dollars, and the patient's family asked quickly.
"68, if you don't make a report, 60 is enough." Song Qi explained.
"Then we can still afford it." There was a smile on the face of the patient's family.
(End of this chapter)
Song Qi was also satisfied with this arrangement.
After all, circumcision is only a small part of his long career, and he cannot stay in such a small operation for too long, as he still has a lot to learn.
In the vast sea of medicine and vast knowledge, how could he stay for a foreskin?
Only by following a big man like Shan Weihao can we get in touch with more patients and more complicated cases.
Since Shan Weihao came to the District Traditional Chinese Medicine and Western Medicine, the number of patients in the expert clinic has increased day by day. Some nearby patients, who originally went to the People's Hospital, now also come to the Traditional Chinese and Western Medicine.
In short, the current Chinese and Western medicine is not a little more lively than before.
Working as an assistant to the director basically involves taking medical history, writing medical records, and doing physical examinations.It will be tiring, but you will definitely learn something.
As soon as I sat down in the expert clinic, before I had time to drink my saliva, Wang Jian, the chief physician of internal medicine, brought a patient over.
"Director Shan, there is a patient here. I have seen it several times. I feel very special. I originally wanted to transfer him to the People's Hospital. I didn't expect you to be here, so I was transferred to you. Please take a look." He pointed to the man behind him, and handed over the outpatient medical records.
As a physician, Wang Jian has the basic qualities of all physicians, for example, he speaks slowly, with a gentle voice and a gentle attitude.
The patient was a young man in his thirties, with a strong body and a dark complexion. He was wearing a camouflage military uniform with three or five mud spots scattered on it.
Seeing this attire, Song Qi guessed that this person was most likely a migrant worker on a nearby construction site.
There are several construction sites near the traditional Chinese and Western medicine in the district, and migrant workers usually come to see the doctor.
Trauma is the majority. Working on a construction site, being photographed by a shovel, or being hit by scaffolding are very common. When such patients arrive in the hospital, they will leave after being bandaged. The workers’ wages are not high, and they cannot afford high medical expenses. Therefore, as long as it is not life-threatening, they will basically choose to heal on their own.
There are also a small number of patients with serious conditions. The traditional Chinese and Western medicine in the district has no ability to diagnose and treat them. Basically, they will be transferred to higher-level hospitals. Most of them will not be referred.
Clearly, this patient falls into neither of these categories.
"What kind of special method?" Shan Weihao looked through the medical records and asked.
"In the past two years, the patient has fainted several times without warning, and each time it resolves on its own. At first, the patient thought it was fatigue and didn't care. But recently, the frequency of syncope is a bit high, so the family members became nervous and came to the hospital many times, but they couldn't find any problems." Wang Jian said slowly.
"Director, please take a good look at my husband. He is the pillar of our family. If he falls down, our family will be over."
Just after Wang Jiang finished speaking, a middle-aged woman standing behind the patient spoke.
The woman looked to be about the same age as the man, with a dark face, messy hair tied behind her head, and eager eyes.
The man patted the back of her hand: "How can it be so serious, I think it must be because I have been too tired recently, just rest and rest, you have to come and see, how much will it cost?"
The woman wiped the corners of her eyes: "You have to watch it even if you spend money, this time you have to listen to me"
Another poor family who can't afford to get sick.
Shan Weihao was used to such situations. After reading the patient's medical records, he didn't say anything, but handed them to Song Qi.
Song Qi looked it up and found that the doctor has been visiting frequently recently. The patient is usually in good health, has no medical history or genetic history, blood pressure, blood sugar and blood lipids are not high, and there are not many auxiliary examinations. He has only had a few electrocardiograms, and all of them are normal.
"Xiao Song, tell me, what differential diagnosis does this patient need?" Seeing that Song Qi had read the medical records, Shan Weihao asked.
Sure enough, it was still the fate of being asked.
In fact, Song Qi had been prepared for a long time. From the first time he saw the patient, he was thinking about this problem.
"First of all, consider the three-high problem, but I just read his medical records, it seems that the patient has no history of three-high, the next thing to consider is syncope caused by cervical spine problems, whether there is otolithiasis, and another thing that needs to be ruled out is cerebrovascular problems."
Song Qi's answer was quite satisfactory.
"Doctor Wang, do you have anything to add?" After hearing Song Qi's answer, Shan Weihaoming turned to Wang Jian again.
"Xiao Song's knowledge is quite comprehensive, and I have nothing to add."
Although Wang Jian is a physician, he has also heard some anecdotes about Song Qi, and knows that he is a celebrity in front of the leader, so he said it cautiously.
"What tests does the patient need?" Shan Weihao asked again.
Wang Jian smiled awkwardly, "Director, are you testing me?"
"Let's discuss and discuss." Shan Weihao smiled, "This case is quite special, and everyone can just brainstorm."
Wang Jian didn't speak anymore. Even if he was the attending doctor, he still couldn't escape the fate of being asked by the director anytime and anywhere.
"Do an MRI of the head and neck to rule out cervical spondylosis and cerebrovascular problems, and then it's best to do an angiography. As for the diagnosis of otolithiasis, it's best to do a vestibular function test and a balance function test. Hearing test, and it's best to do a high-resolution CT of the temporal bone."
Wang Jian is very familiar with auxiliary examinations. Physicians have no income from surgery, and rely on drug income and commissions from auxiliary examinations. Among their small income, commissions from auxiliary examinations account for more than half.
"How much will it cost for such a set?" Shan Weihao asked again.
"No matter what, it will cost a few thousand dollars, and angiography will cost three to five thousand dollars. However, to check the cause, isn't it just like this to rule out one by one." Wang Jian smiled again.Gentle and gentle look.
Today's medicine has become an auxiliary examination medicine. Once you enter the hospital and check it from head to toe, a few thousand yuan is considered a small amount.This is one of the reasons why many people are afraid of going to the hospital.
"A few thousand, this is just a preliminary examination, not including treatment." Shan Weihao also smiled.Don't mean it.
"Doctor, it's going to be so expensive for a check-up." Hearing such an expensive fee, the patient's family members were also anxious.
"Song Qi, tell me what you think." Shan Weihao looked at Song Qi.
"The patient is a manual laborer. He has no bad habits such as looking down at books and mobile phones for a long time, and he has no history of head and neck trauma. I touched his back just now and there is no stiffness that is common in cervical spondylosis. It is probably not cervical spondylosis, so neck CT can not be done for the time being. As for the several examinations of otolithiasis, we can do it ourselves. The rest is brain magnetic resonance and angiography. Have a carotid ultrasound? Do further examinations based on the results?" Song Qi thought about it comprehensively, and then replied.
"How much does this arterial B-ultrasound cost?"
Xu Shi was frightened by the previous several thousand dollars, and the patient's family asked quickly.
"68, if you don't make a report, 60 is enough." Song Qi explained.
"Then we can still afford it." There was a smile on the face of the patient's family.
(End of this chapter)
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