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Chapter 190: Major district manager and country bumpkin doctor

Translator: imperfectluck Editor: Kurisu

Ever since some unknown time, many more teahouses started popping up in Chasu City. They would have extravagant decorations, and were considered high-class. Of course, this meant that they were fairly expensive. Even one kettle of their cheapest tea would cost 80 yuan. Supposedly, such tea leaves were gathered from the cliffs, and were limited in quantity. The female tea servers were also highly skilled at making small talk with the customers. They would also show off their skills in music and dance while trying to sell the teahouse’s confectioneries to the customers!

Most doctors who were even slightly skilled and had worked for several years already would all have the problem of not liking restaurant food, no matter if the restaurant was large or small. That was because the doctors had seen far too many illnesses brought about as a result of eating dirty food in China. It was common for urologists not to eat kidneys, hepatobiliary surgeons not to drink alcohol, and pulmonologists not to smoke!

The female tea server finished making their tea and left the private room. Professor Li then sipped on his tea as he said, “20 years ago, I was among the first group of doctors from the border province who received the opportunity to go study medicine in Japan. The first group was also the last group to receive this opportunity. At the time, Japan’s medical field influenced me tremendously. Japan’s medical environment and medical skills all seemed to be so advanced and high-tech.”

Zhang Fan silently sipped on his tea as he listened to Professor Li reminiscing about the past. This was a topic that Zhang Fan hadn’t expected to hear.

“Can you imagine what I felt the first time that I entered a Japanese hospital’s operating room and saw that the operating bed was fully automatic? I felt bitter, sweet, and sour all mixed together, and I wasn’t able to say it out loud! Japan’s medicine focuses on being systematic. They’ve truly learned the best from Chinese philosophy. A Japanese doctor will be in charge of eight patients at the very most. The doctor will also personally be in charge of all checkups and treatments for their patients from start to finish. As for us Chinese? Today we learn from Russia’s style, and tomorrow we try to learn from America’s style. Although we’re also making progress, when compared to the Japanese, we’ve lost sight of ourselves. It’s the same for our doctors and patients. It’s as if we’re all mechanized parts of a production line. There’s nothing special or anything unique at all!” Professor Li then looked directly at Zhang Fan.

“Maybe it’s because China’s population is too large?” Zhang Fan suggested.

“No! It’s a problem of ideas and way of thinking. Last month, I went to go study in Beijing, and heard that the government is changing the national medical system yet again. This time, it will majorly affect all hospital and doctors, especially the younger doctors.”

“What, are they going to make young doctors go back to school?” Zhang Fan asked out of curiosity. He had no interest in Japanese medicine, since he felt that Japan was too far away!

“Apparently, the government is going to require that doctors have several years of professional training before they can truly enter a clinical environment,” Professor Li claimed.

“The average age for graduating from medical school is 24 years old. Add on three or four years of professional training, and a doctor will almost be 30 years old by then! Such a long path!”

“It’s something that’s going to happen. One of my coworkers from back in the day went back to Japan to get a doctorate degree there. I’m still in contact with him. Did you know? Even normal Japanese hospitals will have their own research projects. But what about our hospitals in China? Just how many hospitals truly even do medical research?”

“Oh! I don’t know,” Zhang Fan answered.

“China invests plenty of money in our hospitals. However, actual research results of our own will only appear once every few years or less. Most of our research is simply repeating foreign countries’ already proven research results. Why is this? First, research isn’t easy. Second, our medical environment is quite limiting. Colleges and hospitals have mostly been completely separated. Tell me, does your hospital have any research projects?”

“I don’t know. It probably does.”

“Ridiculous! I can guarantee that Chasu City Hospital doesn’t have any ongoing research projects. Or, even if there is a research project, it’s only a copy of someone else’s already researched technology or technique, and the hospital is just using it to diddle the higher-ups for some research funding. Even if Chasu City CPC is sometimes willing to give Chasu City Hospital funding to construct new buildings, they would never give any funding to the hospital for research. As for you? You’re so young and talented. You’re still filled with energy and ideas at your age. If you go to a super large, top-level hospital, the internal dissension there will make it difficult for you to concentrate on your work. Smaller city hospitals won’t support any unique ideas of your own. For instance, your ideas about reconstructing the portal vein will only remain as ideas unless you have an animal experimentation laboratory. Right now, you still have innovative ideas and the energy to act on them, but several years later, due to the influence of your environment, all you’ll be at most is Director Zhang of the surgical department at a medium-sized hospital like Chasu City Hospital! This is no exaggeration.” Professor Li then sipped slowly on his tea as he observed Zhang Fan’s reaction.

