Brown, green, red.

A variety of different documents are placed on the table.

Physician qualification certificate, physician practice certificate, intermediate professional title certificate, complete types. (Note)

"Luo Hao." Lin Yuming, director of the medical department of the Coal Mine General Hospital, made a straight face, stretched out his right index finger and pressed heavily on the last card, "This is what you want, I got it for you again." I warn you, this is the last time! ”

Luo Hao lowered his head and looked at the documents under Director Lin's pale index finger because of the excessive force, and a bright smile appeared on his face.

With a height of 1.83 meters, wide shoulders and a thin waist, an ordinary T-shirt wears the temperament of a male model on Luo Hao. An ordinary smile hung on his face, glowing with a faint light, and it was very beautiful.

"And know how to laugh! Just know how to laugh!! Lin Yuming reprimanded unhappily, "Can't you be a doctor?" It is said that the post-zero rectification of the workplace, is that reliable? Why don't you learn something good, problem! ”

"Uncle......

"In the hospital, call me Director Lin!" Lin Yuming warned Luo Hao solemnly.

"Director Lin, this must be the last certificate, I promise it is the last certificate." Luo Hao did not refute, but followed Lin Yuming's words to give assurances.

His smile was clean, somewhat bright, and the sun shining into the Medical Director's office was a little brighter.

"Do you know how many faces I brush for the scope of practice of these intermediate certificates?" Lin Yuming complained, "You have to have further study experience, you haven't gone out to study since you graduated from your bachelor's and master's degrees in eight years......

"The person in charge of this by the Provincial Health Commission should be Mr. Ma." Luo Hao whispered, "He should know me, my level is higher than that of a doctor." ”

"Humph!" Lin Yuming snorted coldly.

Luo Hao has been a child of other people's families since he was a child, and his academic performance is enviable, and he was admitted to the eight-year bachelor's, master's and doctoral program of Concord at the age of 17.

An academician is quite optimistic about Luo Hao, as long as he nods, he can stay in Xiehe after graduation.

But Luo Hao unexpectedly returned to his hometown, to the dilapidated General Hospital of the mining area.

Because Luo Hao got an unopened system a few years ago, the key to opening the system is to get a license for 7 different medical sub-disciplines.

The physician's practice certificate is marked as clinical, and it has jurisdiction over surgery, obstetrics and gynecology, internal medicine, eye, ear, nose and throat...... and dozens of other majors.

There will be a more detailed classification on the intermediate professional title certificate, and what is required for the system to open is the scope of practice on the intermediate certificate.

Generally speaking, a doctor will work in a certain specialty for the rest of his life, and it is rare for someone to change their specialty.

It is not impossible to obtain multiple licenses, but it is extremely difficult.

If you stay in Concord, there is a high probability that you will not be able to open the system for the rest of your life.

Between Union Hospital and the opening system, Luo Hao hesitated for a long time, and finally chose the unknown system.

His uncle is the chief medical officer of the general mine department, and he happens to be in charge of this aspect, and he also has some connections in the provincial capital.

So Luo Hao refused the teacher's invitation, and returned to his hometown in a surprised look and the teacher's regretful retention, and worked in the general mine.

Luo Hao's uncle Lin Yuming did not disappoint him, and in less than two years, he prepared seven dragon balls for Luo Hao to summon the Divine Dragon.

"Luo Hao, you promised me, don't forget." Lin Yuming tapped his practice certificate with his finger, and reminded in an accentuated tone, "Hurry up and find a girlfriend, get married, and have a child, your mother has not been easy all these years." ”

Luo Hao nodded frequently no matter what he said, and he was extremely well-behaved.

Lin Yuming looked at Luo Hao helplessly and sighed in his heart.

Seeing Luo Hao nodding obediently and skillfully, Lin Yuming knew that Luo Hao, a little cub, didn't take his words seriously at all.

Many of today's young people don't get married, don't have children, don't listen to what they say, and really don't know what is going on in their hearts.

Housing prices are high, bride prices are expensive, and doctors' incomes have been low in recent years...... But this can be overcome.

Luo Hao's father was also a doctor, and he was swept away by the flood during the flood and died heroically.

At that time, Luo Hao was only 2 years old, and this baby was strange and pitiful, and his mother had never found anyone to live with, and she raised him alone with hard work.

Mother's uncle is big, otherwise Lin Yuming would not have used small means to get so many intermediate practice certificates for Luo Hao.

"Director Lin, then I'll go first?"

"The obstetrics and gynecology department exceeded the medical insurance again last month, and the head of the medical insurance department talked to me for several days, you can take a look." Lin Yuming pushed a bunch of certificates to Luo Hao, and simply closed his eyes to avoid a heart attack.

