Rebirth 1977 Great Era

Chapter 1426 Personally Investigating Medical Cases, Consulting at Ling Shi Clinic (Bonus Chapter for Monthly Tickets: 5K Chapters)

"This afternoon, I'll first check on the promotion situation at the county hospital," Fang Yan continued.

Upon hearing this, He Yang said:
“Okay, we have all the medical records from these past few days, and we’ve also compiled all the follow-up appointments.”

After receiving Xiao Hanxi's message, they were already prepared and just waiting for Fang Yancha to investigate.

Actually, the liver disease situation in Lingshi County is not too serious, and given their medical resources, it can be said to be the best-controlled area.

As they were talking, the kitchen staff brought over a rough porcelain bowl filled with golden-brown pancakes, the edges of which still had a caramelized aroma, and sprinkled with a layer of white sugar.

"Director Fang, try our Lingshi specialty, Tanhuang'er. It's made with cornmeal and millet flour, and it's very sweet and sticky!" Secretary Zhao introduced with a smile, picking up his chopsticks and placing a piece on Fang Yan's plate.

With staple food served with staple food, Fang Yan took a bite. The texture was soft yet chewy, and the aroma of corn mixed with the sweetness of white sugar was indeed refreshing. He said, "This corn is really good and very unique. It's my first time eating it."

He Yang smiled and replied, "We have a knack for preparing coarse grains here. The villagers rely on this to stave off hunger during the busy farming season. If Director Fang likes it, we can ask the canteen to make more so you can take it with you on the road."

During their casual conversation, Fang Yan recalled the origins of the He family in Lingshi and casually asked, "Dean He, judging from your accent, you're a local, right? The He family in Lingshi is a prominent clan; are you one of them?"

He Yang was taken aback for a moment, then nodded and smiled, “Director Fang is indeed very knowledgeable! I am, but our branch is a collateral branch. After the family separated many years ago, we have been living around the county town and haven’t benefited much from it. It was only by relying on the family’s tradition of ‘studying hard and making progress’ that I was able to get into Taiyuan Medical College.”

“That’s truly a scholarly family,” Fang Yan said with a smile. “I’ve heard about the He family’s reputation in the capital that ‘no examination can be held without the He family.’”

Secretary Zhao added from the side: "Dean He is a good man. After graduating from Taiyuan Medical College, he resolutely returned to his hometown. Over the years, he has worked diligently at the county hospital and became the vice president at a young age. He did it all thanks to his own abilities."

He Yang waved his hand somewhat embarrassedly: "It's all thanks to the organization's training. Besides, our Ling Shi is short of doctors, so I can do more to help when I come back."

The atmosphere at the dinner table became increasingly harmonious, and the group chatted about the local customs and culture of Lingshi, from coal mining to the villagers' spring planting plans. They listened attentively to the local dialect, occasionally interjecting with questions, silently taking note of the situation at the grassroots level in Lingshi, and gaining a general understanding of the local customs and culture.

After the meal, Secretary Zhao asked the cafeteria staff to clear the dishes, while He Yang stood up and said, "Director Fang, the medical records are all organized in the office in the outpatient building. I'll take you there now."

"Okay." Fang Yan nodded. "Please lead the way, Dean He."

The group walked through the hospital courtyard. A cold wind blew, carrying coal dust. The villagers' queue was still open, and they all cast curious glances at Fang Yan and his group as they passed by.

Li Chong and the other two followed behind Fang Yan.

His walking posture clearly indicated he came from the military, and Wang Feng's height of over 1.9 meters was particularly striking.

At this moment, Dean Zhang and Secretary Zhao, who had come along, asked them some questions out of curiosity. When they heard that the guards were specially arranged by the higher-ups, the two of them regarded Fang Yan with even higher regard.

The fact that he was assigned three bodyguards, which was arranged by his superiors, speaks volumes about his importance in their eyes. Otherwise, why didn't Bai Xiaochun, who also came from Beijing, have bodyguards with her?
Although he is only the director of the research institute, there is more to his story than meets the eye.

Thinking of the telegram sent by Xiao Hanxi, they became even more cautious.

The office was a small, south-facing room with sparkling clean windows.

When Fang Yan and the others went in, there were still people taking a nap at their desks.

Hearing Fang Yan and the others enter, he quickly got up.

He Yang said somewhat embarrassedly:

"After lunch, we usually take a short rest."

Fang Yan nodded, "That's quite normal."

Then He Yang led Fang Yan to a cabinet against the wall, where stacks of blue-covered medical records were neatly arranged. He Yang opened the cabinet door, took out the top few volumes, and handed them to Fang Yan:

"Director Fang, these are all the medical records since the pilot program began. They are classified by commune, and each book records the patient's basic information, diagnosis results, medication dosage, and follow-up visit records. Please take a look."

