As Chinese doctors, Qi Jing and Xu Jiakang experienced American-style medical treatment for the first time from the perspective of patients, or patients' "family".

This kind of experience is good for Qi Jing, not too unfamiliar. Because he came to the United States several times in his previous life, and he also had friends who worked as doctors in the United States, so he was very clear about the essence of capital medical care.

Xu Jiakang also worked as a further study doctor in the United States for half a year, but at that time his income was not all paid by local hospitals, so he could only see some bright and beautiful fur.

A few years ago, the so-called fur could grow well on the giant beast "American Advanced Medical" and looked majestic. But a few years later, it was cut into blood by the skinning knife of the financial crisis.

The hospital is full of name Lehn Regional Medical Center Hospital. Although it only has one, two, and three buildings, it is a real medical center in Lehn Town and surrounding areas. While the United States has been moving forward with its front-line medical technology, rural hospitals across the country are working hard to survive.

Lehn Hospital is a typical example.

In terms of scale, there are less than 100 beds in the hospital, and there are less than 300 employees in the hospital. This is a real township hospital.

However, compared with the community hospitals in China that have given up front-line emergency treatment, small hospitals in the United States are limited to regional medical centers and still have relatively standardized emergency services, and also have emergency severity index(esi) rating.

This is a system used in the US emergency clinics. The smaller the number, the higher the level. (1)

Although they drove 40 kilometers to get here and Morton was in a high fever, Qi Jing knew very well that his esi rating was still only 5. It cannot be said that Morton's high fever was not serious, but in the esi rating system, such high fevers were ranked at the end unless they reached the medical sense of confusion.

The prediagnostic nurses at Lehn Hospital obviously have many years of experience in emergency triage.

After seeing Morton, she asked a few simple questions and quietly entered the grading results into the computer. She pressed the "5" on the keyboard with her fingers. Her movements were very concealed, but Qi Jing, who was prepared, caught him right away.

"Miss Nurse, did you press 5 just now?"

"ah?"

She didn't react for a while. When she realized that Qi Jing was talking about the esi level, she nodded and said, "Yes, you go to the seat and wait. You will call his name when you arrive."

"No, Miss Nurse, you must have made a mistake."

Qi Jing shook his head at the judgment given by the prediagnosis nurse and explained with a smile: "He has always had a temperature above 39 degrees, and he has respiratory symptoms, which is very likely to be pneumonia. I think it is unfair to give him only level 5, and he should give him level 3."

After listening to Qi Jing’s remarks, the nurse was a little surprised, and ordinary people did not know about the emergency grading system.

Of course, no matter how surprised Qi Jing said that he wanted to be level 3, he was just a lion. He couldn't do it at all: "What are you kidding me? Level 3 patients need to occupy a lot of medical resources. What you send is just high fever. According to regulations, I can only give level 5."

"He has a wet rosy in his lungs, so he must have X-rays. He may not be able to diagnose after doing it. Maybe he has to have a CT examination. I think it is not an exaggeration to open level 3."

The nurse who originally wanted to send someone away casually couldn't help but look up and look at Qi Jing again.

He turned out to be a yellow man...

She has worked in this hospital for more than ten years, and many of the towns are familiar faces. In the area of ​​Lehn, there are not many people in the population, few people know medicine, and even fewer people understand the emergency workflow of the hospital. In this way, there is still a yellow person from it, and the probability is basically 0.

But Qi Jing appeared in front of her, and it appeared a little strange.

The young man was wearing a mask and a stethoscope on his hand. She felt a little sad and had to be cautious. She had just experienced trouble three months ago. The operation of this hospital was already difficult enough and she couldn't afford to sue.

"You wait..."

The nurse probably prefers sweets and is very exaggerated in size. However, the chair is a fixed size, so her sitting posture looks very inconsistent, like an excessive ice cream ball that is carefully placed on a small waffle crispy tube.

She moved the small chair under her, tilted her head and looked at Morton who was leaning against her son's shoulder, reluctantly took off her phone and called the emergency doctor who was dealing with a pregnant woman: "Dr. Miller, there is a patient suspected of pneumonia here. How much is the rating?"

There was no doctor's reply on the other end of the phone, only: "Put hard, use force, and then use force!"

"Dr. Miller, reply~~~"

"Suspected pneumonia? How do you know it is pneumonia?" Miller did not forget to cheer up the mother at hand while answering the question, "Come on, you can~ Yes, just use force like this, don't be afraid, keep exerting force!!!"

The sound easily penetrated the door of the clinic that was not soundproof, and the harmony of the phone sound made the entire waiting room full of motherly shouts.

There is no need to check it out, just look at the restless middle-aged man in the corner, and you can easily guess who is the expectant father.

"His friend said that the patient had auscultation with a wet rosy sound!"

"Shi Luoyin???" Miller gave a little attention on this phone call, "Does the patient have a high fever?"

“39.5.”

"How do people look?"

"I don't think it's a problem."

Miller thought for a while and said, "If you want to take an x-ray, you'll be fine, give it 4!"

"Okay, I get it."

The nurse hung up the phone, looked at Qi Jing's smiling face that was a little ungrateful, and said reluctantly: "The emergency doctor agreed to give him esi level 4, is this okay?"

"How many patients are there?"

