"Chief Physician Wang, thank you for taking the trouble to come all the way here." Huo Congjun greeted Chief Physician Wang Haiyang of the Hand Surgery Department at the elevator doors.
Wang Haiyang was an old man of slight build. His face was gaunt, his arms bony. He weighed about eighty-eight pounds, which was the ideal weight for recent online celebrities.
He was a former orthopaedic surgeon, but he was basically forced in the Hand Surgery Department due to his weight. If a 220 pound plump patient required amputation, he would be helpless, because he could not even lift the patient's leg.
A well-practiced smile appeared on Wang Haiyang's face, which had not gone through any facelift surgeries before. He smiled at Huo Congjun. "I am not used to this courteous, amicable version of you. Who knew that Rebuker Huo would look so charming when he smiles?"
Several attending physicians came over to Huo Congjun, if only so to make Huo Congjun not look as if he was alone. One by one, they lowered their head, grinning.
Huo Congjun chuckled and said, "It's because you came here. I'm in a good mood today. Don't rush home when you're done with your shift, we need to sit down and have a drink..."
"Oh please, you're making me feel guilty instead with all your flattery. Alright, forget the conference room, let's just head to the ward." Wang Haiyang could see that Huo Congjun had really taken the current case to heart.
"Oh boy, what a shame. We invited you over for a consultation, and you didn't even take a sip of water..." Huo Congjun's false pretense could be picked up three meters away.
Wang Haiyang chuckled and said, "Be more direct when we're in the ward. It'll save everyone time."
"Okay, let's go." Huo Congjun was just as unwilling to head to the conference room and have powerpoint slides shine in his eyes. He turned and said, "Call Ling Ran, tell him to wait for us at the observation room."
The observation room of the Emergency Department was like the wards of the Inpatient Department. The observation room typically accommodated patients who needed to be under observation for a short period of time, but in practice, it was not so easy. The most common patients were the 'three could nots', the ones who could not be cured, could not get better, and could not return home. Some would stay in the resuscitation room for a long time, sometimes up to two years.
Huo Congjun had always been frustrated by the patients who treated the Emergency Department as a nursing home. This time, he took full advantage of this situation and quietly opened up several resuscitation rooms. On paper, they were used to expand the bed space in the observation room, but in actuality, they were used as additional wards.
The Medical Affairs Department pretended to investigate this matter once, but they collectively turned a blind eye and let him use the resuscitation rooms this way.
As Wang Haiyang entered, he saw four beds in a ward and several simple rehabilitation products that were exactly the same as the Hand Surgery Department, and almost laughed out loud.
"Goodness, are you glad that I came. If Department Jin were to see it, he would probably explode in anger."
Wang Haiyang made no attempt to water down his mockery of the two directors.
If a chief physician sought no progress in his professional career, you would have a very casual, lackadaisical chief physician in your hands.
In fact, if Wang Haiyang was an associate chief physician, then it would be impossible for him to step into the Emergency Department. For doctors in the Hand Surgery Department, Wang Haiyang would be seen purely as helping the enemy if he were to help the greedy, opportunistic Huo Congjun diagnose his patients.
However, Wang Haiyang could not care less.
His relationship with the department director, Jin Xi, was bad. The department directors and chief physicians of each department were often fighting against each other, although the arguments were unknown to other doctors. Wang Haiyang hoped that he would never step into the shoes of a department director, neither did he hope to get transferred to another department again. Also, he was not very proficient at improving his own skills either. Therefore, Wang Haiyang, who led his own treatment group, lived as free as a bird.
Huo Congjun had stayed in Yun Hua for many years. He knew all too well about the silent quarrel between the doctors. He smiled and said, "Your Hand Surgery Department still has some patients lying in our resuscitation room. What about it, can't I treat the patients that Jin Xi won't take? You intend to handpick them first? That's unreasonable, right?"
Wang Haiyang chuckled but remained silent.
Selecting patients had been a long-term malady between the Emergency Department and the specialist departments.
According to regulations and regular hospital operating models, the patient would need to be transferred to another department after receiving emergency treatment or basic treatment from the Emergency Department.
Rules were rules, but the execution of those rules was another thing. When better hospitals started experiencing clogs in their patient pipelines, specialist departments would stop taking in all patients from the resuscitation room, and they would start listing various requirements to tell them exactly what sort of patient they looked for.
A referral system easily ended up into becoming a selection system.
