This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 62 Conflict!
"Of course I won't have surgery. If I can avoid surgery, why would I go through with it? Why suffer if I can't?" the young man said naturally.

Lu Cheng thought for a moment and then said, "Of course, there are a few prerequisites for not having surgery."

"First, you need to have enough self-control. You can't take off your forearm sling, not even when you're taking a shower or sleeping."

Are you sure you can do it?

The young man thought for a moment and nodded: "Given the situation, I can only listen to you doctors, right?"

"Alright, come with me. We need to get a statement and signature. If you move around, the fracture will keep rubbing against you, prolonging the recovery time and causing you unbearable pain. That's what it means to suffer without enduring the pain..."

"You must make it yourself..." Lu Cheng patiently instructed as he led the patient out of the room.

……

About an hour later, Tian Zhuang walked into the doctor's office, where Lu Cheng was having dinner and chatting with Tian Duoduo and Deng Zhouzhou.

"Brother Lu, Dr. Tian from the orthopedics department called. I can't explain it clearly over the phone. Would you like to answer it?" Tian Zhuang knew his communication skills were limited and looked apologetic.

If you can't communicate well, you can only be a good doctor by constantly improving your cognitive abilities and practical skills.

Lu Cheng ate faster than Tian Duoduo and the others. He was almost finished eating when he quickly shoveled the rest of his rice into the trash can, stood up, and threw the lunchbox into the trash can.

"Brother Shan," Lu Cheng said cheerfully after answering the phone.

Tian Shan asked on the phone, "Lu Cheng? I heard from Tian Zhuang that you also let the patient with the fracture go?"

"what happened?"

After a moment's consideration, Lu Cheng nodded frankly and said, "Brother Shan, this is just a simple radial head fracture! I've taken a look, and there's no indication for surgery."

Tian Shan chuckled and retorted, "Radial head fractures are routinely treated as surgery in our department, aren't they?"

"You've been here all these years, and you didn't know? I thought it was an avulsion fracture."

Lu Cheng went out and replied, "Yes, Brother Shan, our department performs surgeries routinely, but radial head fractures also have specific subtypes."

“Mason type I and type II fractures are special cases, and non-surgical treatment may be an option.”

"In fact, for Mason type II radial head fractures, the fundamental goal of our treatment is to enable the elbow joint to achieve painless, stable flexion, extension, and rotation functions."

"For type II fractures of the radial head, if there is no concurrent elbow dislocation and flexion and rotation functions are not restricted, the effects of surgical treatment are equivalent to those of non-surgical treatment."

"Of course, the effectiveness of surgical treatment is no less than that of non-surgical treatment," Lu Cheng added.

Lu Cheng did not flaunt how detailed his theory was, nor did he boast about it.

However, not all fractures require surgical treatment.

There is no way to manually reduce radial head fractures; the same therapeutic effect can be achieved without surgery.

This is a matter of cognition.

Tian Shan said, "What if you suggest that the patient not be hospitalized for surgery and let the patient go? What if he causes you trouble later?"

The county hospital is not a top-tier teaching hospital, so patients will instinctively doubt your treatment level. If anything goes wrong, they may say that you misdiagnosed or mistreated them, thus delaying their condition.

Even though Lu Cheng gave sufficient reasons, for diseases where surgery is optional, Tian Shan preferred surgery.

Lu Chengze said, "Then let the patient choose for themselves, and make it clear what the consequences of not having surgery will be."

"If a patient chooses surgery, that is their own choice. If they choose not to undergo surgery, they should also bear the corresponding consequences."

"Furthermore, the worst that can happen with conservative treatment of a radial head fracture is that the healing process will be slower. I assessed beforehand that his flexion and extension functions would not be impaired."

Lu Cheng's theoretical knowledge and corresponding structured theory can confirm that even without treatment, simply wearing a forearm sling can achieve the same therapeutic effect as surgery.

But as I said before, this is just a theory that Lu Cheng has come to understand, not the standard answer. Even if it were the standard answer, Lu Cheng wouldn't dare make a promise to the patient.