‘Is this youngster the type who always conceals his feelings? I’ve said so much already, but he isn’t reacting at all.’ Professor Li was a bit confused on why Zhang Fan didn’t seem to react whatsoever.

“Oh, is internal discord really bad at the super large hospitals?” Zhang Fan was the only one who knew that he had the Medical System. He definitely didn’t want to waste it. The medical field was something so all-encompassing. Since he had received such a chance from the heavens, he definitely wouldn’t allow himself to remain a low-ranking doctor forever.

‘Is that what’s most important here!?’ Professor Li commented in his mind. However, he still answered, “At the largest hospitals, there’s a lot of clashing between different ways of thinking. Maybe you don’t know, but the conflict between different ideologies can be quite cruel. You’re still so young. There’s no need for you to get involved in such things too early. Actually, a provincial level hospital like Dee University Affiliated Hospital would be the most suitable for you. Just look at me. I’m currently a medical professor at Dee University, as well as the general surgery director of DUA Hospital. If you come to DUA Hospital, you’ll have free use of experimental laboratories and research funding!” Professor Li was now beginning to exaggerate while trying to recruit Zhang Fan. Although it would be simple enough to let Zhang Fan use an experimental laboratory, claiming that research funding was ample was just a big scam!

“Oh! Professor Li, I haven’t thought about such things quite yet. Thank you for the offer!” Zhang Fan awkwardly refused in a polite manner.

“Sigh! I just can’t figure out what could possibly make you remain working here!” What Professor Li didn’t know was that Zhang Fan had already monopolized all of the surgeries in the smaller cities under Chasu City’s jurisdiction. Zhang Fan was thus able to practice many different surgeries of all different types. If Zhang Fan went to the provincial hospital, he would likely be limited to a specific department’s type of surgeries only, and would lose this opportunity to grind all surgery types at once.

“Haha!” Zhang Fan was unable to explain this, so he could only laugh.

“How about this? As for that portal vein reconstruction theory of yours, I’ll start a research project on the topic, and you can take some time to come to Dee University to come experiment on animals first. Once you have the experimental data to prove your theory, maybe your theory can be put into actual use for clinical medicine. If you succeed, it’s possible that the liver tumor surgery textbooks will have a technique with your name on it in the future!” Professor Li decided to try for the next best option when he was unable to recruit Zhang Fan. Professor Li was the type who always wanted to further improve. That would be impossible at his current level without a high-level research project.

“Is that really alright?” Zhang Fan asked after a moment of consideration.

“Of course it’s alright. Just wait for my good news. I’ll go set up the research project for you.”

Their conversation ended there. Professor Li didn’t have the time to attend any banquets hosted by the medical equipment supplier merchants afterwards. He flew back to Raptor City together with his two doctorate degree students, along with a youngster from the medical equipment supplier merchant. Basically, the youngster was in charge of seeing to Professor Li’s needs; it was a way for the merchant to keep a good relationship with Professor Li.

Zhang Fan now truly became famous in the local area after this liver tumor surgery observation academic conference. Before, he’d only had some fame in the smaller city hospitals around Chasu City, but now he was gaining fame also in Chasu City’s other hospitals.

In the past, he had to sneak around when working at other hospitals, but now he had the superintendent’s official permission to work there. Chasu City’s other hospitals were now preparing to invite Zhang Fan to work on surgeries as well. In Chasu City, there were only two Class A hospitals, Chasu City Hospital and Chasu City Chinese Medicine Hospital. However, there were countless patients, so many patients would also choose to go to slightly smaller hospitals in Chasu City. When those smaller hospitals met with difficult surgeries, they would typically invite an expert doctor from Raptor City to come perform the surgery.