Fang Yan took the medical record, found a seat, and began to read it.

The office staff quickly poured tea for Fang Yan and the others.

Fang Yan thanked him and continued reading. The handwriting on the pages was done by several doctors, mostly neat, with a few pages containing hasty annotations.

He first looked through the initial records. The patient information was registered in fairly detail, with names, ages, addresses, and symptoms clearly listed. The diagnosis results were mostly marked with terms like "damp-heat accumulation" and "liver stagnation and spleen deficiency," and the medication dosages also met the standards issued by Beijing.

"What's the follow-up visit rate?" Fang Yan asked as she flipped through the pages.

Dean Zhang replied, "The follow-up rate in the county is about 80%. Most patients experience symptom relief after taking the medication, and many have recovered completely. Look at these pages; they are all records of follow-up examinations after recovery. If possible, we also had Western medicine follow-up examinations, and the liver function indicators here have all returned to normal."

Fang Yan nodded, then picked up a medical record, flipped through a few pages, and his brows gradually furrowed.

"What's going on with these cases?" Fang Yan pointed to the contradictory diagnostic records, then looked up at He Yang. "The diagnostic results are inconsistent. Did the symptoms really change during the follow-up visits, or was the diagnosis wrong from the beginning?"

He Yang leaned over to take a look, his face somewhat embarrassed: "These... these cases were made by barefoot doctors from the suburban commune during their trial consultations after training here. They probably weren't sure about the diagnosis at the time, so they re-evaluated it during the follow-up consultations."

"You dare to dispense medicine if you're not sure?" Fang Yan's tone became more serious.

Then, Fang Yan scrolled down to another place and asked:
"What does it mean that these cases of 'family members of cadres' are marked 'priority for medication'? Does the pilot program for medication have different priorities?"

Secretary Zhao quickly explained, "Director Fang, we didn't think this through. These cadres' family members did indeed have hepatitis. At the time, they said they were too busy with work to queue, so our staff gave them the medicine first without thinking too much about it."

Fang Yan didn't show anger or excitement, he simply asked:

"Your county doesn't even have enough medicine?"

"The pilot drugs are intended for all eligible patients, so how do we manage this?"

Dean Zhang said:
“Dr. Fang is right. Their problem is with the process. From now on, I will make it clear to them that all patients must be given medication according to the order of registration and the severity of their condition. No one can be given special treatment, and the word ‘priority’ will no longer be allowed in the remarks column.”

Fang Yan nodded and said calmly:

“If you set the example here, others will follow suit. You can’t do it that way.”

"There are also issues of diagnostic errors, which cannot be ignored. This shows that the training of barefoot doctors is not yet adequate and must be strengthened in the future. Moreover, if the diagnostic results are questionable, they must be clarified before prescribing medicine, otherwise the medicine will not be effective. We can no longer do things in such a muddled way."

Secretary Zhao and Dean Zhang nodded quickly: "Director Fang is right! We'll go down and convey your instructions right away, and make sure the rectification is in place!"

Fang Yan didn't say anything more and continued to bury himself in reviewing the medical records. He found that the medical records of the county doctors were relatively standardized, while those of the trained commune health station doctors were much rougher, some even only writing down names and symptoms, with vague diagnoses. It seemed that He Yang's statement that "the barefoot doctors' skill levels varied greatly" was an understatement.

Turning to the last book, Fang Yan's gaze lingered on a page of follow-up visit records. The patient's symptoms were described as "fatigue, jaundice, and dull pain in the liver area," and the diagnosis was "liver stagnation and blood stasis." After taking the medication, the symptoms were significantly relieved during the follow-up visit. The doctor who signed the record was Li Ke.

The handwriting was strong and vigorous, and in the remarks column there was a line of small print: "Instruct the patient to avoid spicy and greasy foods, drink water boiled with Artemisia capillaris, and have a follow-up visit once a week."

Fang Yan looked at his records and found that not only was the diagnosis accurate, but he also added suggestions for auxiliary treatments, which was much better than some doctors who just prescribed medicine according to the prescription.

“Li Ke’s medical records are quite well-organized,” Fang Yan said to He Yang, pointing to that page.

He Yang nodded: "Dr. Li Ke is extremely serious whether he is seeing patients or writing medical records. His medical records are always well-organized and have detailed notes."

Fang Yan closed the medical record, stood up, and said, "I have a general understanding of the situation in the county. There are quite a few problems, but they are not insurmountable. I'll leave the rectification of the distribution of medicinal materials and the use of medicines based on syndrome differentiation to Secretary Zhao and Dean Zhang."