Specialist departments were not willing to accept patients who were hard to cure and dying. For example: patients who were at terminal stages of cancer, patients you could not operate and were constantly at death's door. Specialist departments were also reluctant to accept elderly patients with chronic diseases such as elderly patients with infection and recurring illnesses. Once they were cured, they might relapse, and then when they were cured again, they would refuse to leave, and then they could take up a bed until the department's bonuses were depleted.
In the top departments such as Yun Hua Hospital's Hand Surgery Department, the patients received were not limited to just Yun Hua or even the Changxi Province. They took in patients from all over the country who heard of their fame, and when the volume of surgeries was sufficient, the Hand Surgery Department would also be unable to avoid the bad habit of choosing patients. Patients who met the requirements of the department director's research direction would be given first priority, followed by patients with effective therapeutic plans and could receive timely treatment. They also took the patient's cooperative level and the ability to pay into condition.
From the department's perspective, the amount of money that can be split among them for treatment was truly minuscule. The average medical case only cost 1,000 to 3,000 RMB. Those that were above 10,000 RMB were few in number. However, if they ever came across a patient who had outstanding medical bills, the deficit may cost several hundred thousand RMB. The doctors in a department who had their performance pay deducted would start to doubt themselves, and any normal, sane person would avoid suffering through these sort of mental trauma.
Patients who did not meet the interests of the department and the hospital would not find any department willing to take them in anytime soon. Some patients would leave for that reason, and some patients would continue staying in the Emergency Department for other reasons.
The mess that Huo Congjun had to sweep up for other departments then became his greatest chip.
As per what he said to Wang Haiyang, if the Hand Surgery Department could select patients, then Huo Congjun could choose not to transfer these patients. Everyone held on to their own arguments, and hence, there were no right or wrong.
"This would be the patient, I presume." Wang Haiyang broke the silence and went up to the hospital bed.
The patient's family got up to greet the doctors, only to be persuaded by Doctor Zhou to go to the corner of the ward. A group of doctors wearing white coats from the Emergency Department surrounded the hospital beds.
Grandeur was not to be missing when a department director was out doing ward rounds. Doctors could also gain some experience from it. Of course, everyone was now most curious about whether Ling Ran's M-Tang technique was successful or not.
"Patient Ma Wenhua, 42-year-old male, sent to our hospital for emergency treatment due to a car accident, negative head CT, different degrees of fracture and intra-abdominal hemorrhage in cervical vertebrae and four limbs. The first stage of the operation was performed over a period of three hours. Left flexor tendon was injured, and M-Tang technique was used to suture" As Zhao Leyi spoke, he looked at Ling Ran before he continued to talk about the patient's past medical history and medication.
Wang Haiyang listened silently without any expression.
For him, these were all contextual factors. Huo Congjun had invited him here to examine the stitches of the arm.
Therefore, Wang Haiyang's gaze quickly flickered to Ling Ran.
He had not seen Ling Ran before, but Huo Congjun had described him as "the best-looking lad in the ward," and that was how Wang Haiyang remembered it. It was easy to find his target.
Zhao Leyi noticed that nobody was really listening to him, so he obediently ended the introduction and retreated behind Huo Congjun.
"How did you stitch this? Run me through the steps." Wang Haiyang knew that Ling Ran had not received any systematic training and deliberately prevented him from using the lines he had prepared.
Ling Ran did not think much about it. He went two steps forward and said, "For the first looped suture, I chose to lock the first suture loop knot at 0.3 inch near the proximal dorsal of the hand tendon before I inserted the trocar vertically through the hand tendon and withdrew the needle at 0.2 inch near the distal dorsal..."
He explained while pointing and gesturing at the back of the patient's hand.
Wang Haiyang had never actually performed the M-Tang technique. He would normally use Kessler and double Kessler suturing technique, and he specialized in Wilms tumor surgery. He would also perform arm amputation and replantation normally, and his success rate was rather high. He was rather confident with his skills.
Relatively speaking, Wang Haiyang did not enjoy employing the vastly more complicated M-Tang technique. Statistics claimed that it would increase the success rate of the surgery by 10% to 20%. The hand function assessment score could be 10% to 20% higher as well, but the burden on doctors would be more than double.
However, Wang Haiyang understood the Hand Surgery Department's popular M-Tang technique fairly well. He had even seen Jin Bo Tang carrying out the operation in person.
Wang Haiyang listened to Ling Ran's explanation and cross-referenced the steps to the contents of his memory. After listening to Ling Ran's explanation, he seemed to have gained more knowledge of the surgery himself as well.
After a while, while gazing at the handsome young intern, Wang Haibo suddenly returned to his senses. 'Son of a gun, Old Huo asked me here to nitpick on the surgery, not to listen to a lecture'