Chapter 905: Medical Insurance Department's Sliding Kneeling Technique

"Excuse me."

He apologized politely to the white coat.

Director Zhao suddenly felt that the guilt in his heart was relieved a lot.

Sure enough, apologizing is a high-quality behavior.

"Director Zhao."

"Go to Dr. Xu's office?"

"Hehehehe, Director Zhao, you have to be tougher!"

The administration building and the inpatient department were separated by about a hundred meters, and they had to pass the outpatient department building in the middle. Along the way, many doctors and nurses greeted each other with smiles.

He didn't hide the gloating on his face at all.

Director Zhao became increasingly nervous.

Soon, we arrived at the emergency department floor.

Xu Qiu's office has a solid wood door, which looks very heavy and gives people a solemn and majestic feeling.

Director Zhao suppressed his nervousness and knocked on the door.

squeak——

A sweet face appeared in the doorway.

When Shi Lian, the first disciple who opened the door, saw that Director Zhao had arrived, he quickly moved out of the way, and the corners of his mouth could not help but rise crazily.

Director Zhao stayed where he was, suddenly afraid to go in.

He glanced inside the office.

Dean Wang, the two vice-deans, the director of orthopedics, and others are all people of the same level as himself...

This is the Hongmen Banquet!

"Director Zhao, come in." Xu Qiu looked at him calmly from the main seat.

Director Zhao's shoulders shook, he took off his sunglasses and walked over calmly with his hands behind his back.

There was a strange look on everyone's faces.

Damn, are you so calm?

Wang Shengde felt a little apprehensive when facing Xu Qiu. With so many big guys looking at you at the same time, you didn't even walk smoothly!

When everyone was admiring him, Director Zhao suddenly swayed. Fortunately, the table was right in front of him. He quickly stretched out his arms to support his body.

"No... I'm sorry, my legs are weak..."

Director Zhao, who was no more handsome than three seconds, quickly found a stool and sat down.

Before Xu Qiu could speak, Director Zhao quickly confessed and leniently said: "Dr. Xu, you know that my heart is all about clinical medicine. This punishment is a requirement of the Medical Insurance Bureau... The higher-ups sent people to investigate. This time There are indeed violations in the medical records and they do not meet the conditions for reimbursement. There is nothing I can do about it!”

Good guy, is this how fast the medical insurance department gives in?

Did you learn the sliding kneeling technique from Drainage China?

Xu Qiu looked at Wang Shengde.

Wang Shengde immediately sat up straight and said: "Xu Qiu, you know that the medical insurance department is special. Although it is under the control of several of our deans, they investigate and deal with various medical insurance violations and are directly under the jurisdiction of the Medical Insurance Bureau... Me too I didn’t know until I received the notice this morning.”

Director of the Department of Orthopedics: "Dr. Xu, you know that my small department dares to go against the medical insurance department. Isn't this just asking for trouble?"

Xu Qiu was stunned for a moment.

I haven't said anything yet, why are you all starting to clear up the suspicions one by one?

and……

This matter itself cannot be said to be right or wrong. If we insist on finding a punching bag, it is the dogmatic reimbursement regulations.

Xu Qiu did not worry about finding someone to take the blame, but asked: "Director Zhao, do you know why I am looking for you?"

Director Zhao was silent for a moment and said: "I probably know...clinically, it would be better for Pang Honggu to have a femoral head replacement instead of the mandatory internal reduction, right?"

He thought for a while and then asked: "Can't we follow the rules and procedures? Do internal fixation first, wait until it doesn't work anymore, and then do femoral head replacement after necrosis occurs... In this case, even the Medical Insurance Bureau will be blameless. "

Xu Qiu glanced at the director of orthopedics.

The latter immediately explained: "This is an ideal situation you are talking about, but in reality, it doesn't work at all!

"Even if you don't understand Pang Honggu's condition, you should understand that her condition is not simple after seeing so many pages of treatment in the medical record.

“Sacrococcygeal ulcers, subcapital fractures, abdominal inverted Y-shaped infections, teratomas, etc…

"The patient himself has underlying diseases of diabetes and hypertension, and has also undergone appendicectomy...

“If a patient like this insists on following clinical guidelines and performs internal fixation and reduction regardless of the clinical conditions, she will definitely develop necrosis.

"At that time, bed rest will lead to the recurrence of pressure ulcers in the sacrococcygeal area, coupled with femoral head necrosis and various complications. Do you think she will have a second life to undergo femoral head replacement?

"Dr. Xu said before that for this patient, femoral head necrosis is the only option. Unless he is willing to pay a huge price for direct amputation, other treatment methods are waiting for death!

"Your regulations can state expressionlessly that 'femoral head replacement should be performed after internal fixation is ineffective and secondary necrosis of the femoral head occurs.' But in clinical practice, patients can really have the opportunity for a second surgery after their condition worsens. Opportunity?"

After saying this, I was shocked and enlightened.

Everyone nodded, approving the words of the director of orthopedics.

Director Zhao shook his head with a righteous look: "Let me emphasize, it is not our regulations, but the regulations of their Medical Insurance Bureau!"

Well, Maipi, you have to stand on the same side as the clinical doctors!

Otherwise, you will have to vent yourself.

Xu Qiu nodded.

The words of the director of orthopedics are indeed clinical reality.

Between death and femoral head replacement, Pang Honggu could only choose one.

In fact, there is a perfect way to avoid disputes, that is, the patient gives up his medical insurance and undergoes femoral head necrosis surgery at his own expense.

If medical insurance is not used for reimbursement, then medical insurance will naturally not be able to handle the "over-medicalization" part. Forget about a hip replacement. If you don't consider the rationality, it's no problem to replace it with Ultraman's legs.

However... patients pay medical insurance money and ask others to voluntarily give up medical insurance?

Is that reasonable?

Therefore, even if they are caught in a dilemma, no doctor dares to tell the patient directly.

Otherwise, there will be complaints + reports + criticisms, and they can't escape.

But can medical insurance be blamed for this?

It's also not possible.

Clinicians face tiny individuals, patients who are specific to people.

But medical insurance is responsible for all patients and is a macro-control of the entire system.

And the most taboo thing about legal provisions is ambiguity.

For the medical insurance reimbursement regulations, as long as there is room for swinging left and right, there will be loopholes.

Therefore, medical insurance has no choice but to make some sacrifices.

From the overall perspective, there is nothing wrong with it.

But the patients or doctors who become victims will pay the price for it.

For a certain patient, it may just be that they did not receive the best treatment.

But for the entire group of doctors, it is a big bomb.

When doctors are deducted money for treating patients with pure purposes, can they really keep their original intentions?

After all, this is just a profession.

A salary of a few thousand yuan is the current situation of the vast majority of grassroots doctors.

However, Xu Qiu at least hopes that in places where he can make the decision, in clinical medicine, all doctors are pure.

Let doctors be pure doctors, and only need to consider patients and diseases.

If this matter is not handled well, I am afraid that many people will have concerns and dare not choose the most appropriate treatment method based on clinical practice!