After being busy in the hospital until the end of work, Niu Tiangou accompanied Dr. Xue Lian back to the Xinyuan community. Pen @ fun @ pavilion wWw. ｂｉｑUｇE。 ｉｎｆｏ

While Niu Tiangou was helping with the cooking, he told Dr. Xue Lian about the doubts and preparations of the Liu family brothers and sisters about his father's medical bills.

"You instigated it, right?" Dr. Xue Lian was stir-frying, turned his head and asked.

"Uh......" Niu Tiangou was speechless for a while, pretending to be innocent.

"Uh, uh, I don't know your stinky temper? I can figure it out with my toes. No one in our Binhai Hospital has reported the charges to the above for so many years, and you want to break the sky as soon as you come, but you have the ability. ”

Doctor Xue Lian glanced at him coquettishly: "I see, you are about to become a professional complainer." ”

was robbed by Dr. Xue Lian, and Niu Tiangou had no choice but to shut up and serve the food.

"These are all ills of the medical system, and I am afraid it will be difficult to completely solve them in a short period of time."

During the meal, Dr. Xue Lian said: "Even if the matter you reported is resolved, the management of the hospital will definitely not change greatly because of this, at most a few grassroots direct responsible persons will be punished, once the matter is over, the problem will still be the same, and the patient will continue to play the role of a doctor in the hospital for a long time." ”

"I think this is mainly due to the imperfect medical fee system, and some medical staff take advantage of the loopholes in the system to make profits." Niu Tiangou analyzed.

"What hospital doesn't have a sound management system? The key point is that there is a lack of strict internal supervision mechanisms, and many systems are difficult to be strictly implemented and implemented, and have become decorations to cope with inspections from above. ”

Doctor Xue Lian stopped her chopsticks and said, "No matter how sound the system is, it has to be implemented by people, and as long as it is implemented by people, there will be loopholes to be drilled." ”

"I think the key to solving the problem of indiscriminate collection of medical fees lies in the dean." Niu Tiangou hit the nail on the head and said, "Deal with a few deans of him, see if he still dares to charge indiscriminately?" ”

"Cut, you think you can just deal with the dean? If you change the dean again, you will behave for a while, but after a long time, the doctors will see that the salaries and bonuses of the employees of other units are high, and their own efforts are not proportional to their income, and their hearts will be unbalanced, and they will inevitably have resentment against the new dean. ”

Doctor Xue Lian pouted and said: "In order to win the support of the doctors, for his own status and the survival and development of the hospital, the new president can only be sloppy in the end. ”

"Why?" Niu Tiangou asked.

Dr. Xue Lian replied: "Because the current state financial investment in the medical and health sector is seriously insufficient, the hospital mainly relies on drug income and medical income to sustain itself. If hospitals want to be efficient, and doctors want rebates and bonuses, they can only charge indiscriminately in terms of drugs and medical treatment.

"Of course, doctors will be more obscure than before, and some will even make patients unaware of it."

Seeing that Niu Tiangou was puzzled, Dr. Xue Lian then explained: "Let me give you a few examples, so that you may understand how doctors 'cleverly' charge indiscriminately in terms of medicines and medical treatment."

"For example, if a patient comes to the hospital who is sick with a poisonous cold, he can spend tens of yuan or 100 yuan for medicine according to the pathology to achieve the purpose of treatment, but the doctor can prescribe more medicine or some expensive drugs to him, and he can use ordinary domestic medicine, but the doctor prescribes imported medicine that is more than ten times or even dozens of times higher, and makes him spend 300, 500 or even 700.

"The quantity and price of the drugs are there, and they are also aimed at the patient's condition, can you say that the doctor is charging indiscriminately?

"Only when doctors understand in their hearts that if they prescribe more medicines and expensive drugs, they can get more deductions and bonuses.

"This is one of the common methods used by doctors to charge indiscriminately: prescribe more drugs and prescribe expensive drugs.

"For another example, if a patient with bronchitis comes in, he just needs to take some medicine and pay attention to keeping warm, but the doctor can ask him to do a scan first, then a CT, then an ECT, then an MRI, and then a ...... Or the use of imported instruments without the patient's knowledge, the cost is often hundreds of yuan higher than the domestic instrument, so that the patient spends hundreds or even thousands of yuan.

"These examinations are done to accurately identify the patient's condition, and they are highly responsible for the patient, and they are 'striving for excellence'.

"Only the doctor understands in his heart that the examination list he prescribes has his signature, and the more the list is written, the more examinations he will make, and the more he will be able to improve in the future.

"This is one of the two common methods used by doctors to charge indiscriminately: to check more and use high-end medical equipment.

"For another example, according to the regulations, one bottle of intravenous infusion charges 5 yuan, and from the second bottle onwards, each bottle is charged 1 yuan, but the doctor can charge 5 yuan per bottle.