"Okay." Luo Hao smiled and was about to get the documents in his hand, but the "Dragon Ball" that was close at hand was blocked by Director Lin.

"You go to the obstetrics and gynecology department first, they exceeded the medical insurance last month."

Luo Hao was helpless, drooling and watching the last practice certificate only a stone's throw away from him, but far away from the end of the world, quite helpless.

"What are you still doing, go to the obstetrics and gynecology department to have a look." Lin Yuming's hand pressed on the practice certificate, closed his eyes, and reprimanded with a constipated expression.

"This goes, this goes."

Luo Hao took a deep look at the license and turned around to go to the obstetrics and gynecology department.

……

……

Donglian City, the city where Luo Hao is located, is located in the northeast, which is once an old industrial base and a well-known coal-producing city in the country.

Donglian Coal Mine General Hospital was invested by the coal group more than ten or twenty years ago, and it can rank among the top 50 in the country in terms of technology level and equipment.

Especially in the years when coal prices were high, life was smooth sailing for the public hospitals affiliated with the group company.

At that time, the General Institute of Mining was a very good large-scale public tertiary hospital.

However, with the decline in coal prices, the difficulty of excavation has increased, the cost has increased, and environmental protection and other factors have been superimposed, and Donglian Coal Group has fallen into losses.

When it is difficult to protect itself, the group can only survive, and there is definitely no money to invest in the hospital.

Therefore, even the General Mine Institute will inevitably enter the downward channel.

With less income, more people will leave, technical backbones have left and gone south, and a large tertiary hospital has gradually become dilapidated.

But these have nothing to do with Luo Hao, and he can't manage them if he wants to.

He is now attached to the Medical Department of the General Mining Hospital, and his most important job is to ensure medical safety and ...... Medicare payment.

Luo Hao walked out of the office building.

The sky blue is dazzling, like Luo Hao's mood.

He wanted to solve the problem of obstetrics and gynecology immediately and get his seventh license and start the system.

In the past, the Department of Obstetrics and Gynecology of the Mining Hospital had two 40-bed wards and performed nearly 2,000 surgeries per year.

With the continuous southward movement of technical backbones and the declining fertility rate, the obstetrics and gynecology department has now shrunk into a ward, and there are still empty beds all year round.

This is the case, Luo Hao knew that Director Lin asked him to "deal with" the problem, not to let himself solve anything, but to tell the doctor in obstetrics and gynecology - your medical insurance share is overspent, save some money.

Luo Hao walked quickly to the door of the obstetrics and gynecology ward, and saw from a distance that Director Sun of the obstetrics and gynecology department, who had just come to work and had not changed his clothes, was talking to the patient.

"Director Sun, can't we do laparoscopic surgery, I want to do minimally invasive surgery, I don't want to have a major surgery."

At the entrance of the ward, a young woman whispered and begged.

Her face was a little unsightly, with some fear and confusion.

"The laparoscopic equipment is broken, and the hospital is looking for someone to repair it. As for how long it will take, it's hard to say. Director Sun stretched out his hands and said helplessly, "Don't worry, just wait, if you are in a hurry to operate, I can open your abdomen, a small incision, not a big knife." No impact on ...... It doesn't affect the aesthetics too much. ”

"But my friend had a laparoscopic operation at our place last month, and when I accompanied her, I heard from your doctor that there is still a difference between surgery and laparoscopy." The young female patient said blankly.

"Then the device broke down." Director Sun was a little embarrassed, annoyed and angry, and his tone began to be irritable.

What kind of machine is broken and the like are all excuses, the share of obstetrics and gynecology medical insurance has been used up, and a laparoscopic surgery hospital or department will lose hundreds of thousands of dollars.

It's not that I don't want to do it, it's not that I can't do it, it's that I can't afford it.

After Luo Hao understood, he scratched his head, showed his trademark smile, and raised his hand to greet Director Sun.

"Yo, the leader is here." Director Sun joked.

"Harm, don't lead, how dare you, I'm just an errand boy, today the king called me to patrol the mountains." Luo Hao smiled, the sun was shining, and after making a little joke, he immediately returned to the topic, "Director Sun, you are busy first, I will wait for you." ”

The director of the Department of Obstetrics and Gynecology saw Luo Hao appear, knew what he was doing, and had a few perfunctory words with the young patient, and came to his office with Luo Hao.

"Xiao Luo, this is Director Lin who wants to talk to me for admonishment. It's okay, admonishment is admonishment, just so I take a break for a while. Director Sun asked half-truthfully.

