Healing Doctor

Chapter 16 Dancing in Shackles

"So much is going in, but so little is coming out, why is the blood sodium still so low? I think the teachers in all departments were also struggling with this problem at the time."

Seeing Professor Mo and Director Sun's expressions, Ji Xiang knew that the system NPC must have guessed correctly, and his mood immediately improved. He continued to repeat the system NPC's explanation in his own words.

"When I thought of a formula from physiology and biochemistry—concentration = solute ÷ solution"

"Then I discovered the problem."

Clinical medication to supplement sodium increased the total amount, but the blood sodium concentration still decreased—there's only one reason: more water in the blood vessels diluted the sodium. Therefore, I estimate that the various 24-hour urinary electrolyte indicators also changed, and that's where it comes in.

As he listened to Ji Xiang's explanation, Director Sun's saliva began to flow uncontrollably, as if he had suffered a sudden stroke.

He could understand every single word Ji Xiang said, but he couldn't understand what they meant when put together.

"This is because the patient's hormones that regulate fluid balance are malfunctioning, which leads to a series of symptoms."

Based on the above, this is a disease called SIADH, also known as antidiuretic hormone secretion disorder syndrome.

One point that requires particular attention is that antidiuretic hormone secretion disorder syndrome may occur in patients with severe infections.

Therefore, my treatment plan included a slightly risky approach: administering albumin intravenously while simultaneously using furosemide to flush out excess water from the body, which also helped raise other diluted indicators.

"Teacher, I have finished reporting my thought process for answering the question."

After Ji Xiang finished speaking, he stood calmly in front of everyone, bowing slightly, much like someone giving a thesis defense.

The meeting room was completely silent, without a single sound.

Was Ji Xiang right?

no one knows.

Although Dean Zhao, Professor Mo, and even Director Sun all have clinical backgrounds and a thorough understanding of clinical practice.

However, Ji Xiang's reasoning was too profound, and even if he explained it in simple terms, no one could understand it.

It's not that I don't understand at all; I understand every word. I also have some understanding of antidiuretic hormone secretion disorder, but...

I reckon only an endocrinologist or a nephrologist could have a few words with this trainee in reserve.

Where did this monster come from?!

You can guess the complexity of the 24-hour electrolyte report just by looking at it!

Many doctors in grassroots hospitals have never even heard of this kind of examination.

Dean Zhao felt slightly frustrated, wishing his own son could stand in front of him and say those words.

Although he was filled with a complex mix of envy and jealousy, Dean Zhao did not lose his composure.

He slowly stood up, walked to Ji Xiang's side, and gently patted his broad shoulder.

"Young man, welcome to the Second Affiliated Hospital."

"Thanks."

"Work hard from now on!"

After speaking, Dean Zhao left the conference room.

Director Sun suppressed his surprise and chased after Dean Zhao.

He was in such a hurry that he accidentally bumped into the table and stumbled.

Fortunately, Director Sun reacted quickly, bracing himself with his hands on the ground to avoid banging his head on the ground. But in that instant, he scrambled out of the conference room like a dog.

Professor Mo did not laugh at Director Sun. No matter how flustered Director Sun was, it did not attract Professor Mo's attention. He looked at Ji Xiang with a complicated expression.

"Professor Mo, I still have a skills test to take," Ji Xiang said with a hint of regret.

Ji Xiang couldn't wait to go with Professor Mo to perform the surgery. No matter how well he did on the exam, the system wouldn't give him any rewards.

But surgery is different; each surgery builds up experience.

Whether it's the techniques, experience, or the rewards given by the system, they are all tangible benefits for Ji Xiang.

"Who is the examiner for the skills test?" Professor Mo asked.

"Professor Deng from the Department of Orthopedics."

"I'll call him," Professor Mo said. "Come with me to perform the surgery. He can perform surgery; why bother with some ridiculous skills test?"

Ji Xiang wasn't sure if it would work, so he glanced at the junior staff member in the medical affairs office.

"Old Deng, it's me, Mo Chenggui." Professor Mo had already dialed the number. "Are you in charge of the skills exam for the residency training today?"

"What's wrong, Lao Mo?" Professor Deng asked on the other end of the phone.

"I have 32 outpatient surgeries today, and I just happened to have a new resident trainee helping me," Professor Mo said with a smile. "He's quite skilled. If you want to watch him perform the procedure, come to the outpatient operating room."

"That's not a good idea, what about the others..."

"But it's a holiday," Professor Mo interrupted, "The students at the school are all rushing to get their bags removed at this time, it's so crowded, we just can't finish all the surgeries."

"Can……"

"You asked me for help late last night, saying you'd treat me to drinks, but I haven't heard back. Can you help me with this? Don't leave after get off work today, it's my treat."

The person on the other end of the phone had already given up resisting.

The residency training exam is nothing special, and with Professor Mo's strong support, we should give him some face.

"I've taken leave." Professor Mo hung up the phone and looked at the junior staff member in the Science and Education Department.

The junior clerk's lips moved, but he didn't dare to refute.

It's not just the Second Affiliated Hospital; almost all the professors leading surgical teams have connections in the community. If it weren't for arrangements made by higher-ups, no one in the organization would want to offend them for no reason.

To build a good connection, who knows when you might develop a kidney stone and need to consult Professor Mo.

It's just a residency training exam.

Professor Mo led Ji Xiang out of the office building. This time, Professor Mo was no longer as aggressive as before, and instead asked cautiously, "Dr. Ji, about that case analysis..."

