This article is from WeChat official account:Eight-point Health News Plus (ID: jianwennews), author: bear Taihang, Liu, head map from: “I and my hometown” stills
Help brother Jian!
My cousin is suspected of having lung cancer. The family wants me to take the film to the hospital in Beijing first. What should I pay attention to when I go to Beijing to watch the film? Is it better to rule in Beijing or in your hometown?
——Unprepared hit workers
Hello, brother.
There are many people around Jian who have the same need for help. After all, the workers in Beijing, Shanghai and Guangzhou may have a cousin who wants to come to see a doctor.
Illness in the family is a big deal, the sooner the better, we just said it.
Sixteen words: First diagnose, then seek a plan, do what you can, and follow the rules.
Diagnosed
If the patient does not come, be sure to bring out a pathology report.
To confirm whether a person is lung cancer or not, pathology must be obtained.
Holding CT, PET-CT, or even MRI and other imaging examination reports, I rushed to the major hospitals in Beijing. There would only be one result, which is “work and no work.”
In “The Silent Truth”, the prosecutor Jiang Yang played by Bai Yu was told by the doctor that he had advanced lung cancer, only five months without doing pathology. No, the average doctor would not make such a judgment.
Either bring the patient over and do pathology in a big hospital in Beijing, or do the pathology at the best hospital at your doorstep, and then bring the report and image data together for analysis by doctors in Beijing.
Are there any cancer treatments that do not require pathology, and there are also, such as the mildest form of thyroid cancer.
Most of the time, if a thyroid nodule is found, if the doctor suspects it is malignant, he will use the knife to drop it and cut it forever, because the operation itself is not big, and it is not cost-effective to have the patient puncture one pathology at a time.
However, no doctor dared to make a decision such as surgery, radiotherapy and chemotherapy for a person who may have lung cancer without looking at the pathology.
Only take the CT image to ask the doctor “is it cancer?” The doctor in Beijing can only suggest “further examination.” This is not because the doctor is afraid to take responsibility for not saying it, nor is it because the doctor wants to order more tests.
The pathology report also has a chain of contempt. If the hometown hospital does pathology, it is best to find the most famous general hospital in the local capital city, or the pathology report of the tumor hospital. Beijing experts are most worried about some low For pathology reports that are not well done by grade-level hospitals, they dare not make judgments if they haven’t done some analysis.
Brother Jian had a distant relative who had a CT scan at a secondary hospital in the northeast, and he was suspected of having stomach cancer. Brother Jian’s relatives sent the CT images to Guangzhou, and asked them to help them to the cancer hospital in Guangzhou, but they didn’t do pathology. The doctor gave no advice.
Jian’s relatives have done pathology through gastroscopy biopsy and sent them to relatives in Guangzhou, but this time the doctor said that we can’t trust the pathology done by a secondary hospital in a municipal district, and once again refused to give judgment and diagnosis. Program.
Hospitals with names and surnames will recognize each other and cherish each other. Some doctors may even know each other, or even classmates at all, but most large hospitals will not trust the pathology of lower-level hospitals—the risk is too high. Taller.
A well-done pathology report should include the location and size of the primary tumor, the location and size of the metastasis, the pathological stage, and the degree of tumor differentiation. Some hospitals will also attach preliminary immunohistochemical results.
Project
The first thing to determine is “where to look”.
A friend of Brother Jian, who works as a chief physician in a cancer hospital in Beijing, would ask this sentence first after viewing the imaging data and credible pathology reports.
“If he decides to watch in Beijing and leave himself to me, he will have to undergo further examinations with us, and possibly be hospitalized.”
“If he just wants me to give some advice for reference to the doctor in his hometown, then I might give him a more cautious advice.”
Most of the doctors in cancer hospitals can understand the feelings of patients and family members of “seeing more doctors” and “shop around”. After all, tumors are still the ultimate killer of human beings, but they fluctuate between several hospitals. It is a taboo of medical treatment.
Doctors often put several different options in front of patients or their families for their families to choose.
What the doctor has to deal with is the tumor, and the life, after all, is the patient’s own.
Of course, if a patient decides to give his treatment to a doctor, he may unlock more suggestions. After he is hospitalized in his department and becomes his patient, he will also have more suggestions to give patient.
But if the patient only has a one-hundred-dollar expert account, and everyone does not understand each other, ask the doctor to talk about risks, and the doctor will be very worried.
is also a “boyfriend”. Lovers who have experienced life and death together must talk about different topics with their newly established blind date. The same goes for doctors. Let the person you meet first decide the life-critical issue for you.
In the interaction between doctors and patients, “trust” is the most important thing. If you are unwilling to make the decision to give yourself to a certain doctor, the other party will not dig your heart out, or even give some risky advice .
For most patients, the quality of the doctor is the title and reputation, as well as the reputation of the hospital where he works. This is actually wrong.
