According to the oncologist of Peking University Third Hospital and Zhihu user

Described that a patient with liver metastasis from gastric cancer was “deliberately tricked into treatment” by a general surgeon in that hospital during treatment at a tertiary grade-A hospital in Shanghai, which led to “the patient’s survival period was significantly shortened, and his family spent more than 10 times the conventional treatment.”

It is not the first time that Doctor Zhang has questioned the doctor on an open platform. On October 18, 2020, Dr. Zhang attached a handwritten chemotherapy plan of the doctor to another post on Zhihu, and refuted the plan in detail.

On April 18, he once again posted two posts in a row, exposing medical problems.

Doctors from the Third Hospital of Beijing Medical University expose the shady of tumor treatment: patients are deprived of money and money, mostly because of doctors’ reckless actions_Zhang Yu

The National Health Commission immediately carried out the investigation and disposal of online information related to cancer treatment. After paying attention to the relevant online information of “Oncologists of the Third Hospital of Beijing Medical University reported the shady tumor treatment”, our committee attached great importance to it and immediately organized an investigation of the relevant situation and the problems reflected. Verify. Once relevant issues are verified, they will be dealt with strictly according to laws and regulations, and will never be tolerated. The relevant situation will be announced to the public in a timely manner. In the next step, our committee will continue to promote cancer diagnosis and treatment management, further improve the management system and standardization system, increase supervision and guidance, ensure that relevant requirements are in place, and strive to improve the standardization of cancer diagnosis and treatment, and safeguard the health rights of the people. Source: National Health Commission official website


By zhiwo

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6 months ago

On April 18, the Zhihu user “Dr. Yu Zhang”, who claimed to be an oncologist at Peking University Third Hospital, posted an article on the platform to expose “tumor treatment shady”. The informant soon became “unable to bear the pressure and possible consequences.” Delete posts by yourself. The National Health Commission has stated that it will investigate and verify the relevant situation and the reported problems. Once the relevant problems are verified, they will be dealt with strictly in accordance with laws and regulations and will not be tolerated. The facts are being investigated, but at present the masses are also concerned about what mysterious force forced the whistleblower to delete posts? Why is the voice of overseeing medical fairness suppressed and restrained? Can the vested interest groups behind the chaos be broken? How can the guardians of fairness and justice dare to speak up in the future? The existence of “tumor treatment shady” hides the answer to the question and makes everyone feel insecure. We should decisively break the shady scenes and cut off the black hands that affect medical fairness. The doctor put on a white coat and accepted the sacred mission of saving the dead and helping the wounded and promoting great love. However, it is undeniable that in reality, some medical institutions and a few doctors are driven by interests to alienate the doctor-patient relationship that could be entrusted to life into a consumer relationship. The medical industry is highly professional, ordinary people lack medical knowledge, and the information between doctors and patients is not equal, and it is difficult to identify and protect rights in the later stage. Therefore, in safeguarding medical fairness, society needs “supervisors” who are brave to speak up, and the public needs “people of conscience” who dare to speak the truth and daring to break the shady scene. Relevant departments need to find out who is forcing “Dr. Zhang Yu” to delete posts, follow the path to uncover the “medical black hand”, and eliminate the “medical shady” that hinders fairness. It is necessary to rely on strong supervision and institutional “cages” to return medical and health care to purity, so that patients are no longer regarded as cash cows, and medical skills return to benevolence.

