Practicing Medical Skills in a Small Clinic-Chapter 235 - 145: This Isn’t Bronchitis, Status Seems to Be Rising (2)
He racked his brains trying to diagnose the patient’s cause of illness.
A disease name that closely matched the symptoms and course appeared in his mind.
Chronic obstructive pulmonary disease (COPD).
It is a disease name that causes extreme distress to many patients.
While not a terminal illness, once afflicted, it’s very difficult to reverse.
Just like cirrhosis or kidney failure, once it starts, it can’t be reversed.
This disease cannot be cured.
It can only be managed with medication and other treatments to alleviate the condition, such as oxygen therapy.
If not treated promptly after symptoms appear, the condition will quickly worsen, and the patient could even die in their sleep.
Also, people with COPD cannot engage in vigorous exercise.
They cannot perform heavy physical labor.
This has a substantial impact on their life.
The patient also mentioned that after being checked in a large hospital, the doctor told him that there was a problem with his lungs.
Li Jingsheng’s eyes turned bright and confident.
It’s definitely this disease.
The symptoms and course have many highly consistent aspects.
Now he finally understood why the patient’s sputum was yellow and sticky, mixed with purulent foam.
"Doctor, did you find out what disease it is?"
The patient appeared to be very patient.
Seeing that Li Jingsheng seemed to have reached a diagnosis result, he finally spoke.
"Your condition is highly similar to COPD."
Li Jingsheng answered.
The patient’s expression clearly showed a hint of approval.
"Since you’ve found it out, please prescribe me some medication!"
"Alright."
Li Jingsheng calmly began to prescribe medication for the patient.
The efficacy and pharmacokinetics at the Minor Achievement level are enough for him to easily write prescriptions.
The patient has been treated long-term at other hospitals, so when prescribing, he must consider avoiding certain long-term medications.
Drug resistance would greatly decrease effectiveness.
His mind promptly made judgements, bronchodilators expand and relax airways, glucocorticoids increase exercise tolerance, reduce probability of acute exacerbation.
Expectorants promote sputum expulsion, reducing the probability of recurrent exacerbations.
Antibiotics prevent infection.
From four aspects of symptomatic treatment, the patient should not have poor efficacy after taking the medication.
Three types of bronchodilators are commonly used clinically, and β2 receptor agonists are probably the most used type.
He decided to bypass that category, choosing to try cholinergic receptor blockers, and eventually opted for tiotropium bromide.
Actually, aminophylline could also be used, but considering the patient’s poor constitution and older age, if anything went wrong, his small clinic could not bear the responsibility.
...
Finally, Li Jingsheng prescribed medication for the patient, some requiring oral administration or nebulized inhalation, and some requiring intravenous drip.
As soon as this patient was settled, a new patient arrived.
Li Jingsheng was happy to find that the small clinic had become busy again.
If he truly reports it and successfully appears on television, the small clinic being overwhelmed is not out of the question.
Being on television, he was both nervous and expectant.
First of all, being on television is undoubtedly a great thing. But if it triggers the nerves of a bigwig in this area, it could be serious.
Not knowing how to close down.
Boss Zhao mysteriously clued him in that it’s best not to plan on expanding the small clinic or grassroots healthcare institutions in the southern city area.
But some things are beyond Li Jingsheng’s control.
For instance, appearing on television, will the reporters listen to him?
Everyone works for their own interests, not likely to care about others.
Busy until nearly seven, Li Jingsheng finally managed to handle all the patients in hand.
That COPD patient had already seen efficacy after medication.
Leaving with great satisfaction.
Giving Li Jingsheng a thumbs up, praising him for his skills, for treating him well.
Li Jingsheng also successfully earned 61 life value points from this patient.
Successfully diagnosing the COPD should be rewarded with 50 life value points.
Then giving a good review when the patient left earned another 10 points.
The remaining 1 point was earned via diagnosis.
When the patient heals in a few days, he can earn another 1 life value point.
The profit was quite good.
A single such patient can compare to dozens of ordinary patients.
Li Jingsheng also experienced how impressive Minor Achievement level internal medicine diagnosis, efficacy, and pharmacokinetics truly are.
None of today’s afternoon patients were turned away.
All were dealt with.
Moreover, he himself could predict that these patients would have very good efficacy.
He believes that at least a majority will become returning customers or refer friends and family to come for treatment.
Brother Qiu took away his clinic materials last time some time ago, but there’s been no movement.
If he could enter the centralized procurement platform, it would be perfect.
Although his prescription level is very impressive now, many medications are unavailable at clinics and pharmacies. This is a big problem.
Additionally, entering the centralized procurement platform has a huge benefit, automatically obtaining extremely hard-to-get medical insurance qualifications.
By then, with both, the path to rise for the small clinic would be much smoother.
"Brother Li!"
A fat head poked through the door, it was Boss Zhao.
It’s been several days since Boss Zhao last came by.
After being disturbed by patients at Sunshine Clinic, its customers dared not enter and all went to Quick Recovery Clinic.
Boss Zhao’s days recently should be quite pleasant.
"Boss Zhao hasn’t been seen for some days. Your clinic’s business should be doing very well these days!"
Li Jingsheng consciously stepped out.
Whether willing or not, everyone is making a living on this street, must maintain cordial relations.