The patient's right to choose always outweighs the doctor's advice; if the patient requests surgery, then that is the patient's own choice.

The emergency department called for a consultation and contacted Tian Shan. Since no one from the orthopedics department came forward to see the patient, the emergency department naturally had the authority to conduct its own internal diagnosis, and Lu Cheng was also an attending physician.

As one of the attending physicians, Lu Cheng naturally trusted his own abilities and believed that he could do a good job in the emergency room.

Therefore, Lu Cheng did not think there was anything wrong with sending the fracture patient back home without surgery.

Tian Shan took a deep breath and said, "Xiao Lu, this patient, broadly speaking, is under the first-visit responsibility system. As the first-priority patient, your emergency department is also the primary care provider for this patient."

"Although you made a consultation call, my consultation advice to you was to come to the orthopedic ward, but you did not follow it."

"If the patients cause trouble later, you'll have to take responsibility yourselves."

Tian Shan couldn't say that Lu Cheng's choice was wrong, nor could he force Lu Cheng to call the patient back.

He's already in the wrong if he doesn't come for a consultation in person. No matter how powerful he is, he still has to follow certain rules.

Lu Cheng hasn't encountered any brainless colleagues yet, but they are rather cold-hearted.

Lu Cheng nodded: "That's for sure, Director Tian. Even if the patient really comes looking for trouble, I won't say it was your idea, Director Tian."

"My name is also written on the patient's medical record."

[Trauma Surgery (Proficient 9/10) (+1)] This level of theory is enough for Lu Cheng to memorize the knowledge points in the orthopedics textbook.

Lu Cheng remembered correctly, and the guidelines did not provide any specific recommendations on whether to operate on a radius fracture. So, if Lu Cheng followed the textbook, even if the patient came to cause trouble, he would have a reason to avoid the fact that he had not made a mistake.

Tian Shan clearly didn't make this call to shift the blame onto Lu Cheng. Instead, he said, "Lu, you actually know the specific situation in our department. We don't have a lot of patients, so..."

Lu Cheng interrupted Tian Shan, saying, "Director Tian, ​​I didn't intentionally send the patient away. He really doesn't need surgery. If you need, I can take a picture of the original textbook for you."

"If I'm mistaken, I'll call the patient immediately, apologize, and ask him to come back to the orthopedics department for a second opinion."

"If even the textbook is wrong, then I guess I'll just have to accept it!"

Tian Shan is indeed an associate chief physician, but what is the relationship between him and Lu Cheng, who is now an attending physician in the emergency department?
"No need for that."

"Xiao Lu, you go ahead with your work... Actually, you know that I mainly work in sports medicine."

"But if you send the patient away like this, Director Peng and Director Xiang will have objections. They specialize in trauma and fractures." Tian Shan understood what Lu Cheng meant and was too embarrassed to dwell on it any further.

Tian Shan was also a smart man; he didn't offend anyone, and instead, at the right moment, he did Lu Cheng a favor.

Four associate chief physicians in the orthopedics department.

Peng Haibo specializes in spine and trauma, Xiang Kuihua specializes in trauma, Luo Changzhang specializes in spine, and Tian Shan has carved out a unique path in sports medicine.

"Thanks for the reminder, Brother Shan. We're all just doing our jobs. Personally, I think what's best for the patients is the most important thing," Lu Cheng said, expressing his opinion.

Who isn't a proper orthopedic surgeon?

Just take responsibility. If you're a doctor and don't want to take responsibility, you might as well change careers...

"That's right, Xiao Lu."

"If there's anything I can help with, remember to call your brother Shan anytime." Tian Shan hung up the phone with a sense of brotherhood.

Lu Cheng was taken aback, then suddenly realized.

Tian Shan was sitting on the sidelines watching the two tigers fight, hoping that he and Xiang Kuihua, the deputy chief physician of trauma surgery, would fight each other, preferably to the point of mutual destruction. He was indifferent to adding fuel to the fire.

(End of this chapter)