The three patients and Director Wang took the second medicine, and at noon, Zhao Shichao gave a chest X-ray to the three patients, including Director Wang, and the results of the chest X-ray came out, and Zhao Shichao was not calm again.

"Dr. Fang, from the results of the chest X-ray, the patient's lung infection is still significantly expanding, which indicates that the patient's condition is still deteriorating. ”

From yesterday to noon today, the patient has taken the medicine twice, but there is no obvious improvement in the symptoms, and it continues to deteriorate, the body temperature continues to rise, and the lung infection lesions shown on the chest X-ray are still significantly expanding.

Zhao Shichao felt that he couldn't let Fang Han continue to be treated like this.

Yesterday, Zhao Shichao decided to let Fang Han try treatment, one is that he really has no effective method, and the other is that Fang Han is indeed famous, but judging from the results, it seems that the methods of Chinese medicine are not satisfactory.

In particular, Director Wang, Zhao Shichao and Director Wang's colleagues for more than 20 years have a very deep relationship, and he can't just watch Director Wang's condition continue to deteriorate, even if Western medicine does not have an effective method for this new virus, conventional antibiotic therapy can be used, maybe it can be effective?

"Dr. Fang, I have decided to temporarily stop using traditional Chinese medicine therapy and switch to antibiotic treatment. ”

"Director Zhao, the changes in the patient's symptoms are still within the controllable range, and the judgment standards of traditional Chinese medicine and Western medicine are different. Fang Han tried to convince Zhao Shichao.

However, Zhao Shichao had completely decided that Fang Han's traditional Chinese medicine treatment was ineffective, so he decisively called outside to rearrange the treatment plan.

......

In the emergency department duty room, Chen Guozhong, Guo Wenyuan, Sun Yuangen, and Director Zhou were all there.

When the patient's chest X-ray results came out, not only Zhao Shichao was checking it, but Chen Guozhong and Director Zhou were also checking it at this time.

"Judging from the effect of the chest X-ray, the infection is still expanding, is it possible to cooperate with antibiotic treatment?" Chen Guozhong asked Guo Wenyuan.

Compared with Fang Han, Guo Wenyuan's status is absolutely undoubted, even if Chen Guozhong faces Guo Wenyuan, he has to discuss.

This is also the influence of the doctor's status in the medical field, in the clinic, the reason why Zhao Shichao completely rejected Fang Han's plan is precisely because Fang Han is too young, if Guo Wenyuan is replaced, even if Zhao Shichao doubts it, he will never dare to deny it completely.

"You can add some anti-infective drugs, and Xiaofang's prescription is still effective. Guo Wenyuan gave a conclusion.

"What do Director Zhou and Director Sun have in mind, and what kind of medicine can be added?" Chen Guozhong looked at Director Zhou and Sun Yuangen.

"Why don't you add Tyne?" suggested Director Zhou, "Tyneng is a very broad-spectrum antibiotic suitable for co-infections caused by multiple pathogens and aerobic/anaerobic bacteria, suitable for the treatment of various moderate and severe infections, as well as early treatment before the pathogen is identified." ”

"Then add Taineng!" Chen Guozhong nodded.

As soon as Chen Guozhong's voice fell, Director Zhou's phone rang, he hurriedly picked up the phone, listened to two sentences, and hurriedly looked at Chen Guozhong and Guo Wenyuan: "Guo Lao, President Chen, Director Zhao's phone, Director Zhao means that the patient's condition continues to deteriorate, and the treatment of traditional Chinese medicine is not effective, so it can be canceled and completely changed to antibiotics......"

"Nonsense!"

Before Director Zhou's words were finished, Guo Wenyuan couldn't help but scold: "What does it mean that there is no effect at all, there is no right to speak without understanding, how can the efficacy of traditional Chinese medicine be measured by simple symptoms and the judgment standards of Western medicine, isn't this playing the piano indiscriminately, what did Fang Han say?"

"The call was from Director Zhao, and I don't know what Dr. Fang means. Director Zhou hurriedly said.

"Call me. ”

Chen Guozhong's face was a little unbearable, how did this Zhao Shichao do it, don't you know that the most taboo during the treatment is to waver?

Director Zhou hurriedly handed the mobile phone to Chen Guozhong.

"Hey, Director Zhou, old Zhou ......"

On the phone, Zhao Shichao was still shouting Director Zhou, talking about why it was silent.

"I'm Chen Guozhong. A hearty voice came from the phone.

Chen ...... Dean Chen. Zhao Shichao was stunned for a moment, almost not reacting.

"Is the treatment plan you just decided on your own or is it the result of the decision you made with Fang Han?" Chen Guozhong got straight to the point.

"It's my own meaning, Dr. Fang's meaning is that the patient's condition is still under control......."

"Since Fang Han said that it is within the controllable range, why do you insist on going your own way?"

Zhao Shichao was stunned again, very aggrieved, he is the chief physician, do you need to consider the idea of a resident doctor?

Allowing Fang Han to treat him before, Zhao Shichao felt that he was already taking a risk, if it weren't for the special situation, he would not easily hand over the treatment to Fang Han.

"As the chief physician, don't you know that the most taboo in the treatment process is to vacillate, change the treatment plan at will, and respect the advice of the first doctor when you are treated?"

"Dean Chen, I'm ......" Zhao Shichao opened his mouth, a little unsure of what to say.

