"Director Huang, in fact, I think it's okay. It's just a release operation, and many of the guys in our department can do it. Fang Xian said.

Release, in fact, is a variant of debridement, which is simpler than debridement, how can it not be done?

It should be Huang Bohang and others who are unwilling to expand in this area, so as not to ask for trouble, right?

"Doctor Fang, let's take a few for the time being, anyway, these two patients have already been hospitalized." Huang Bohang saw that Fang Xian insisted, and he didn't say much.

It's just that in and out of the words, there is an attitude that you don't want to do things, but the expression is very vague.

Fang Xian is here to provide counterpart support, yes, but after all, you are only the counterpart support, you will go back, we are the resident doctors here, what we should do, what we want to do, it is not up to Fang Xian to have the final say.

Fang Xian, who hung up the phone, sighed again in a deep groan.

Although everything has two sides, the negative effect of the current "ladder to the sky" system of the medical association is far more profound than Fang Xian imagined.

It seems to have deviated from its original purpose and become extraordinarily utilitarian.

It's not that utilitarianism is bad, it's an excellent thing to recognize your own level and ability. But when too many people become utilitarian, the consequences are also huge.

You say, is it a mistake for others to have the ability to go to the top?

Not really.

However, if talents are gathered in one direction, the result will inevitably be a more imbalance caused by the tilt of medical resources.

The original intention of the medical association to establish the physician hierarchy and the medical hierarchy system is actually to rearrange medical resources and let really outstanding people go to better positions.

It's just that in this way, the result is that everyone just wants to go to a good position, and in a bad position, the mobility is naturally very large, and it is only for stability, no longer for change.

I thought that I would just be here for a few years anyway, and after I did some basic things well, and after I practiced my skills, I ran away, and I went to a better unit.

As for the diseases other than these basic diseases, I have nothing to do with them.

For example, this kind of release surgery, this technique is not in the routine assessment of trauma surgeons, so many people do not go for such surgery.

It's not good for my growth, it might cause trouble, so why should I make a fuss?

In the Level 1 Physician Certification and Level 2 Physician Certification in Trauma Surgery, I will learn what I want to do and only do what I want to assess.

In this way, isn't the hierarchy of the medical association set up to be a mass-produced and stereotyped doctor?

That's just the way it is.

Even Fang Xian is taking such an old path, for example, during his master's degree, Fang Xian only learned basic skills, some more advanced technical modules, and Fang Xian didn't have time to pay attention to it at all.

That is, now, after letting go of a lot of baggage, and looking back, I found that in fact, the focus of my eyes was also very narrow.

But it's hard to change other people's minds.

……

The next day, Tuesday.

In the morning shift class, Huang Bohang deliberately took the routine diseases and rare diseases in the department and explained it again: "I specially mention a few words here." ”

"Our hospital is a county-level hospital, so we must be clear about this positioning, clear and clear, the policy documents of the Medical Association and the Health Commission."

"We are a relatively grass-roots unit, and what we need to do is to ensure the quality of basic medical and health services......"

It was not explicitly stated, but the meaning of the words was that he hoped that Fang Xian would recognize his own positioning and the positioning of the county hospital and not make trouble.

To be honest, in the current situation, before coming to the countryside, no one had ever talked to Fang Xian, and Fang Xian was also the first time he encountered a situation that was inconsistent with the ideas and concepts of his superiors or doctors with higher professional titles.

Rebuttal must not be refuted, this is other people's territory, how others want to be the masters of the house, that is someone else's business.

Baba.

After the shift is over, it comes to the ward rounds.

In this link, Huang Bohang still gave Fang Xian enough face, and Fang Xian didn't hold it, some said it, and put it up bluntly if he didn't have to say it, and he didn't put it up because Huang Bohang was inconsistent with his own ideas.

After checking the room, Huang Bohang took the initiative to invite Fang Xian to the director's office, and also said to Zhou Xiyin, who was following Fang Xian: "Doctor Zhou, you can go around casually first, I still have something to look for you later." ”

Zhou Xiyin nodded, she didn't need to arrange, she made at least two sets of plans and plans for herself every day, and she belonged to the kind of person with strong independent learning ability.