"Look at what you said." Luo Hao said, "How can I talk to you admonishmently, you are the pillar of the obstetrics and gynecology department of our hospital, and you can't move without the obstetrics and gynecology department of your hospital, and the patient has no place to see a doctor." No matter how you say that we are all hospitals, it is better to close the door if we are separated from treating diseases and saving people, you say. ”

Thousands of clothes are worn, and the sycophants are not worn, Director Sun's expression has softened.

"Director Sun, I'm just here to ask about our department's medical insurance situation last month to see if we have any difficulties."

"Situation." Director Sun frowned slightly, "What the hell is going on, don't you know the medical department?" ”

"Last month, we did 5 ovarian cancer and cervical cancer surgeries over 70 years old, and the medical insurance cost was exceeded.

"Serve the people, treat the sick and save people, even if you don't give rewards, you also want us to bring our own dry food, Xiao Luo, do you say that you do this."

Director Sun was a little anxious as he spoke, and his face turned red.

Luo Hao nodded again and again, well-behaved and docile.

He expressed his understanding of Director Sun's words.

DRG/DIP payment does not take into account multiple diseases, and the payment standard in the province is to count the hospitalization expenses of all ovarian cancer patients, and then to average, there is no statistics on the cost of surgical patients.

To put it simply, patients who come back from inpatient surgery in the imperial capital or provincial capital to recover or patients who are hospitalized for postoperative re-examination do not spend much, but the overall amount of such diseases is lowered in the DRG payment system, resulting in super low medical insurance costs for some diseases.

Surgery is done at a loss, so the number of clinical surgeries has dropped sharply recently.

The wealthy provinces in the south have a lot of allocations, adequate medical insurance, and high reimbursement amounts for similar diseases, and such problems are relatively rare.

In contrast, the problem in the north is more acute.

"You also saw just now, that young patient diagnosed ovarian cysts. Laparoscopic surgery, more than an hour to solve, decompression, no difficulty.

But now, do I dare to have surgery?

When the doctor doesn't improve his technical level, he has to take a calculator to settle the account, Xiao Luo, what is the matter. ”

Director Sun didn't wait for Luo Hao to speak, and began to chatter and complain.

"Xiao Luo, our department has to be deducted money every month, we will be deducted twenty or thirty for having a child, we will be deducted for two or three hundred for a minor operation, and we will be deducted for a small one thousand for cancer, on average, everyone has lost several thousand, and the bonus is equal to zero."

"You don't need to tell me how much our basic salary is. To put it mildly, our obstetrics and gynecology doctors can't even afford to eat. ”

"If this continues, I can only take people to a private maternity and children's hospital."

“……”

Luo Hao automatically blocked Director Sun's chatter.

Now clinical work is difficult to do, who doesn't know, the general environment is like this, no one has a problem.

In order to solve the problem of difficult ovarian cyst surgery, Luo Hao feels that the first thing to do is to raise the cost of medical insurance.

After all, laparoscopic ovarian cyst decompression is a very mature procedure and is not very difficult.

"Xiao Luo, you are talking." Director Sun saw Luo Hao in a daze and asked directly.

"Director Sun, there are still a lot of core points in laparoscopic surgery for ovarian cysts in DIP payment." Luo Hao said.

"It's DRG and DIP again, and it's a net new term to deceive people. Those small and medium-sized private hospitals that cheat insurance have been full of fat brains over the years, and no one has ever been able to engage in them. The more Director Sun spoke, the more angry he became, and his face became redder and redder.

But he couldn't say much, so he could only complain, and Director Sun immediately turned the topic back.

"I'm talking about decompression of ovarian cysts, you see the dip payment......"

As he spoke, Director Sun grabbed Luo Hao's white sleeve, pulled him to the computer, and found the cumbersome DIP paid documents.

Other unspecified ovarian cysts: laparoscopic unilateral ovarian-salpingectomy, score 1267.

The medical insurance score × 10 is about the cost that the medical insurance department reimburses.

More than 12,000 seems to be a lot, but Luo Hao understands what Director Sun means - this does not include laparoscopic ovarian cyst decompression.

People write clearly in black and white that they will do ovarian-salpingectomy.

"Decompression has to be classified as something else, and you look at the treatment scores for other ovarian cysts."

663 points.

In other words, it can only cost 6,630 yuan, and no matter how much, the medical insurance will not reimburse.

"Look at the appendicitis score."

Director Sun said, pressing ctrl+F with an unskilled movement to find the appendix-related note-2035.