"Do you think that you are the chief physician and Fang Han is just a young man, so you can completely disrespect Fang Han's treatment suggestions and insist on going your own way?" Chen Guozhong's tone was a little stern.

"As a department director, you can't completely convince Fang Han, and you don't respect Fang Han's treatment suggestions, do you think it's appropriate to change the treatment plan so rashly?"

Zhao Shichao didn't dare to say anything, as the chief physician, as the chief director of the department, he had not been questioned and reprimanded like this for many years.

As the chief physician of the same level, few other directors dared to question Zhao Shichao like this, not even a few vice presidents of the Affiliated Hospital, but this time he faced Chen Guozhong, and Zhao Shichao did not dare to have any arguments.

If Zhao Shichao is a full-level player who has already dominated a certain region, then Chen Guozhong is a top player who has completely jumped out of the region and spanned the entire server, and the level of the two is quite large.

Of course, Chen Guozhong's questioning is not completely overwhelming.

The first diagnosis responsibility system can be said to be one of the core systems of the current medical system.

The first diagnosis responsibility system includes three levels: hospital, department and physician, the hospital where the patient is first diagnosed is the first hospital, the department that is first diagnosed is the first department, and the first physician is the first doctor.

All patients who come to the hospital for treatment are responsible for the first diagnosis of the hospital. The hospital shall not refuse to treat patients within the scope of diagnosis and treatment, and patients who are not within the scope of diagnosis and treatment shall be rescued on the spot if they are in critical condition and endanger their lives.

Under the premise of the first diagnosis responsibility system, the following situations: 1) patients who are not within the scope of diagnosis and treatment, 2) patients who are transferred to the hospital by their families or units, 3. patients who really need to be hospitalized or placed under observation because there are no beds in the hospital, if the condition allows for transfer, the first physician of the first hospital must write the medical records, make necessary medical treatment and fully explain the condition, inform the risk on the way, sign and agree on the medical records and the letter of knowledge of the patient, and implement the receiving hospital before transferring to the hospital.

For the first doctor, the first attending physician should be responsible for the medical work of the patients he treats, especially for the examination, diagnosis, treatment, consultation, referral, department transfer, hospital transfer, and condition notification of critical, urgent and serious patients.

In the first diagnosis responsibility system, there is a clear provision that the invited physician should immediately rush to the scene when receiving the invitation of the first doctor, and it is clear that after the undergraduate illness, the patient should be rescued according to the responsibility of the first doctor, and shall not shirk or leave without authorization. The emergency department strictly restricts the management of interdisciplinary and interprofessional patients in the form of "co-management", and should distinguish the priority according to the patient's complaint and the degree of illness, with one department managing the patient as the main department, and other departments assisting in the diagnosis and treatment in the form of consultation. If it is not possible to distinguish the priority, the first department is fully responsible, and other relevant departments are consulted.

Although there are some loopholes, there is no doubt that the first diagnosis and treatment system is based on the patient-oriented, which can completely divide responsibilities and avoid disputes between doctors at critical times and delay the treatment time.

This time the treatment situation, it can be said that when Zhao Shichao completely let go and handed over the patient to Fang Han for treatment, Fang Han had undoubtedly become the first doctor of this treatment.

That is to say, when Fang Han took over, the previous division of responsibilities was already very clear, and if there was any accident in the follow-up treatment, then Fang Han was the first person responsible.

In the follow-up treatment, the invited doctor or the doctor who participated in the follow-up treatment should also respect the advice of the first doctor, before Fang Han, the first doctor, did not completely let go, Zhao Shichao's practice of completely abandoning Fang Han's previous treatment plan can be said to be extremely irresponsible.

I am responsible for my patients, if Fang Han has already said that he will let go, or if he is not capable enough, then Zhao Shichao will take over completely, and there will be no problem with being fully responsible, but now Fang Han himself does not approve of the treatment plan after Zhao Shichao takes over, and there is controversy about Zhao Shichao's complete abandonment of his own treatment.

At this time, Zhao Shichao must respect Fang Han's treatment, or negotiate with Fang Han as much as possible to reach an agreement, or persuade Fang Han, or find someone else to negotiate and coordinate on the premise that the two cannot reach an agreement.

On the premise that no agreement can be reached in the end, it is necessary to follow the principle that if the priority cannot be distinguished, the first department is fully responsible and other relevant departments are consulted.

In other words, if there is still a dispute between Zhao Shichao and Fang Han in the final negotiation, then Fang Han should be the main one, and Zhao Shichao can only be responsible for assisting or suggesting.

The reason why a senior doctor is a senior doctor, and why a senior doctor is a senior doctor, is not only because of the high professional title and position of the senior doctor, but also because of the high level of the senior doctor.

As a chief physician, if you can't fully convince an attending doctor or resident doctor, and are questioned by a resident or attending doctor, then the senior doctor will inevitably lose his prestige.

If the senior doctor does not respect the treatment recommendations of the first doctor and forcibly accepts the patient with full authority, then the responsibility shifts.

Just like now, the place is the emergency department of the Affiliated Hospital of the Hospital, and Zhao Shichao is the chief physician, after Zhao Shichao completely abandoned Fang Han's treatment plan, Fang Han could only stare dryly, but in this case, the responsible person is no longer Fang Han, but has become Zhao Shichao.