But now, it was likely that they would first ask Zhang Fan for the more difficult general surgeries. Zhang Fan was young and gaining fame. He also had no conflicts with the doctors of these hospitals, and charged some of the cheapest prices around for his services. Besides, there would always be a difference in price between a local expert doctor and an expert doctor who was renowned in the entire province. Expert doctors from provincial hospitals would simply come work for some money and instantly leave afterwards. It wouldn’t really be possible to establish long-lasting friendly relationships with them. Things would be different instead if the invited doctor was from the same city. Thus, Zhang Fan’s market for working at other hospitals to perform surgery was expanding greatly due to this academic conference.

However, Chasu City Hospital’s main competitor, Chasu City Chinese Medicine Hospital, would still be inviting Raptor City’s doctors no matter what. They would never invite Zhang Fan. This was because their superintendent would feel like he would lose too much face if he had to invite a doctor from Chasu City Hospital. Since the patients would be paying the bill for inviting the doctor regardless, it didn’t matter to the hospital so much where the invited doctor came from.

There was something quite unique about the medical industry in China. The leaders really liked to see equalization. For two hospitals of roughly equal level, they would be expected to pay roughly the same in income tax every year. However, if there was a huge difference in income between two equal-level hospitals, then the superintendent of the hospital which did poorly would be considered incompetent and likely to be fired. Equal-level hospitals would also be issued about the same amount in government funding. This was why lower-level hospitals had very little motivation to research their own projects, unless the research project had highly expensive resource costs that they could ask to be sponsored by the government.

For instance, coronary stents were a fairly new technology that had now entered the international medical field. Coronary stents had slowly spread even to the smallest city hospitals. But, would you really dare to perform a percutaneous coronary intervention with a coronary stent unless your hospital had a strong and knowledgeable cardiothoracic surgery department? Even if the patients had no idea what coronary stents were, the leaders would obviously understand the high difficulty of using them. Yet, because coronary stents had a high cost to them, many Chinese hospitals would establish “percutaneous coronary intervention” departments without even having a cardiothoracic surgery department just to obtain more money by claiming to need coronary stents.

China’s medical equipment supply industry was just getting started. The medical equipment merchants were basically the middlemen between companies that made medical equipment and the hospitals. These merchants would have rather rough ways of doing business, directly using power and benefits to do business. Although this could bring nice short-term effects, this wasn’t good as a long-lasting method of doing business, not to mention the illegal factors involved. This all led to those in the medical field not daring to openly discuss the topic of medical equipment, as there was far too much illicit money involved.

Meanwhile, the mega foreign pharmaceutical companies had far better business tactics. They typically wouldn’t use illegal money to get their way. Instead, their products were simply too good. For instance, maybe other countries and companies could try and imitate and make generic brands of insulin or anti-cancer drugs, but the effects wouldn’t be as good. Some generic brands were actually less than 40% effective compared to the original.

Additionally, they would claim to be investing in academics in order to secure control over department directors and expert doctors. At most, they would only treat ordinary doctors to a free meal. But for the department directors and expert doctors, the foreign pharmaceutical companies would organize international academic conferences and study programs. For instance, in order to convince a hospital to buy their company’s coronary stents, the foreign medical company would help the hospital to train and raise expert coronary surgeons for free.

Zhongyong Hospital, one of the very best hospitals in all of China, had very limited opportunities for study programs there. Otherwise, doctors from all over China would want to come there, which would make it impossible for Zhongyong Hospital to handle the numbers. It would be quite difficult for a local hospital to arrange a study program at Zhongyong Hospital. In that case, how was one supposed to try and get into a study program at Zhongyong Hospital? You would have to find a district manager at an international medical equipment supplier. It would be quite easy for them to arrange a study program at the department and hospital that you wanted.

The foreign pharmaceutical companies would also host all sorts of academic conferences. They could be quite arrogant sometimes as people wouldn’t have any choice but to use their medicine. They would use these academic conferences by inviting expert doctors to perform experiments and write theses. Both sides would benefit here in a win-win situation. The foreign pharmaceutical companies were also strong in more than one way. They could create high-end medicine, and possessed a large amount of resources for drug production.

The foreign pharmaceutical companies would use patents to monopolize their high-end medicine. They would then artificially jack up the price on the base resources required to make their medicines to make it harder for generics. This would also make it harder for the patients, and allow the companies to completely control the medical market.

In the year 2010, if you had cancer, especially if the cancer was in a major organ, you would probably have no choice other to wait for death unless you were really rich. The most effective cancer drugs and cancer therapy would cost more than 100,000 yuan. What ordinary families would have so much money on hand?

