CHAPTER 137: THE DOCTOR-PATIENT RELATIONSHIP IS NOT SIMPLE

"You’ve trained very well so far. I reckon in another month or two, you’ll be able to operate directly alongside Chief Director Li," Liu Banxia said to Liang Xiaolin after the earlier commotion.

"Am I really good enough?" Liang Xiaolin asked, somewhat surprised.

"Why wouldn’t you be? Didn’t you suture very well today?" Liu Banxia encouraged.

"That’s different. Surgery isn’t just about closing incisions. I still don’t know how well I can suture a blood vessel; I’m afraid I’ll mess it up if I rush," Liang Xiaolin replied, her brow furrowed.

"Let’s work hard together. You’re just starting your residency, what more do you expect? To take over Chief Director Li’s job? Come on, everything has to be done step by step," Liu Banxia said, chuckling.

"In the Emergency Department, the main goal is to help you overcome your minor issue of being slow during procedures and to improve your suturing skills. Your specialty is cardiothoracic surgery, so you still need to return to the ’battlefield’ of cardiothoracic surgery."

"However, it’s still uncertain who from Cardiothoracic Surgery will be assigned to the Emergency Department. We’ll see when the time comes. Anyway, you still need to train diligently."

Liang Xiaolin wrinkled her nose. I don’t know why, but I always feel like I should talk back whenever Banxia lectures me.

"President Liu, consultation," Wang Huan called out.

Liu Banxia led Liang Xiaolin to the internal medicine consultation room and froze. It was the patient who had refused instrumental examinations that morning.

"He’s experiencing abdominal pain again and also feels nauseous. We performed a simple physical examination but found nothing abnormal. He’s still refusing any instrumental examinations. What should we do?" Wang Huan asked with a forced smile.

Liu Banxia felt a headache coming on. This seemingly simple problem had suddenly become complicated.

"Sir, we are doctors, but we’re not deities. We can’t just look at you and know what’s wrong. We can only make a diagnosis through physical examinations and instrumental examinations," Liu Banxia reasoned with the patient.

"We couldn’t confirm a diagnosis when you came in this morning. Now your abdominal pain has recurred, and you’re feeling nauseous. Can’t you trust us this once and undergo an instrumental examination?"

"Doctor, I just ate something bad. The medicine is too slow. Can you put me on a couple of IV drips?" the patient said.

"What’s the point of those examinations? It’ll probably be the same result anyway. It’s just a waste of money—hundreds, even thousands, for nothing I can even see."

"With a physical examination for abdominal pain, we can usually only confirm the location of the tenderness. For many patients, the pain is diffuse and not clearly localized, so we have to rely on instrumental examinations as an auxiliary diagnostic tool."

"Doctor, I was supposed to leave on a business trip today. I’ve already been delayed a day, and it’s causing me enough trouble as it is," the patient insisted.

"Alright then, let’s do a stool test," Wang Huan suggested.

"But I don’t need to move my bowels right now," the patient frowned.

"That’s alright, we can use an enema. If it’s really enteritis, the stool test will show indications of it," Liu Banxia quickly added.

"Besides, there are different types of enteritis, and treatment is only effective if it’s targeted. Anyway, since you’re not going on your business trip today, I’ll ask the lab to expedite it. It won’t delay you too much."

The patient thought for a moment and nodded.

Only then did Wang Huan begin working on the computer.

"Brother Wang, do you have any idea what’s going on?" Liu Banxia asked after the patient left to provide the sample.

Wang Huan shook his head. "He just says his abdomen hurts, with intermittent cramping pain. I initially suspected enteritis too, but the lab results don’t support it so far."

"Besides, if it were enteritis, how low would his pain tolerance have to be for him to come to the emergency department? I also suspect a cardiac issue, but after ruling out myocardial infarction, we’d need to do instrumental examinations."

"Now we just have to wait for the stool test results. If they’re negative, I don’t know what to do. Should we still have him sign an informed consent form?"

Liu Banxia frowned. "We’ll see. If it really comes to that, we’ll contact his family. If the stool test is negative, it at least proves his assumption that enteritis is causing diarrhea is wrong."

"I thought we only encountered patients like this in the outpatient department. I didn’t expect them in Emergency too," Wang Huan said, shaking his head.

"Sigh... It’s mainly that patients don’t fully understand our medical procedures these days. Plus, there’s been a lot of negative press about hospitals. Many people assume that when we order instrumental examinations, it’s just to make money."

"What if the patient still refuses?" Liang Xiaolin asked.

"Then, just as Brother Wang said, we can only have them sign the informed consent form. Otherwise, if the patient experiences even the slightest problem, they can sue us. The hospital has been pushing for standardized procedures since last year, including here in our Emergency Department."

"For any emergency patient accompanied by family, we must explain everything clearly. If surgery is required, we not only need the family members to sign but must also clearly explain all potential complications."

"That sounds so time-consuming," Liang Xiaolin frowned.

"Special circumstances call for special measures. If a patient is truly in critical condition and needs immediate life-saving treatment, that step can be completed later," Wang Huan said with a smile.

"Previously, whether a doctor provided emergency treatment depended on family consent if they were present. But now, a new regulation allows doctors to proceed with life-saving measures if they believe there’s a chance of success, even if the family has given up on treatment."

"However, this is still risky. It’s always best to get the family’s consent. Otherwise, future costs or issues from a failed resuscitation attempt can become ammunition for the family to use against us."

"Why do so many departments operate at a deficit? Why are families constantly urged to pay medical fees? Once a patient is admitted, the hospital is responsible. One wrong move, and we could face a lawsuit."

"There are so many considerations. Being an emergency physician is incredibly difficult," Liang Xiaolin said with a forced smile.

"It can’t be helped. People’s awareness of their rights is very strong these days. For instance, if a patient dies during surgery or emergency treatment, we’ll likely bear some responsibility, one way or another," Wang Huan said.

"Fairness? Where’s the fairness in that? It’s our responsibility whether we attempt treatment or not. If we try and fail to save them, it’s still our responsibility. Once the Emergency Department is officially up and running, we’ll see no shortage of such cases."

Wang Huan had been at Second Hospital for a long time and had seen a lot. He was essentially giving these two rookies a primer, lest a single well-intentioned act land them in trouble.

The doctor-patient relationship is far from simple.

Whatever happens, people’s first assumption is often that the hospital is up to something shady. It’s not to say some hospitals aren’t like that, but in most hospitals, the doctors truly earn their pay.