Secretary Zhao quickly replied, "Director Fang, don't worry, we'll hold a meeting tonight to implement your instructions and we'll definitely rectify the problem!"

Fang Yan continued:

"Let's go check on the situation at the outpatient clinic."

"Okay!" He Yang immediately agreed, pointing outside and saying:

"The hepatitis pilot clinic is located on the east side of the first floor of the outpatient building. It's currently peak season, so you can take a look at the actual situation." Then, the group followed He Yang out.

As you walk along the gravel path, the closer you get to the outpatient building, the clearer the noise becomes.

As Fang Yan approached the entrance of the outpatient building, his gaze swept over the queue of about twenty people. Most of them were wrapped in thick cotton-padded coats and clutched crumpled medical forms. Some were leaning against the wall with their eyes closed, resting, while others were whispering to the people next to them about their conditions.

Beside the queue, a young nurse in a white coat was checking the information of each person on a registration form.

"Director Fang, this way." He Yang led the group eastward and pushed open a door with a wooden sign that read "Pilot Hepatitis Clinic".

There were three wooden tables in the consultation room, and behind each table sat a doctor in a white coat, surrounded by two or three fellow villagers.

A large diagram of dialectical reasoning was posted on the wall, and next to it hung a dialectical reasoning disc that the dialectical reasoning disc had been promoted before. However, the paint on the edge of the disc was worn, indicating that it had been used many times.

Behind the innermost table sat an elderly doctor with gray hair, taking the pulse of a middle-aged man.

Fang Yan slowed down, her gaze falling on the doctors' procedures.

Most doctors are able to skillfully refer to the diagnostic flowchart, combine it with the patient's symptoms to determine the type, and then prescribe medication according to the type, so the process is relatively smooth.

But when he reached the middle table, Fang Yan stopped in his tracks. Behind the table, a young doctor was looking at an old woman's symptoms with a troubled expression, turning the diagnostic disc around in his hand with a deep frown.

"Madam, you feel weak, have abdominal distension, and are a bit cold. Is it due to cold and dampness affecting your spleen, or liver stagnation and spleen deficiency?" the young doctor muttered to himself. He looked up at the older doctor next to him, but saw that the older doctor was busy seeing patients. Feeling embarrassed to disturb him, he could only lower his head again and ponder the disc repeatedly.

The elderly woman sat opposite me, her face full of anxiety: "Doctor, is there any cure for my illness? I still have my grandson to take care of at home..."

He Yang explained in a low voice, "This is a young doctor who just passed the exam. He's still learning and sometimes he's not sure about making accurate diagnoses."

Fang Yan didn't speak; he just stood there observing.

After a while, the young doctor seemed to have made up his mind. He wrote "cold and dampness trapping the spleen" on the consultation form and was about to get the medicine when Fang Yan stepped forward and asked softly, "Ask the old lady again if she has symptoms such as bitter taste in her mouth or dry mouth? How are her bowel movements?"

The young doctor was taken aback for a moment before realizing that a hospital leader was following behind Fang Yan, and that the leader was constantly giving him meaningful glances. He quickly came to his senses and asked, "Ma'am, do you have a bitter taste in your mouth or a dry mouth? Are your stools dry?"

The old woman thought for a moment and shook her head: "I don't have a bitter taste in my mouth or a dry mouth, but my stool is a bit loose."

Fang Yan said to the young doctor, "Weakness, abdominal distension, fear of cold, and loose stools are typical symptoms of cold and dampness affecting the spleen. If it is liver stagnation and spleen deficiency, there will usually be symptoms of low mood and distending pain in the hypochondrium. The old lady did not mention these, so your judgment was correct, but you need to ask about all the symptoms to be more accurate."

The young doctor looked enlightened and nodded quickly, "Thank you! I'll definitely ask about the symptoms more thoroughly next time!" The three leaders were somewhat embarrassed at this point. He Yang said to Fang Yan:

"Director Fang, the doctors here can't compare to those in bigger cities..."

According to the local dialect, someone with real ability would definitely go to a bigger place.

Fang Yan smiled and said, "I know, don't be nervous."

Then he stopped looking at the doctor, left the consultation room, and went to the dispensing room next door.

Several large medicine cabinets were placed in the dispensing room, and a queue was formed outside the window in front of the cabinets. The nurses were orderly dispensing medicines according to the medical records, and giving instructions on the usage and dosage as they did so.

"Director Fang, all the medicines here were sent over from above and have already been sorted by type. The doctor writes the consultation form, and you can just pick up the medicine here according to the form. It's very quick," He Yang explained.