6 months ago

Because of the Sashengwan thing, I think he is dripping too much muddy water, and it is dark near the ink. My personal impression of him is actually not very good. I am a non-clinical person. I am a layman in biology. I am a real layman, but I still understand the basics. I can’t avoid contact with pharmacies. Just talk about this, he is right. When I think of the cases running in my demo at this moment, how many of them have been arbitrarily entrapped by some doctors in this way? I trembled all over and couldn’t help but want to say a few words. Having dinner with a teacher the day before yesterday, he mentioned a case of gastric cancer during the day. A 59-year-old man who had been diagnosed with surgery was in line. He insisted on apatinib, but finally found that the effect was really not optimistic. He brought the information to the teacher and took a look. In the previous images, I was so angry that I asked why I need second-line drugs instead of direct surgery! Generally speaking, surgery is the first choice for ca. Conventional radiotherapy and chemotherapy should not be considered for surgery, followed by immunotherapy and targeted drugs. Targeted drugs are generally used as second-line drugs. The second-line here is not to say that he is not better than conventional chemotherapy, but to be a retreat Once the chemotherapy effect is not good, you still have to choose. The patient has not invaded the blood vessel, and the position is good. Isn’t it better to cut the stomach in half? The teacher’s most irritating thing is not to drag people like this, but to treat his father, the son sold the car and mortgaged the mortgage. That’s it, the guy still stretched out his hand. And this is quite logical, in many cases, the medicine is wrong. If it is a cancer treatment, it will be used. I wonder if these hospitals have been chaotically entered by the Putian Department. I have also seen Da Vinci on the appendix, but people know that the patient’s family is rich in capital, and that the little money from Da Vinci can help them save scars and save troubles. But for cancer patients, who doesn’t trust you with fate and wealth? I am not a clinical person, and I am not qualified to comment on the doctor’s plan. So I can only say that I have personally contacted some of the nearly 3k pieces of data that have been counted, of which less than 800 valid data, and most of them are invalid because the treatment plan and the guideline are too far apart, at least there are With as many as 1,200 copies, humanity will appear more direct in the face of cold numbers. Too many doctors who have deviated from the guidelines, their data is not a little bit of hips, and even the threshold of our questionnaire is not up to that kind, and among them, there are provincial tumor hospitals and medical university affiliated hospitals… . I have met, visited, and communicated with excellent doctors and technicians in oncology, radiology, and nuclear medicine. Anyone with a little bit is chasing the updated guidelines and classifications of various CA societies and institutions, and several operations I always check the grading guide for flexible choices during the operation. Occasionally, people who don’t pursue it are not essentially people who don’t pursue it, but they are the people who can give these societies and institutions the most complete data. These people have their own characteristics. : Either you are a newcomer who is just working and still has a heart of justice, or you are a leader who maintains the balance of justice. I remembered what a patient’s family said to me a few days ago: Little brother, I don’t know how to choose. Our family only has this little money, and I also understand this little medical knowledge. From the county to the city. When I went to the province and then went to Beijing and Shanghai, I saw a total of six hospitals, and the consultation cost more than 30,000. The same examination results showed that the six hospitals had different plans in five directions. Tell me, I How to choose? They know that these things are “medical lords” that can rely on authority to exercise authority, so…when authority loses checks and balances, it is no longer authority, but power, and power is absolute. And do you have to rely on the doctor’s lofty respect to maintain your character? The white tower… is collapsing all the time. And no matter how he collapses, there are always some people who will withstand the pressure of all sorts of strange things to right him. For us, as long as we don’t talk cold words, it is enough, otherwise the wind will be strong, and the first person to hit the tower will be yourself. Tribute to Lao Zhang!