After coming to the director's office, Huang Bohang enthusiastically showed Fang Xian a cup of tea, and then said, "Doctor Fang, don't get me wrong?" What I said in the morning is definitely not aimed at you, the main thing is that our county hospital has our own difficulties. ”

Fang Xian immediately nodded: "Director Huang, that's your misunderstanding." ”

The county hospital has the difficulties of the county hospital, which Fang Xian knew before.

Huang Bohang rolled his eyes several times before he said, "Doctor Fang, you must be an ambitious person, Director Qin and I both know this, but we are different from senior talents like you, Doctor Fang. ”

"Perhaps for you, if you dare to fight, you will have a clear view of many visions in the medical field."

"But for us, this is a profession, doing things clinically, not seeking merit, but seeking no fault."

"Honestly do what you can do, practice what you can practice, some safe medical techniques, orthodox medical technology, set a good unit, and support your family, this is the right reason."

"You're right?"

Huang Bohang explained to Fang Xian in detail, as far as he was concerned, a person like Fang Xian couldn't afford to be provoked or offended, so he could only accompany him carefully.

Huang Bohang just wants to maintain stability, and after smoothly transitioning to the position of director of a county hospital, he can mix with the position of director of a prefecture-level city hospital for retirement, which is the end point of Huang Bohang's imagination. He didn't want any twists and turns to happen during this period.

Fang Xian is now a doctor who supports and helps his counterpart, and he is still here to gild.

Even if Fang Xian's skills are exquisite, once something goes wrong, he will also be jointly and severally responsible, so why bother?

In the short term, it is nonsense to break through some diseases that the county hospital will not be able to treat, and it also puts itself in danger.

Once a medical dispute occurs, it will be handled by the medical department, and there will be no upper limit until death.

In such a medical environment, there can be fewer twists and turns, and Huang Bohang thinks that it is better to have fewer twists and turns.

The county hospital treats emergency trauma and fractures, and it's good.

No one has to ask the county hospital to treat some difficult diseases that they don't have, so why bother?

Of course, yes, there are some patients in the county who really need treatment in addition to trauma and fractures, so he has a place to treat it, Zhangshi People's Hospital, Hunan Province, Modu, Kyoto, so many big hospitals in Huaguo are tall and tall.

"Yes, Director Huang, I didn't think it through before, so I admitted these two patients."

"The main thing is that I don't have any experience in this area, so I'm embarrassed." Huang Bohang gave enough face, and Fang Xian naturally had to take into account Huang Bohang's difficulties.

No one will ask a county hospital to overcome the problem, as long as it maintains stability and inherits and carries forward the mature medical technology that has been there.

If you force it too much, you will do to others what you do not want to do to yourself.

Fang Xian also doesn't like to be forced to drive ducks to the shelves.

Speaking of which, the trauma surgery department of the county people's hospital is from Cixian County, and Huang Bohang is currently the director of the ward, and he is the first person in charge.

In someone else's territory, there is nothing wrong with being honest and low-key.

If Huang Bohang insists on not wanting to contact new diseases, then Fang Xian can only start from the existing diseases that are routinely treated by trauma surgery here and do something.

Otherwise, the relationship is too stiff, and others directly don't let people cooperate with you for surgery or other things, can you still run back to the Affiliated Hospital of Shonan University to sue? What a shame that is.

Huang Bohang sighed: "Doctor Fang, I know you may think that I am conservative and conservative, but the problem now is, what you learn, if you don't take the exam, what do you learn from him?" ”

Huang Bohang came to a soul question.

Fang Xian was momentarily speechless.

To put it bluntly, in the level assessment of the level 2 specialist in trauma surgery, there is no osteotomy and orthopedics, and there is no release surgery, who do you love?

……

However, Huang Bohang still gave Fang Xian a certain amount of face after all.

Fang Xian had already admitted two patients, and Huang Bohang asked the department to arrange surgery as soon as possible. Chen Fangjun is the doctor in charge of the bed, and Chen Fangfang is connected with Fang Xian throughout the operation schedule, and when the operation is done, everyone in the group is in place.

