Reporter: The question about pathology is so complicated. Does an ordinary person who sees a doctor in a small hospital have the right to ask for his pathological report or slice to be sent to a big hospital?
Zhou: It should be said that it is allowed. The problem is that many ordinary people don't know now The media pays too much attention to the clinic and too little attention to it. A lot of publicity is needed to make everyone really aware of this and let patients find ways to learn to protect themselves. Now many patients doubt themselves, and then come here with pathological sections, and it turns out that it is really wrong. There are still many patients who come to consult directly with pathological reports and want to know how to treat them from a pathological point of view. In the past, it was impossible for patients to get pathological reports. Now the national laws allow patients to have the right to get pathological reports. If he doesn't understand the contents, he will consult a pathologist. What I'm accepting now is an acquaintance asking me what I know. In fact, pathologists should also go from behind the scenes to the stage, directly face patients, set up pathological clinics, and hang the pathologist's number. A large hospital in our city has set a precedent, and we are also going to set up such an expert clinic to provide more and better services for the majority of patients.
Reporter: After the first two interviews were published, there was a great response. Readers said that seeing a real disease diagnosis process is very helpful to communicate the doctor-patient relationship. We seldom heard the voice of pathologists before, and everyone thought you were honest.
Zhou: Pathology is very practical. This profession requires pathologists to tell the truth. In order to comfort patients, clinicians can't tell the truth to patients, pathologists can't, and pathologists are not allowed by law to make false reports, otherwise they will bear legal responsibility and make compensation. Therefore, the pathologist says one thing, two things, and even if it is difficult for the other party to accept it, the pathologist can't tell lies. This is also a reason why pathologists do not directly deal with patients, and it is actually a kind of medical protection for patients. Pathologists tend to keep a low profile. There used to be a joke widely circulated among pathologists: during the Cultural Revolution, the son of an old pathologist saw that all kinds of powerful people in society could open all kinds of "back doors" and then asked his father, "Why don't you see any back doors for this director?" The old director replied, "I can do an autopsy in advance if anyone dies." Although this is a joke, it also shows that it is difficult for pathologists to abuse power for personal gain.
Reporter: Will other hospitals and smaller hospitals send you pathological sections for consultation?
Zhou: Yes, there are many now. In the past, more than 200 cases were consulted every year, and now nearly 3000 cases are consulted outside the hospital. Here I want to say a misunderstanding, that is, the hierarchical management of hospitals. Everyone wants to be a secondary hospital, a tertiary hospital, and all hospitals have established pathology departments, so hospitals that do not have the conditions to set up pathology departments have also set up pathology departments. In some hospitals, there is only one pathologist in the pathology department, or even only one person in the general department, who is both a doctor and a technician, which is very, very dangerous. Not to mention his level, he made the decision alone, and his mistake was 100% on the patient. There is a group of people in the science of serious illness, and everyone has a discussion. Generally speaking, it is impossible for everyone to make mistakes at the same time, so the probability of making mistakes in big hospitals is of course low. Also, young pathologists in general hospitals often have to work with senior doctors for five years before they are qualified to issue pathological reports independently, while pathologists in some small hospitals let him take the lead and issue pathological reports as soon as they get there. His training and knowledge are unmatched by big hospitals. Large hospitals can see 10000 cases a year, while small hospitals only have hundreds of cases a year. You still call him. So I suggest that small hospitals should not pursue small and comprehensive. Small hospitals can carry out surgical operations, but it is not necessary to establish a pathology department. Specimens can be sent to large hospitals and pathological centers, which is a very popular practice abroad.
In addition, I want to remind patients through the media that some hospitals do not attach importance to pathological specimens and throw them away without a pathology department. Patients have never thought of asking clinicians for pathological diagnosis reports, which is wrong. According to medical standards, all tissues in vitro must undergo pathological examination. You said it wasn't cancer. How can we know without pathological examination? You said it was cancer, but did you finally get a pathological diagnosis? Therefore, patients must ask clinicians, which is not only a basis for future review, but also an important basis for litigation. Processed specimens, especially paraffin-embedded tissue blocks and pathological sections, can be preserved for a long time. The pathological report is also a part of the medical record, which is equally important.