6 months ago

As long as medical care is still a business, such things will continue. Our current “semi-market” medical model is a hotbed of conflict between doctors and patients. It is necessary to choose between full marketization or full welfare. Thanks to Dr. Zhang Yu, Dr. Zhang Yu for his righteous remarks. You have shown me the hope of China’s medical system. I believe that most doctors, like Dr. Zhang, joined the medical industry with a sense of support for the world, but there are also quite a few people who become doctors out of financial interests. Especially in small and medium-sized cities below the second-tier, studying medicine is the best way for locals to return to their hometowns for employment. They have stable jobs, high incomes (relative to the local level), and opportunities to expand their contacts (doctors, teachers, and traffic police are everyone Just need a place to walk where you want to get acquainted). Therefore, for the medical industry, it is absolutely impossible to just talk about feelings. It is necessary to break up the relationship of interests and clarify them. Our medical system presents a distorted “semi-market” pattern. On the one hand, universal medical insurance and public hospitals and public hospitals have obvious welfare colors. On the other hand, in terms of patient medical treatment and hospital operation, It is almost completely market-oriented. This “semi-market-oriented” pattern combines the disadvantages of doctors seeking profit and over-medicating in the market-oriented medical model, and the disadvantages of rigid staff management in the welfare-based medical model and insufficient income from normal channels for doctors. In addition, it also caused everyone to squeeze into large hospitals with medical insurance. As a result, the top three hospitals squeezed their heads, and the grassroots medical centers were unstoppable. This was a huge waste of resources. As a result, patients are dissatisfied, and doctors are dissatisfied. So a weird scene occurred: In the doctor-patient relationship, both the doctor and the patient declare that they are a disadvantaged group, but the strong and the weak are always opposite. In a pair of relationships, how can both be the weak? In fact, the weakness of patients is a weakness relative to market rules. Measured by market rules, hospitals are simply not too scary. The information is severely asymmetry, and because the demand for health is extremely rigid (there is nothing if the person is gone), the patient has almost no bargaining power, how can it not be slaughtered? The weakness of doctors is relative to the weakness of the welfare management system. The salary level of doctors and the promotion of professional titles are all under the unified administrative control, and due to the nature of the hospital’s own welfare, doctors cannot reject and screen patients. If we insist on making a metaphor, our current medical model is like a public canteen with price subsidies. The diners (patients) feel that this is a public canteen and is for welfare purposes. How can you always calculate my money? . The masters (doctors) in the canteen are all tied into the system, and the salary is clearly arranged. To increase income, you can only improve business performance, buy vegetables more expensive, and keep costs down. So the diners were dissatisfied, “This is a public cafeteria…” How can we solve it? There are two ways of thinking. One is to turn public canteens into private clubs, like the United States, which is completely market-oriented. In many hospitals in the United States, you can’t get in without the medical insurance provided by the insurance company. A proper membership system. Since you are spending money on services, you know how much you have spent and what services you will buy. Moreover, once medical care is troubled, it may be difficult to buy medical insurance in the future. Who dares to make trouble? The other is full welfare, with price subsidies changing to planned distribution. Further improve the universal medical insurance, implement a strict referral system, referrals from the bottom to the top for medical treatment, abolish the free flow of medical treatment, and de-market hospitals in an all-round way. In this way, patients no longer have to worry about being scammed, but the doctor may not be satisfied. After all, the income may be on par with the military and public education.

6 months ago

Thank you very much for Dr. Zhang Yu’s reply. The hospital had common sense errors in the pemetrexed chemotherapy regimen prescribed by my father for lung squamous cell carcinoma. The doctor has revised the plan and switched to the K drug combined with gemcitabine. This time I was exposed in Moments and Zhihu, and I got the help and support of many people. Thank you very much. I will hide the name of the specific hospital. This may be an isolated incident, and I hope it is an isolated incident. If it weren’t for Dr. Zhang’s article, my dad would have died of this medical accident. At 9 am on April 18th, the doctor made a round of the ward. He decided to use pemetrexed as a chemotherapy regimen and started taking folic acid. It was planned for April. Chemotherapy started on the 21st. On the evening of April 19, I saw Dr. Zhang’s article and searched Zhihu for the pemetrexed solution and found that it only applies to non-small cell non-squamous cell carcinoma. I wrote this answer overnight and sent a private letter to Dr. Zhang Yu, and got the wrong answer to the treatment plan. So I consulted a friend who studied medicine, and the friend affirmed Dr. Zhang Yu’s answer. At 11:15 am on April 20th, I called my father’s doctor in charge and told her of my question. I got a shocking answer. She actually thought my father had adenocarcinoma! ! ! Since March, we have done genetic testing and pathological examinations, and every report clearly stated poorly differentiated squamous cell carcinoma. It’s shocking that the hospital is so sloppy! If it weren’t for me to read this article, with our unreserved trust in the hospital, tomorrow we would personally send my father to a dead end. I hope this article can get attention and remind the majority of cancer patients and their families. For cancer patients, every choice is crucial, and we don’t have any trial and error costs. At the same time, I asked my friends who studied medicine to help consult professional doctors.

