Trial and error is a very important part of clinical diagnosis. It allows doctors to quickly determine the true condition of a patient, rather than trying to deal with multiple possibilities at the same time. However, in China, there are generally two clinical methods for "diagnostic trial and error". The first is trial and error through testing – the only downside to this approach is that it increases the burden on some patients and health care. The second is "diagnostic treatment" that is more restrictive.

Sun Lien had used diagnostic treatment, but as long as there were other options, he didn't want to do so. The complexity of the diagnostic treatment process cannot be explained in a few simple words.

In principle, diagnostic treatment is very easy to explain. Doctors have narrowed down the range of diseases that patients can suffer from from a few thousand to just two or more. But for a variety of reasons – perhaps because the disease is progressing too quickly, perhaps because the science has not advanced enough – in short, after carefully balancing the possibilities, doctors decide to treat the patient with a particular drug and observe how the treatment responds.

If the patient improves, the disease can be determined to be A, and if it does not improve, then the diagnosis and treatment will be repeated according to B, C, D, or other diseases.

Doctors choose this way to "diagnose", and the risk to the patient is obvious - if they don't guess right the first time, if they rule out all possibilities in a row but they don't work...... Then the patient himself is likely to have to pay the painful price of the delay in the disease.

Therefore, in the current situation in China, doctors will basically not use this kind of program unless they have to. If you want to use it, the cumbersome and cumbersome notification process can become very painful. Not all family members are able to accept the doctors' plan to "gamble and give it a try", and they prefer to be able to take everything into their hands, including the life and health of their loved ones.

"Whenever necessary, do it. If it's what you think is best for the patient, do it. Professor Zhang Zhifu gasped twice, coughed and said, "This is the diagnostic center, what kind of patients will come to the diagnostic center to see a doctor? People who can't see well or understand in other places, but are unwilling to go home and wait for death will come here - forget all the habits you used to have in Tongde!"

Clinicians, especially those in the big three, often have a habit. At best, they are used to choosing the most appropriate treatment for their patients. To put it mildly, they are used to watching the dishes.

Not all patients can afford all types of treatment options. Medicare is not a panacea, and there are many drugs and treatments that are not covered by Medicare. Even if there is medical insurance reimbursement, different patients are also divided into medical insurance reimbursement levels, and there are even a considerable number of patients who are not covered by medical insurance at all.

When faced with such patients, doctors in "experienced" large tertiary hospitals often talk to patients first. Ask about the work of the patient and his family. In short, it is to determine the economic conditions, affordability, and willingness to treat of patients and their families through various methods that are not easy to arouse the disgust of patients and their families.

If the doctors clearly know that the patient's family is not in a good financial situation and the family does not have a strong desire for treatment, they usually do not mention the matter of surgical treatment at all, and recommend conservative treatment instead. However, if the patient's family conditions are acceptable, and the patient's desire to survive and family treatment is very positive, then the focus of the recommended treatment will be shifted to more active and more expensive programs.

What Professor Zhang Zhifu wants to correct is the habit problem of his own team members. In his opinion, the Integrated Diagnostic Center is a less complex institution. The doctor only needs to see the patient, and the patient and family only need to cooperate. If the family is not willing to receive treatment, or cannot afford to pay for it, they may not come to the comprehensive diagnosis center at all.

Hearing this, Sun Lien felt that it would be better to explain a little, "Actually...... If a patient is unable to pay the fee, the consultation fee will be waived if the patient agrees to disclose the diagnosis information and share it with Takeda Pharmaceutical after review. ”

Sun Lien deliberately put the word "diagnosis fee" more seriously, after all, this is also part of the contract reached between Takeda Pharmaceutical and the Fourth Hospital. Under Takeda's contract, the diagnostic center can diagnose no more than 10,000 patients per year, free of charge. Although the proportion is not very large, the promise of "50% off all drugs under Takeda Pharmaceutical" is enough for many people to cross the distance between life and death.

At present, Takeda's products marketed in China are mainly focused on digestive tract diseases, cardiovascular diseases and tumors. Other products listed overseas have not yet been approved and put into use in China. It's fair to say that Kobayashi's "generous commitment" itself doesn't put much pressure on the entire business – the cost of diagnosis is a very broad category, and not every patient who needs to be diagnosed needs a PET scan or whole-body MRI or mNGS after admission. Moreover, these inspection items, including the machine and consumables, are all provided by Takeda Pharmaceutical, and the cost is not too high.

"Then it's all the more important to get checked. Professor Zhang Zhifu nodded, and then went on to add, "Don't worry about putting pressure on the laboratory department, and don't worry about family members not understanding. You just have to go and get the diagnosis out to me — get it?"

The three doctors nodded together, while Chen Tianyang asked another question, "Then Takeda is also responsible for paying our salaries?"

"The salary is paid by the hospital......" Sun Lien wiped the sweat that didn't exist on his forehead, "But Professor Chen, your salary ...... Maybe the academy has to send some of it, right?"

"I'm not like Lao Zhang, he is now devoted to the cause of people's health. Chen Tianyang seemed to feel that the atmosphere was not very good, so he gaged, "My old man is more concerned about his own-my grandson will soon be one year old, and he has to earn red envelopes for him when he is a grandfather." ”

The old fritter smoothly led the topic to a not very serious direction, and after chatting a few words with the doctors present, they were taken to the office by Professor Zhang Zhifu to the side, ready to arrange a position. And Chen Tianyang left Sun Lien behind.

"Why didn't you see Xiao Xu today?" Chen Tianyang changed his posture to make himself sit more comfortably on the stool, "She is off duty today?"

"Doctor Xu......" Sun Lien hesitated for a moment, "She seems to have some personal matters, and she asked for leave today......

Before the words fell, Sun Lien's mobile phone rang inappropriately, he picked up the phone, but saw a local number that was not recorded in the address book.

"Hey?" Sun Lien answered the phone with the sound of "baked gluten", "Which one?"

"I'm Xu Yourong. On the other end of the phone, Xu Yourong's voice rang. She sounded like everything was fine, but Sun Lien could still vaguely feel a little fluctuation, "I'm ready to resign." ”