"Our obstetrics and gynecology department is all raised by the mother, right, the same laparoscopic surgery, the general surgery will give a reimbursement share of 20,000 yuan for an appendix cut, and we only give more than 6,000, how do you say this operation."

"The more you do, the more you deduct."

"Xiao Luo, why don't you go back and talk to Director Lin, he admonished me and asked him to come to the Department of Obstetrics and Gynecology as the director, and I'll see what your medical department does."

"You dissipate your anger, our hospital is the city's maternal and child health hospital, you are the top expert in the city, no one but you." Luo Hao's clean and sunny smile was like a tranquilizer, which made Director Sun, who had turned on the state of rage, quiet down a little.

"I'm just here to find out the situation and report back to Director Lin. If we are really in difficulty, the hospital can adjust the medical insurance quota. ”

"Which department in the hospital doesn't call, and the crying child has milk to eat. Now that there is less milk, I have been crying for more than a year, have I adjusted the quota? Although Director Sun still didn't believe it, his words were a little softer.

Luo Hao took out his notebook, asked Director Sun for a pen by the way, and began to write down all the difficulties in obstetrics and gynecology.

In fact, Luo Hao knows what difficulties there are in obstetrics and gynecology, and the reason why he is so formal is to express a serious attitude.

Before leaving, Luo Hao put Director Sun's pen into the pocket of his white jacket.

The action is fluid and logical.

"Xiao Luo, there's something I forgot to tell you." When Director Sun saw that Luo Hao was leaving, he pulled him and vomited bitterness.

"Three months ago, we had a pregnant woman who was in labor. After she was hospitalized, relatives and friends came to see her, and she went out to drink at noon, but she drank too much, and when she came back, she sat on the belly of a pregnant woman. ”

"......" Luo Hao was speechless.

"Emergency caesarean section, multiple fractures after the birth of the child. We did our best to treat the child and get the child out of the hospital. The results are good, and the cost of rescue and treatment of fractures is counted on the head of our obstetrics and gynecology department, and a large amount of money is deducted from our department. ”

"We'll have to get the money back."

Yes, Director Sun of the Department of Obstetrics and Gynecology also began to make requests.

Luo Hao reassured Director Sun again and again.

As a young man and a small clerk, he is simply not capable of solving such a big problem.

Or give feedback to your uncle...... Director Lin, let him consider.

As for himself, he has already told Director Sun about the medical insurance exceeding the standard, and now it is the most important thing to rush back and see the legendary system.

For it, he did not stay in Concord but returned to his hometown, paying a very high price. It's impossible to say it's not in a hurry.

"Then I won't delay your handover." Luo Hao said a few perfunctory words and said goodbye to Director Sun.

"Patient's family, wait a minute!"

An obstetrician and gynecologist ran out with a signature slip.

Luo Hao turned sideways and looked back to see the obstetrician and gynecologist catching up with a man in his 30s.

"What's wrong?" The man asked impatiently.

"The name you signed is not the same as the ID card information you entered."

"Of course it's different, I'm not her husband."

“……”

“……”

The obstetrician and gynecologist and Luo Hao were stunned for a moment.

"And what is your relationship with the mother?"

"I'm her ex-boyfriend."

"Where's her husband?"

"Quarrel, don't come, you have to find me to take care of you, do you think I can sign my name? The child is not mine. ”

Luo Hao was troubled by the complicated relationship said by the patient's family, and hurriedly sped up his pace to leave the place of right and wrong.

It's really hard to do clinically, and this kind of happens every day. Luo Hao was afraid that the obstetrician and gynecologist would catch him and ask what to do, so he hurried up and left.

What can I do about something like that?

Cold.

Out of the inpatient department, Luo Hao returned to the office of the director of the medical department.

Director Lin was not there, and the certificate was on the table.

Luo Hao picked up the certificate.

"Ding Dong~"

As the last card was held by Luo Hao, a crisp voice came from his ears, the screen in the upper right corner of the field of vision flickered, and rows of characters appeared like a waterfall.

The system panel at the top right of the field of view has its own digital properties.

Stamina: 11

Intelligence: 12

Endurance: 11

Psychic power: 14

Luck: 32

10 This value should be the standard value for adult men, Luo Hao's body is good, and everything is a little stronger than ordinary people.

In addition, Luo Hao's luck value is ridiculously high.

Luo Hao admits this.

He has had good academic performance since he was a child, and he has always been the first in his grade.

Very few people are willing to study hard, and Luo Hao is not M, so he has no interest in abusing himself.

But he usually secretly sells homework, and his classmates copy homework for 9 yuan at a time, with a monthly subscription of 180, and it is not good if he doesn't work hard to become the first place.

It's branding.