"Teacher Mo, when I was doing my internship, my supervising teacher and I encountered a patient with a similar condition." Ji Xiang lied without blushing at all, appearing completely at ease, just like it was true.

What a coincidence!

Professor Ke Mo accepted Ji Xiang's explanation in just 0.1 seconds.

This is the most reasonable possibility; there are no other possibilities.

Professor Mo had heard how difficult that case was back then.

At the dinner table, he heard Professor Deng from the orthopedics department say it countless times, and each time Deng Chaohong spoke with great enthusiasm and pride.

To my utter surprise, it was "easily" resolved by a junior resident trainee.

wrong!

When Mo Chenggui thought about this question, he thought about Deng Chaohong, and he thought about Dean Zhao. A line of thought had been straightened out.

It's estimated that Dean Zhao wanted to arrange for his son to go to the orthopedics department, be mentored by Deng Chaohong, and stay there afterward. Director Sun had heard about this, so he chose one of Deng Chaohong's best cases as the exam question.

Although it was of little use, it couldn't be called superfluous either. Mo Chenggui wasn't surprised that the people in the organization had these little schemes.

He didn't like it, but he didn't object either.

"Dr. Xiao Ji, take a look first, don't rush to start. We're going to perform a circumcision with a suture device."

"Teacher Mo."

"Um?"

"The first thing I learned was circumcision using a suture device," Ji Xiang explained.

"..."

"I'm more familiar with the instruments than with hand sewing," Ji Xiang said confidently.

"!!!"

Professor Mo was stunned.

Is this something a resident trainee should say?

"Teacher Mo, there's something I don't understand and would like to ask you about."

"Go on," Professor Mo said, glancing at Ji Xiang with interest.

Using instruments to cut the skin would make the surgery simpler, and he believed Ji Xiang was telling the truth. If that were the case, it would be like a pillow being delivered to someone who was just dozing off.

"Why did you do manual suturing a couple of days ago, but you're doing surgical surgery today?" Ji Xiang asked.

"Hehe." Professor Mo breathed a sigh of relief after hearing Ji Xiang's question.

This problem proves that Ji Xiang is just a highly talented novice, not the legendary time-traveling monster.

"Dr. Ji, do you know about the staffing system for doctors?"

"I know a little bit. Doctors at our Second Affiliated Hospital should be on the civil service payroll," Ji Xiang replied vaguely.

"Yes and no." Professor Mo didn't keep Ji Xiang in suspense and explained as they walked, "There haven't been any government-affiliated positions for a long time. They're all retiring, and now the vast majority of them are outsourced to third parties."

"Outsourcing?"

"It saves money," Professor Mo sneered. "Let's not talk about that. Let's talk about public sector employees. There are four categories of public sector employees. Leaving aside the others, hospital doctors belong to the category of partially funded public sector employees."

"Differential public sector employment is a type of public sector employment where the government provides partial funding, and the benefits and income are linked to each other to a certain extent. Examples include hospitals and some tourist attractions."

"But you know what, funding... hahaha."

Professor Mo then burst into laughter.

Ji Xiang was puzzled, not knowing what he was laughing at.

"The national regulations are regulations, but the actual amount of funding allocated to the Second Affiliated Hospital is only 18-23%."

"So little."

"That's not all," Professor Mo said. "During the public health and epidemic prevention events a few years ago, the city and province didn't use medical insurance; instead, they asked various hospitals to advance the payments, and they still haven't paid them back."

"..."

"They owe our Second Affiliated Hospital 220 million yuan, and other similar hospitals probably owe about the same amount."

Ji Xiang remained silent, as he didn't quite understand what Professor Mo was saying.

"Why not use medical insurance? Because medical insurance doesn't have the money. A surgical stapler costs 1680 yuan, and it's either fully reimbursed or 80% reimbursed. It's just cutting up a leather bag, and it costs so much, the medical insurance department definitely won't allow it."

"Oh, then I won't do it," Ji Xiang said.

"It's not that simple." Professor Mo smiled. "Ordinary people all know about reimbursement; it's not something we can control. But if we claim too much, the medical insurance won't settle the accounts, and the hospital will have to pay the extra money, deducting it from our departments."

"We do treat the sick and save lives, and we might lend a hand to impoverished patients occasionally. But we only earn a pittance, and we still have to give it back..."

This is so complicated, Ji Xiang felt a headache coming on.

What Professor Mo said seemed to be different from what Ji Xiang knew about medicine, so he immediately dismissed it as useless information.

"Everyone wants to be a good person and get benefits, and doctors and hospitals are caught in the middle, making it very difficult for them to be good people," Professor Mo said.

"Then why are there still so many suture surgeries today?" Ji Xiang asked.

"The patients won't agree. Consultation is so advanced now, we can't just tell them we don't know how," Professor Mo said, shrugging helplessly.

"Besides, other hospitals will do it if we don't. If we don't do it, we'll end up starving. Using manual suturing is a compromise. We're caught in the middle, dancing in shackles."

"Teacher Mo, I've heard that the profit margin for medical equipment is very high."

"That was before centralized procurement; there wasn't much money after it," Professor Mo said calmly.

"you……"

Ji Xiang recalled the cigarettes Professor Mo smoked.

"Go to a private hospital to make money; that's where you really make money performing surgeries." Professor Mo didn't show his excitement like Colonel Wang, but calmly said, "But you're young, don't rush, practice your surgical skills first."

(End of this chapter)