Be able to combine the current evidence-based medical evidence of this condition to customize a personalized treatment plan for the patient, then this is a reliable doctor.
Most of the time, patients waver on their own. After starting the treatment, if the treatment is not effective, they wonder if the doctor is not good enough or is “not worried”.
In fact, it is the doctor who most hopes that the patient will live longer. In some extreme cases, the family would rather give up treatment because of financial pressure. The doctor is the one who has worked hard until the end.
Do what you can
“Governing in Beijing or at home” is not a suggestion that Brother Jian can give. The suggestion given by Brother Jian is that you have to hold a family meeting.
The patient’s spouse, children, and relatives who love to stab children, it is best to participate, and we will chat together.
Because it involves money.
The common people have the common people’s governance, and the big boss has the big boss’s governance. Specific to each patient, whether there is only medical insurance, new rural cooperative medical insurance, or commercial insurance, or even public medical care, the treatment plan may be different.
“Sherlock on the Plains” stills, in many cases, the competition for treatment is actually how much conceited part you can take out.
For the procedures and reimbursement ratio of remote medical treatment, it is best to consult your home medical insurance institution in advance.
Brother Jian has a doctor friend who is in charge of the special needs ward of the hospital where he is located. All expenses in this ward are borne by himself and cannot be reimbursed by medical insurance.
Patients often ask him how much the special needs ward is more expensive per day than the ordinary ward. This friend’s answer is “People who can live in the special needs ward usually don’t ask this question.”
The hospitalization fee is not all. We must remind the family that there are many issues to consider.
Who will be responsible for post-operative care? (Employing a caregiver/hands at home)
Do you need radiotherapy and chemotherapy after surgery? (Adding radiotherapy and chemotherapy is more reassuring, but it may burden the patient’s body)
Can you take targeted drugs? (This may have a huge co-payment part)
At the end stage, there are practical problems such as alleviating cancer pain and rescue strategies. Is it to let the relatives die peacefully and suffer less, or to extend his survival period, live an extra day to earn a day, and consider the feelings of family members , May also pay attention to the wishes of patients.
With the advancement of science and technology, some tumors may become a lengthy tug of war.
Jiange knows of a young patient who was diagnosed with neurofibromas at the age of 14. This is a genetic disease that cannot be completely cured under current medical conditions.
The parents definitely hope that their children can survive, so they do their best. He comes to the Beijing hospital for follow-up visits every six months, and has undergone multiple surgeries for more than ten years.tumor.
This kind of physical condition makes him unable to work and earn money after he is an adult. However, for inter-provincial treatment, although medical insurance can be partially reimbursed, this young man has long been unable to support him without the wealth of his parents. .
Similarly, when his parents are old, he will be able to cope with such medical expenses when he is in his 40s or 50s. It is also worrying.
Although it is realistic, living in reality requires practical consideration.
Follow the rules
There is a movie on the National Day file called “My Hometown and Me”.
Beijing Zhang, played by Ge You, asked his uncle to shave his head and take his medical insurance card to see a doctor. Finally, he was found by the doctor and was very embarrassed.
In “My Hometown and Me”, Ge You asked his cousin to shave his head and hold his medical insurance card to see a doctor.
Never have such a cleverness. Things that are done beyond the rules will be discovered sooner or later.
In 2019, Beijing once investigated and dealt with a number of cases of fraud using medical insurance cards. A small hospital surreptitiously refunded self-paid patients, and then used medical insurance funds to fill the gaps.
There are a group of insured people who rent their cards to traffickers and criminals in order to be greedy for petty gains. As a result, more than 110 people have been suspended for medical insurance settlement.
Using someone else’s medical insurance card, or renting out your own medical insurance card, may make your own medical insurance card completely unusable, and in serious cases may also cause crime.
Go through various referral procedures in a proper manner. If there are really difficulties, there are actually solutionsa lot of.
Seek help from various fundraising platforms (Remember to find legal ones), apply for local government’s difficult subsidies, and apply for trials of certain pharmaceutical companies It is possible to use drugs for sex or for difficult patients.
In addition, if the elderly in the family has a serious illness, the children can also apply for tax deductions at the tax authority. This is also another form of payment.
By the way, don’t believe in all kinds of witch doctors, folk remedies, health care products, those:
It’s all a pit!
I believe in big hospitals and doctors. Give more care to patients, make them happy and do things they like to do. The life span of cancer patients is certainly important, but more importantly, the quality of life during survival.
Wish, the whole family is healthy!
Special thanks:
Chief physician Yuan Peng, Cancer Hospital, Chinese Academy of Medical Sciences
Qiqihar Jianhua Hospital Doctor Lou He
This article is from WeChat official account:Eight Point Jianwen Plus (ID: jianwennews), author: bear Taihang, Liu