So Luo Hao studied hard and had savings at the same time.

In 2011, he paid attention to a small broken station - Zhihu.

With the blessing of lucky value, the gears of fate slowly turn.

In 2012, a college student asked what would be better to invest in, if he had a thousand dollars in his hand.

An answer caught Luo Hao's attention, and a bigwig in the currency circle suggested that the subject buy Bitcoin.

At that time, Bitcoin was $0.003 a piece, and ordinary people didn't know what a virtual currency was.

It just so happened that Luo Hao had an elder of a classmate who was trading virtual currency in Lijiapo, and after learning about it, Luo Haoba bought all the 13,241 yuan of pocket money he had saved for many years.

He wrote down the password according to professional advice and forgot about it after saving it, until people around him kept speculating and mining, and Luo Hao felt that it was time to clear the warehouse. Only then did he clear all the warehouses at 15,000 yuan a piece, and then purchased a trust in Xiangjiang.

Although Bitcoin rose to more than 500,000 yuan later, it seemed that it had lost dozens of times, but Luo Hao had already made a lot of money, and he didn't care about the minced meat of the fish's tail.

At a young age, Luo Hao was already financially free, and to be honest, he thought that the luck value determined by the system was still slightly low.

"Ding Dong~"

At this moment, a crisp and pleasant voice sounded in Luo Hao's ears.

A few lines of words appear on the screen in the upper right corner of the field of view.

【Beginner Quest】

Quests, there are newbie quests!

Generally speaking, the novice task will be a big gift package, and I hope it will not be a big pit for recharging 648 in front of it.

Luo Hao's eyes lit up and he continued to look down.

[Beginner's Task: Complete 10 ovarian cyst treatment surgeries.]

Duration: 1 month

Rewards: +1 for random basic attribute points, +1 for surgical skill level.

Special Reward: Starter Pack ×1. 】

This......

That's it?

Luo Hao's head turned into two big.

It's not that Luo Hao dislikes the few rewards of the task, but that the task seems to be a little difficult. It's true that you have a license to practice, but you can complete the surgery independently...... I don't know if there will be so many opportunities.

As soon as he saw the system panel in the upper right corner of the field of vision, Luo Hao had a headache.

It's better to let yourself recharge a 648 to be refreshing.

Is this a beginner's task?

Director Sun of the Department of Obstetrics and Gynecology refuses to even do a laparoscopic ovarian cyst decompression surgery, can he do it himself?

Besides, can Director Sun let himself complete so many surgeries independently?

It seems that the task is not difficult, it is just an ordinary task to fight monsters and upgrade, but there is a lot of content in it, and it is not that simple.

Now that the system has promulgated a novice task, Luo Hao can only begin to deepen his understanding of the system and find a solution.

Then he found the skill option in the interface, Luo Hao moved his mind and clicked to enter.

Surgical skill level – 3.

This...... It doesn't seem to be too high, the full score should be 10, and I'm only level 3.

Since the sky fell from the sky eight years ago, although the system has not been fully opened, there are certain benefits - Luo Hao found that he could train surgery in the system operating room after research.

Over the years, Luo Hao has had countless general teachers to do training, and tens of thousands of surgeries have been performed.

He thought his surgical skills were at least level 6 or above.

I didn't expect to be judged by the system to be level 3.

Internal technology energy - 2.23.

Gynecology – 2.12.

Pediatric technology energy - 0.228.

The skill was accurate to three decimal places, and Luo Hao was a little embarrassed.

I don't have any interest in pediatrics, so my skills are "slightly" low.

Ovarian cysts involve gynecology, Luo Hao's heart moved, and the science and technology tree of gynecology automatically opened.

In Luo Hao's imagination, there should be a variety of techniques, and he should choose and learn by himself.

But every row of procedures is gray, and the words are not clear, and you can vaguely recognize lofty words such as quantum and RNA robots.

The drop-down bar kept moving, and when it reached the bottom, Luo Hao saw laparoscopic ovarian cyst decompression.

Do you really want to use this "backward" technique to solve the problem?

Luo Hao knows that the problem is not how difficult the operation is, although Director Sun of the Department of Obstetrics and Gynecology has an average level, there is still no problem with this basic operation.

But there were no other techniques below, Luo Hao sighed in his heart.

This broken task is simply embarrassing.,Novice period to give yourself epic difficulty tasks.,This system is really not serious.。

Just when Luo Hao was in trouble, a pale white light appeared on the system screen, and a corner of the skill tree that Luo Hao had not come to carefully check lit up that was easy to be overlooked.

……

Note: It seems that the color of the certificate is different in different provinces, emmm.