Fang Yan walked to the medicine cabinet, opened a medicine box and looked inside. The medicine packets were all dry and had not been damp or spoiled. He nodded and said, "They're well preserved. That's good."

Emerging from the dispensing room, Fang Yan stood at the entrance of the outpatient building, looking at the fellow villagers still queuing, and asked He Yang and the others:

"How long do I have to wait to get my medication now? Have any fellow villagers reported difficulty in getting their medication?"

He Yang replied:

“It’s okay in the county town; you can usually get the medicine after queuing for half an hour. It’s just that for people from a little further away, it’s not easy for them to come all the way. Sometimes there isn’t enough medicine, so they have to make a second trip.”

Fang Yan pondered for a moment and said:
"The allocation of medicinal materials needs to be optimized further, prioritizing the needs of the villagers so that they don't make a wasted trip."

Just then, a middle-aged man carrying a bundle rushed over and shouted to the nurse in the dispensary, "Nurse, do you have any more medicine? I came all the way from Pingyao. I heard that the medicine here can cure hepatitis, so I came here specifically!"

The nurse shook her head helplessly: "You don't meet the requirements. We have to follow the rules!"

The middle-aged man's face instantly fell: "I've already come all this way..."

Fang Yan saw this and felt uneasy. He said to Secretary Zhao:
"In the future, we can count the number of patients from other places in advance and reserve some medicine so that they don't make a wasted trip. It's not easy for people in rural areas to see a doctor, so we should help them as much as we can."

Secretary Zhao nodded quickly: "We'll arrange for someone to do the statistics right away, and we'll start reserving places tomorrow. We won't let our fellow villagers come all this way for nothing!"

Then He Yang immediately went to make arrangements for the middle-aged man.

The dialect group knows they are also troubled, as the pilot program is not yet being rolled out nationwide, but people outside the pilot program also want to get treatment, which is the demand.

Fang Yan stood motionless at the entrance of the outpatient building, his gaze still fixed on the fellow villagers queuing up.

A cold wind blew by, and several villagers, bundled up tightly, couldn't help but hunch their shoulders, but no one complained; their eyes were filled with anticipation for seeing a doctor.

“Director Fang, this is just an isolated incident,” Dean Zhang said to Fang Yan.

He said in dialect:

“This kind of thing will definitely happen more and more often in the future, as can be seen from the situation at the grassroots level. I understand your difficulties, but to promote it, we must do a good job in the current pilot projects.”

"The higher-ups have spent money, so they definitely need to see good results."

Dean Zhang said:
“You’re absolutely right! We understand that if the pilot program goes well, we can expand the scope and benefit more people. But sometimes we are at a loss when faced with these needs that are beyond the scope of the pilot program. We are afraid that if we don’t handle them well, it will affect the pilot program’s effectiveness, and we are also afraid that we will disappoint our fellow villagers.”

He said in dialect:

“No grassroots work is perfect; it is constantly improved through the process of discovering and solving problems. I am here today to help you find problems and come up with solutions so that we can work together to make the pilot project a success.”

Hearing Fang Yan's attitude, Dean Zhang and Secretary Zhao breathed a sigh of relief.

This young man is alright; he's quite reasonable.

He Yang has now taken care of things for the people over there.

Fang Yan saw that there were still people coming and queuing in the cold wind, and he said to He Yang and the others:

"Please find me a seat, I'd like to sit for a while and see patients."

"Huh? Director Fang, you're going to see patients?" He Yang was taken aback at first, but then he realized what was going on and quickly said, "No problem! I'll go arrange it for you right away. Use the empty table at the very back, and I'll have the nurse bring over the necessary medical tools!"

Dean Zhang and Secretary Zhao were also somewhat surprised. They didn't expect Fang Yan to not only come to inspect, but also offer to hold consultations. Was this just a show of force?
"Director Fang, you've been busy all morning, why don't you take a break?" Secretary Zhao said with concern.

Fang Yan waved his hand: "No need to rest, the villagers are still waiting in the cold wind. Help as many as you can." As he spoke, he walked towards the clinic, with Li Chong and the others following closely behind, stopping a short distance behind him.

He Yang worked quickly, and in no time he had prepared the diagnostic tools: stethoscope, sphygmomanometer, and diagnostic disc were all placed on the table.

"Director Fang, it's cold. If it gets too cold, we'll call it a day."

Fang Yan smiled and nodded, then sat down and said to the villagers queuing at the door, "Come on, one by one, let me show you."

PS: The 5,000-word chapter is now complete. I've received 200 more monthly votes. I still owe you 2000 words after finishing this chapter.

(End of this chapter)