Qi Jing never acts good when he takes advantage of it, and will only actively look for the next one to continue to take advantage. After receiving the 4th grade score, he immediately poked his head out of his head with a timidity and glanced at her computer screen: "Can you let me see it?"

The nurse lay helplessly on the table, covered the screen with her little body, and pointed to the empty seat not far away: "Please go and wait patiently. I will call my name when it's his turn."

"......All right."

Qi Jing reluctantly retreated to the waiting area, looked at the patients and family around him, and explained the situation to Xiao Morton: "I tried my best. It seems that I can't get in in less than two or three hours. There are too few medical resources here and too few doctors."

"It's okay, North Carolina is actually much better." Morton Little is much more optimistic than they thought. "In Texas, small hospitals of this quality are closing down one by one, and even if they are kept, many hospitals have closed the passages for delivery of pregnant women."

"No wonder you're moving here."

"Fortunately I moved early. I heard that there are no baby hospitals around my hometown. The most recent trip takes more than 200 kilometers."

Medical care has always been a money-making black hole for every country. Superpowers like the United States have a very astronomical expenditure. How many bubbles are there and how many have entered the pockets outside the medical system, the authorities are very clear about, but they just can't control it.

This financial crisis did not poke the medical bubble, but poke all the other bubbles around it. The huge medical creature will naturally be affected when it sits in it.

Morton's family is already very lucky.

Qi Jing patted his shoulder and comforted him: "Wait with peace of mind, we will wait here together."

"Thanks."

......

The waiting at night is extremely long. Compared to Qi Jing, who is closing his eyes and resting, Xu Jiakang, who is next to him, pays more attention to the operation model of this hospital.

It has to be said that ESI's grading system can indeed save a lot of medical resources, and also allow nurses to simply and quickly identify which patients need treatment in urgent need of treatment, and which ones will be fine if they wait for a while.

Xu Jiakang used to stay in the emergency room of the Medical Center in Seattle for half a year, so he must know ESI. But only by personally experiencing the difficulties of patients with mild symptoms can he realize how wasteful this grading and triage system is.

A Level 4 patient can wait for three or four hours in a public hospital, and a Level 5 patient has to wait for five or six hours.

As an emergency doctor who has worked at home and abroad, Xu Jiakang has to admire the strong level of American medical hardware. A township hospital with such complete inspection instruments is rare in China. Just now, a car accident trauma was treated, and the emergency treatment was done well.

But at the same time, he also had to complain about the inefficiency of medical care abroad. It only takes 3 minutes for a patient to start a check-up, but it will be extended to 10 minutes or even half an hour here.

And since the last time he went to Seattle, he has been wondering about one thing.

"Oh, I said..."

Xu Jiakang subconsciously pushed Qi Jing beside him: "I just got gastroenteritis. Why did the doctor only check blood routine but not electrolytes?"

"What blood conventional electrolyte..." Qi Jing waved his hand randomly, not in the mood to talk to him about this, "I want to sleep!"

"I just thought it was very curious. Gastroenteritis electrolyte testing is a regular item for us."

“…”

Xu Jiakang sighed and got up and walked around the entire emergency hall, which surprised him very much. Because those patients who have been treated often only have a blood test form in their hands, and the checked items are usually only 1-2, and rarely more than 2.

This is rare in domestic emergency rooms, because even for ordinary gastroenteritis, blood routine and blood electrolytes must be checked. To be cautious, many doctors will also arrange for abdominal b-ultrasound to mainly eliminate the problems of liver, gallbladder and pancreas.

So this kind of random single-item check is simply a mess.

When Xu Jiakang returned to his seat, his doubts became even heavier: "Oh, wake up..."

Qi Jing tried hard to open his eyes and tried his best to ensure his peace of mind: "What's wrong? It's Morton's turn?"

"No, I want to ask..."

"Oh, why are you asking again? I want to go to bed!"

After saying that, Qi Jing changed his seat and prepared to sniff for a while. Before he could think of Xu Jiakang, he couldn't help it: "You just used my shower gel and haven't settled the score with you yet. What's wrong with asking a few questions?"

Qi Jing was in the wrong, and could not persuade him, so he could only breathe a lot and sit up straight: "Ask, ask."

Xu Jiakang’s question is actually not difficult to answer. It mainly involves two aspects: one is why the doctors give so few examinations, and the other is why the doctors here chat with the patients for so long.

"Just ask this?"

"Yes, these two."

"Have you been to Old Man Coent for a while? Don't you know the trick here?"

"What trick?"

Qi Jing was moved by his innocence and innocence: "You...don't you think that less examination means saving money for the patient, and chatting for a long time means grasping the patient's medical history as much as possible, right?"

Before going to Seattle, Xu Jiakang really thought so, but since he went there, some feelings have changed.

He didn't know why the local doctors did this, but the hospital he went to was the top in the country, and the condition of taking over the patients was mostly very serious and troublesome, so it was not obvious in these two points.

But Lehn Hospital made Xu Jiakang fully feel a sense of incongruity.

"This is a capitalist country, what is capitalism?" Qi Jing rubbed his fingers, "Money!"

"I know this, but what does it have to do with medical treatment?"

"Did you ask patients how much it costs to see an emergency room during your time in Seattle?" Qi Jing asked.
To be continued...