"When the anesthesiology department uses a bottle of intravenous anesthetic drugs for a patient, it has already charged the first patient's drug fee, but if the first patient does not use it, the doctor can directly use it to the second patient, and if the second patient has not used it up, it will even be handed over to the third and fourth patients for use, and the fee is still charged according to one bottle per person.

"When a patient has a cardiac electrophysiology treatment, the fee is already charged, but the doctor can repeatedly charge for radiology, imaging monitoring, and surgical kits (one-time interventional materials).

"When the hospital does CT scans on patients, according to the regulations, head and neck scans are 180 yuan per person (contrast agent and film fees are charged separately), and full body scans are 310 yuan per person, but doctors can only let patients do full-body scans, and then add the money for head and neck scans to it, a total of 490 yuan.

"When giving a patient an abdominal examination, the five organs of the liver, gallbladder, pancreas, spleen, and kidney should be charged 90 yuan for a single one, but the doctor can separate the examination of these five organs and charge a total of 450 yuan.

"When changing dressings, infusions, and injections to patients, the cost actually includes the cost of materials, but doctors can list gauze, adhesive strips, disposable infusion sets, disposable injection needles, etc. separately for additional charges.

"When performing tumor resection surgery for patients, if 40 slices are to be made for observation, according to the price standard of raw materials, no matter how many slices, only 40 yuan can be charged for one slice, but the doctor can charge these 40 slices one by one, a total of 1,600 yuan.

"When charging for beds, the air conditioner was included in the heating fee of the ward, but the doctor could charge the heating fee after the bed fee.

This is the third common method used by doctors to charge indiscriminately: dismembering the charging items and duplicating the charges.

"For example, if a patient has been discharged from the hospital, but has not settled the bill or has not gone through the discharge procedures for the time being, the doctor can charge for the inpatient bed.

"If you ask them, they can say, 'You haven't been discharged, and the bed is empty, but we don't dare to arrange for new patients, so how can we not charge for it?' Could it be that if you go to the hotel to open a room, because you haven't stayed in the hotel for two days, you won't be charged for these two days? You didn't check out! ’

"There seems to be some truth to what they say, can you say that they are charging indiscriminately? This may be the case when the doctor overcharged Liu Sisi's father for two days' hospital stay.

"This is the fourth common method used by doctors to charge indiscriminately: hanging the bed.

For example, doctors can transfer patients with complex conditions from one department to another ward, such as transferring cancer patients from surgery to chemotherapy, from chemotherapy to radiotherapy, and from radiotherapy to traditional Chinese medicine...... These departments are subject to inpatient fees.

"They are hospitalized according to the patient's condition, can you say that the doctor is charging indiscriminately?

"This is one of the five common methods used by doctors to charge indiscriminately: breaking up hospitalizations or repeating hospitalizations.

“…… There are many other common methods used by doctors to charge indiscriminately, so I won't go into details. There are also doctors who inhale oxygen to patients casually, and oxygen will not harm people, and it doesn't matter if you don't need to inhale oxygen, anyway, after such a breath, it is a lot of money piao. As for the fact that before the patient's operation, the family secretly stuffed red envelopes into the attending doctor, not to mention it, which is an open secret.

"You say, can these things be stopped? It will be difficult to eradicate it for a long time to come, no matter how many deans are replaced.

"Why is it so hard to put an end to it?"

After saying this, Dr. Xue Lian put down the dishes and chopsticks, wiped her mouth with a napkin: "Because after the patient comes to the hospital, how to diagnose it, and whether the diagnosis is accurate; what tests should be done and whether they are duplicated; What medicines to take, whether they are symptomatic or can be replaced with cheaper medicines; what drugs should be injected and whether they are necessary; Which department should I transfer to, do I have to transfer to another department......

In short, these aspects are all decided by the doctor or the attending doctor, the patient does not understand, the family does not understand, and there is no third-party supervision agency, the patient and the family can only passively accept and passively be slaughtered.

"If you are more serious, you can only die and be transferred to the hospital. But every hospital is the same, 'the world is as black as a crow', even if you change hospitals.

"If you are still not convinced, wait until you are discharged from the hospital, go to complain, go to the complaint, but is it useful?

"The higher-level authorities have a working relationship, a personal relationship and a relationship of interests with the subordinate hospitals and directors, will they tear their faces and go to great lengths to investigate because the hospital overcharged you?

"Besides, most of the doctors overcharge have many high-sounding reasons, can you find out clearly? I can't find out, so I have to stop it, and in the end, 'the star is still the star, and the moon is still the moon'.

"These things are related to the current medical system, and we doctors or patients can't solve them."

Niu Tiangou was stunned at the table when he said something, and he didn't come back to his senses for a long time.