Practicing Medical Skills in a Small Clinic

Chapter 606: Chapter 278: Ranked First, Prolonged Diarrhea (Part 2)

"This patient experienced multiple episodes of massive hematemesis upon admission, with the condition being critical. Therefore, timeliness became a bonus point for this case. The ones who performed the best were Director Xiao Linlin from the Second Hospital and Director Luo Hou from Jiangli City Medical University Affiliated Hospital. After the first examination results were out, both of them immediately applied for a second examination without hesitation. Director Luo Hou from the People’s Hospital applied for chromoendoscopy.

Director Xiao Linlin applied for ultrasound endoscopy and a second pathological biopsy, specifying the deep tissue of the lesion as the specimen.

In the face of the first round of gastroscopy and pathology biopsy results showing gastritis, both directors insisted on thorough examination, which is commendable. Both earned bonus points."

No wonder Xiao Linlin has successfully risen to first place.

She is currently tied for first place with Director Lian Tao from the People’s Hospital.

Director Lian Tao originally took the first place with high scores in the first round, leaving Qiaobang Hospital behind.

Xiao Linlin and doctors from four other hospitals were tied for second.

At this moment, Xiao Linlin has caught up with Director Lian Tao, with both scores tied for first.

This also shows that in the second round, Lian Tao’s diagnosis was correct, but his time efficiency score was not as good as Xiao Linlin’s.

This is a common issue in large hospitals.

Large hospital diagnoses demand strictness, steady progress, and gradual precision.

Upon having doubts about the initial diagnosis results, they generally do not rush to immediately conduct a second repeat examination. Rather, they seek more evidence, undergo more analysis and argumentation, before deciding whether to repeat an examination.

The regularity and rigor of large hospitals have already been deeply rooted in people’s minds.

Unless certain departments or doctors act for personal gain, doing things that violate medical ethics and harm patient interests, these are not included here.

Some doctors in large hospitals recommend that patients or their families purchase expensive nutritional supplements or special medications, often from designated pharmacies or sold privately via WeChat. Patients should be more vigilant.

Theoretically speaking, now buying any medication, the hospital pharmacy is generally the cheapest.

With medical reform, hospital medications are sold at zero profit.

Medications available at the hospital should decisively be prescribed by doctors, and never bought outside.

As for patients worrying about offending doctors by not following their arrangements, there’s no need to worry. At worst, just change doctors. If every doctor in this hospital is the same, then change the hospital.

Normally, it’s unlikely that all doctors in a hospital are bad.

The vast majority of doctors have a conscience and professional integrity.

"Dr. Li, in this case, is it more efficient to do chromoendoscopy for the second examination?"

Xiao Linlin now harbors deep trust and admiration for this young doctor, more than ten years her junior.

Li Jingsheng is indeed exceptionally strong.

She humbly seeks guidance from Li Jingsheng.

"Uh...this has pros and cons! Chromoendoscopy, mainly methylene blue, toluidine blue, has a dye uptake rate of over 90% for malignant lesion tissues. It can identify those with early cancer lesions smaller than 4mm. Moreover, for gastritis-type gastric cancer which ordinary endoscopy cannot recognize, it holds significant diagnostic value. However, methylene blue isn’t ideal for some malignant tumors or lesions and might lead to misdiagnosis or missed diagnosis.

So, I don’t think there’s a best examination method.

Just analyze based on symptoms, medical history, and other information, and have a fairly intuitive preliminary diagnosis result mentally, then basically, there’s no worry about not finding the cause.

If one method doesn’t work, switch to another, try two more methods, and the demon of disease will be uncovered."

Li Jingsheng’s view is that the direction of diagnosis by doctors is more important than any instrument checks or lab tests.

At this time, Li Jingsheng received a message from Lian Tao.

"Jingsheng, is this your handiwork?"

Lian Tao’s skills are unquestionable. Now he’s been caught up by the Second Hospital, a very mediocre third-level hospital, and is tied for first with them.

The only possibility he could think of was Li Jingsheng’s intervention.

Because the Second Hospital’s gastroenterology department has always been mundane, he truly couldn’t think of anyone besides Li Jingsheng with the ability.

"I just provided some support!"

Li Jingsheng is very humble.

Were it not for his good, almost brotherly relationship with Lian Tao, he might not have answered directly.

"Damn, I knew it was you. Can you show some mercy? Having a female director from your hospital above me is quite embarrassing!"

Lian Tao sent a painful, aggrieved emoji.

"Haha, give me a break! Who doesn’t know that you’re a well-known diagnosis maniac? Have confidence in your skills. Besides, I’m just a half-baked level; Director Xiao is the real main force."

Li Jingsheng and Lian Tao each have their allegiances.

Belonging to different camps, there’s no talk of letting up.

And given Lian Tao’s pride, he doesn’t need anyone’s mercy.

He’s just joking with Li Jingsheng.

"Alright, being bested by your Second Hospital is better than being overshadowed by Qiaobang. There’s only one last question left, let’s have a thrilling showdown!"

Lian Tao sends messages out of curiosity, wanting to confirm if it was Li Jingsheng’s intervention.

Now learning that Li Jingsheng assisted Director Xiao from behind the scenes, he’s instead excited, anticipating a duel with Li Jingsheng.

"Earlier, that patient had early gastric cancer, indeed surpassing many doctors’ expectations. Sometimes, identifying the cause is difficult, as they are adept at disguising, hiding deep or in unnoticeable body corners. This demands us doctors to use rich clinical experience, solid foundational medical knowledge, and persistent dedication to outsmart the disease, ultimately discovering it and eliminating it.