6 months ago

The biggest difference between county hospitals and provincial hospitals in cancer treatment is that provincial hospitals can use treatment plans that do not even conflict with the guidelines. The doctors in the provincial hospital have enough authority to persuade the patient’s family. In fact, it is difficult for family members to understand how well the tumor is treated. The authority of the doctor is very effective in the overall evaluation of the patient. In fact, many of their doctors are “speeding” and may lose the lawsuit. Dr. Zhang Yu has improved the level of awareness of the guidelines among the public, which is conducive to improving the level of homogenization of medical services in hospitals at all levels. His contribution is conducive to allowing patients’ families to spend less money and running less, and promotes hierarchical diagnosis and treatment. Now my country does have problems such as the abuse of targeted therapy. Many patients use targeted drugs as soon as they are diagnosed. Targeted drugs are second-line drugs. The medication should be “first-line first and then second-line”. It is determined that classic drugs are invalid before using new drugs. The median time of resistance of targeted drugs has not been for two years. Once the drug is resistant, there is no cure for the patient. What should I do? In the end, it is certain that people and money are empty. To be a doctor is to avoid the lack of wealth in the patient’s family, and to recommend less or not to the schemes that put the patient’s family into painful family ethical choices, which is conducive to social harmony and harmony in practice. Reporter: Last year, many doctors were hacked across the country. What do you think of the current tension between doctors and patients? Chen Zhu: If the masses spend a lot of money to see a serious illness, but because of medical uncertainty and can’t cure it, in the end, people and money will be empty, and their hearts will definitely be unbalanced. We must reform the shortcomings of taking medicine to replenish medical treatment. If a hospital’s survival and doctor’s income depend on making money from the most disadvantaged group, can the doctor-patient relationship be good? Vested interest groups have now formed around these expensive therapies, and every day some cases of misery that everyone cannot refuse to promote these therapies into medical insurance. Fortunately, we Chinese don’t eat this set. We will purchase medical insurance first and make a serious discount at the world’s lowest price. However, Chinese people talk about “filial piety”, and when there are serious patients in the family, they still tend to deviate from the family’s economic foundation and choose some expensive treatments with low cost performance or low marginal utility. Thank you Dr. Yu Zhang for giving everyone a reason to refuse excessive medical treatment. Life is not easy, there are young and old, and there are too many places to spend money.

6 months ago

Prescription rights must be implemented under the sun, and must be supervised by knowledgeable professionals! Answer During his PhD study, the master has had many internship experiences in top hospitals in the United States (ranked in the top five). Here I would like to introduce you to the United States’ regulatory practice of doctors’ prescription rights. I believe that it will have a certain enlightenment for solving similar problems in China in the future. In the United States, every prescription issued by a doctor must be reviewed by a clinical pharmacist before the medicine can be delivered to the patient. Among them, the content of the clinical pharmacist’s review includes but is not limited to: Is there any repeated medication in this prescription? Is the choice of drugs reasonable? Is the dose selection reasonable? Is there a more economical choice in drug selection? Is there an interaction between the drugs? Is the patient a special population (hepatic and renal insufficiency, pregnant and lactating patients)? Does the patient have contraindications that the drug cannot be used? And so on a series of questions about the rationality of drug use. If we find a problem with the doctor’s prescription during the prescription review process, the clinical pharmacist will intercept the prescription and call the doctor directly to communicate and inquire to solve the problem in the prescription in a timely manner. If there is a huge safety hazard in the prescription (for example, the patient has drug-related contraindications) and cannot be resolved through communication, the clinical pharmacist will refuse to pass the prescription, and the prescription cannot proceed to the next step of distributing medicine. If related problems continue to appear, they will even respond upward to the hospital management for communication. Of course, in foreign countries, if there is a problem with a prescription, it is not only the doctor who is involved in the lawsuit. If the problem is not found in the prescription review process, and the clinical pharmacist fails to detect and communicate with the doctor in time, the pharmacist is also mainly responsible. The good thing about this working model is that, on the one hand, it helps doctors get the bottom line: Everyone knows that doctors are usually very busy in clinical work, and occasional work errors are inevitable when writing prescriptions: the dosage is written in the wrong unit, and the patient’s situation is wrong. Wrong choice of oral or intravenous injection, etc. But everyone knows that such small mistakes are often fatal to patients! At this time, I believe that most doctors also hope that someone who is knowledgeable will help to see if there are any omissions in their work, so as to avoid lawsuits in the future. Prescription review is actually a combination of two different but similar professions, clinical pharmacists and doctors, who are jointly responsible for the life safety of patients, and together help improve the safety and rationality of medication. On the other hand, for patients, because they do not understand relevant medical knowledge at all, they need the help of a knowledgeable person to see if the doctor’s prescription is reasonable or unreasonable, reliable and unreliable, and there is no relevant interest at this time. Relationship, clinical pharmacists who do not have peer pressure to report to each other are actually the best choice. In the United States, clinical pharmacists are not only responsible for reviewing prescriptions, but also for patient drug education in the clinic, helping patients understand and understand the doctor’s treatment plan, and clarify the basis and reason behind each drug prescription. Make the diagnosis and treatment process more transparent and open. I believe this is a good thing for both doctors and patients. So in the United States, one of the most trusted professions by the public is pharmacist. Regarding the random prescribing of oncology drugs, think about the fact that before the patient takes the medicine, if there are more medical staff from different departments and different professions to look at the prescription, and to discuss and discuss the prescription from different angles, it will be Does this result? Therefore, no matter what power it is, even medical-related prescription rights that are difficult for the public to understand must be supervised and restricted by relevant professionals under the sun, otherwise there will be no insecticide restrictions in places where the sun and ultraviolet rays are not exposed. Locally, the growth of bacteria and borers is inevitable!