In this way, Huang Bohang's lining and face were sufficient, so Fang Xian got up first and said goodbye, without saying much.

It's just that not long after leaving the office door, Zhou Xiyin was called into the director's office by Huang Bohang again, and he didn't know what to say.

Fang Xian looked left and right, and still felt that it couldn't be the environment that adapted to you personally, you needed to adapt to such an environment, so Fang Xian went to the doctor's office first.

"Brother Xiao, Brother Jun, will we have a cup of coffee together?" After Fang Xian entered the door, he took the initiative to greet him enthusiastically.

"Dr. Fang likes to drink coffee, huh? Order takeout or go out for a drink? Du Lixiao immediately turned his head, and his eyes lit up instantly.

"Let's order first, can Luckin?" When Fang Xian was driving before, he saw a sign of Luckin in the county.

"It's all right, Doctor Fang, wait a minute, I'll do it, you're too lazy to position." Chen Fangjun said with a grin.

Chen Fangjun insisted on having a treat, so Fang Xian didn't be polite to him.

I don't have much money, and no matter how much I pay attention to pushing around, I will almost become an aunt who buys vegetables in the vegetable market.

However, after the order was over, Chen Fangli approached and whispered, "Doctor Fang, this patient with calf adhesions can really recover his range of motion by loosening it?" ”

"What should I do if the scar regrows after release?"

Chen Fangling has not seen a fresh case in the department for a long time, mainly because he doesn't dare to accept it, and he can't treat it himself, of course, he can only rely on the opinions of Director Huang Bohang and do what he can.

If you can't do it, you will push it out.

"It is natural to prevent scar recurrence, mainly through the patient's rehabilitation training and passive activities to avoid recurrent adhesions."

"Brother Jun, hasn't our department had such an operation for a long time?" Fang Xian asked curiously.

Although the difficulty of releasing joint stiffness, or lower limb stiffness, is not small, if the director of the county hospital is willing to push forward in this direction, it should be said that the difficulty coefficient is not particularly high.

After all, diseases such as joint adhesions are only second-level diseases at most.

"If you don't do it, neither will the former Director Xing."

"Probably that means, why are you in trouble?"

"Actually, it's no wonder that Director Huang and Director Xing are reluctant to do it, but after they reach the position of director, they need to maintain the stability of the department, which is the first priority."

"Doctor Fang, you don't know, in a county hospital like ours, the mobility of lower-level doctors is very high, and Director Huang doesn't know what kind of ghosts, snakes, and gods the new recruits are."

"I'm more and more afraid to venture again." Chen Fangjun said meaningfully.

"Huh?"

"Brother Jun, can you elaborate and let me increase my knowledge?" Fang Xian was curious.

Perhaps this is the reason why Huang Bohang and others dare not explore in the direction of new diseases.

"At present, township hospitals are basically a springboard for many employed doctors, after all, you also know that now they are calculated according to the academic year system, and only look at the comprehensive ability of individuals."

"As a result, when many people are not able to find good jobs for the time being, they will go to the county hospital or town hospital level and take temporary jobs."

"In this process, some people are extremely good, but there are also people who don't know how they graduated from the exam......"

"In the current county hospital, if there is a shortage of people, it is not easy to find a regular and stable person who can do debridement and suturing."

"Of course, there are also people who have done relatively well and have very good qualifications, but some of them will leave after a few months, and some will only stay for half a year. The longest is about a year, and it will be fished out by other good hospitals......"

When Fang Xian heard this, he suddenly realized: "Ao! ~”

After all, the people who have laid down all kinds of strange rules in medical school have already worked, and maybe there will be no breakthroughs.

Immediately afterwards, Chen Fangjun said: "Doctor Fang, in fact, there are not a few doctors like you, who provide counterpart support and counterpart assistance in our hospital, and there are as many as three or four in our department a year. ”

"However, after everyone goes to the countryside, the types of diseases and techniques they help are different. Each of them is also different. ”

"The last time Dr. Zhu came was an associate professor of orthopedics at the Provincial People's Hospital, and the type of disease he helped was nonunion, and the last time was a complex fracture of the pelvis......

Fang Xian's eyes slid several times in an instant.

……

(End of chapter)