6 months ago

Except for Dr. Zhang’s own future, there is actually not much that can be changed. Oncology is not the only one doing this kind of thing, nor is it the best one. This is a personal issue. I know that a long time ago there was a question, why not test human nature. This is actually the same. Recovering a doctor with medicine is a Pandora’s box. It is difficult to close it at the beginning, and it will always be more extraordinary on the basis of extraordinary. You are a medical student, and the whole department is like this when you enter the department. What can you do? I also saw a second-line clinical idiot who helped a certain pharmaceutical company publicize it for free on the WeChat group, thinking that he was doing good deeds. That was really brainwashed. The energy of some pharmaceutical factories and device factories is much greater than what the clinical front-liners imagined on Zhihu, and journals, selections, etc. have their shadows. There are always people who say that scholars, medical sects, these big men and even sects, what are their motives? Where are the benefits?

6 months ago

What I am concerned about is that this matter has caused such a big trouble, why did I not see any empirical data about the patient’s tumor conditions, such as pathological results, gene sequencing results, fee invoices, etc., after all, the parties and the patients’ family members are all aware of it. What…
Otherwise, what’s the point of discussing with the air…
In addition, I feel that Dr. Killing is about to make a comeback…

6 months ago

Things are more sensitive and can only be anonymous. I work in the Medical Administration Department of the Municipal Health Commission of a certain city on the east coast. (Mainly responsible for the management of hospital business, so we are basically responsible for complaints about medical disputes) 1. I want to talk about this from the perspective of the administrative department. In our work, most of the complaints we contact are vulnerable patients, but the administrative department does not have much power, and there is no set of operating mechanisms to punish and handle medical disputes, and they can only coordinate and coordinate. 2. Doctors really lack supervision, especially those with vested interests, mainly directors and experts of major hospitals, because the power to use drugs is basically in them. 3. It is hoped that third-party supervision can be introduced, instead of relying on peer supervision by doctors, it is easy to form a community of interests. Or the state has given the administrative department the power to punish irregular diagnosis and treatment. (The current situation is that we can’t punish it)

6 months ago

My attitude towards this type of news is quite contradictory. On the one hand, I hope that all violations of law and professional ethics can be exposed to the sun and make society more fair. On the other hand, I also know that the public is irrational. This exposure behavior will definitely be exaggerated and understood. It will be expanded to criticize the entire medical industry, and it is very likely to deteriorate the entire medical environment. As far as my personal limited contact is concerned, most doctors (of public hospitals) are still good, with professional ethics and professionalism. The world is safe and secure, paying off the good doctors and punishing the evil doctors!

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