To the foreign mega pharmaceutical companies, profits that criminal organizations could gain from illegal drugs were absolutely nothing in comparison to the profits that they could gain from their own perfectly legal drugs.

Currently, China didn’t have the technology and research required to produce its own high-end drugs. China wasn’t even capable of making similar generics. China could only produce the basic and ordinary medicine. China’s pharmaceutical companies would also compete to the death, pressuring each other with prices. Due to such intense infighting, China’s pharmaceutical companies had developed for many years already, yet had much less income on average than even health supplement companies. This was such a ridiculous joke!

Zhang Fan headed to Shao Hua’s place after he split up from Professor Li. However, the major district manager who worked for the medical equipment supply merchant surnamed Yun, who hosted the liver tumor surgery academic conference, found Zhang Fan at the entrance to Shao Hua’s home’s neighborhood. This female district manager had already received her boss’s orders that she should first try and contact Zhang Fan. President Yun would then soon fly over to the border province and meet Zhang Fan herself.

“Oh my! Teacher Zhang! You’ve already performed such a difficult surgery this morning, yet you wouldn’t even come when we invited you to a meal. Was there something we did that dissatisfied you? You must tell me right away. I can have it changed immediately to your satisfaction! Please allow me to make it up to you.” This major district manager was incredibly skilled. In her boss’s company, she was completely put in charge of managing all sales in Gansu Province, Qinghai Province, Tibet Autonomous Region, and the border province. Her income was more than eight times that of Zhang Fan. But even so, she spoke with such a humble attitude that Zhang Fan felt too awkward to refuse her.

In the medical equipment profession, there was a certain saying. When a doctor was no longer annoyed by you, you would be able to discuss business with the doctor! How would a medical equipment district manager manage to make a doctor not annoyed with them? No matter what the weather was like, go meet the doctor every day. There would be no need to discuss business. Simply greet the doctor and inquire how they were doing. At first, most doctors would be really annoyed to hear that someone was working for a medical equipment merchant, and wouldn’t even talk to you. However, that was nothing to be afraid of. It wasn’t like doctors would be violent. The medical equipment district manager would need to be patient. Perhaps it would take one month, two months, one year, or two years. In the end, the doctor would be unable to take it. The original feeling of annoyance would change into “Just say it, what do you need?”. That would mean that the district manager had successfully become the doctor’s friend. The rest would depend on the district manager’s emotional intelligence. Think about the rest by yourself!

This major district manager was named Yang Lu. She was from Jiangsu province, and had worked in the medical equipment industry for more than 10 years now. Jiangsu was a major province for the medical equipment industry. Although she was just in her early 30s, Zhang Fan had still been a student back when she started working. Yang Lu was highly skilled at dealing with and talking to doctors like Zhang Fan, who were highly skilled, but not good with social graces.

Since she was a woman and acted so humble, Zhang Fan found himself unable to say much in response. “Um, I really was tired today. I’m so sorry! My apologies, my apologies.” Zhang Fan was still young and naïve. He was being run around in circles by the far more experienced Yang Lu.

“We were the ones who were inconsiderate, honest! Sigh, Doctor Zhang, I’m so sorry that you didn’t even get to eat a good meal. I’m someone who’s quite shameless. I would like to ask you for help yet again. I have some medical textbooks and a set of Bayer brand medical equipment. These are trial products that our company is loaning to highly skilled doctors like you. Make sure to tell me immediately about any thoughts or problems about this medical equipment. Advice from a skilled doctor like you is the most valuable. I’m being shameless here in taking advantage of you.”

“This really won’t do.” Earlier today, Zhang Fan had been using the Bayer brand medical equipment provided by the medical equipment merchant. Bayer was a German pharmaceutical company and one of the largest pharmaceutical companies in the world. Zhang Fan had felt that the Bayer medical equipment was especially easy to use. He glanced at the medical equipment that Yang Lu was offering, but didn’t dare to ask for it!

“Oh my! My dear Doctor Zhang, rest assured, this isn’t a gift for you. This is only on loan to you. We’ll still need to take it back afterwards. Besides, this set of medical equipment hasn’t been mass-produced yet. It’s only a sample! There’s not even an official price for it!” Yang Lu instantly knew that Zhang Fan was tempted from seeing the change in his expression as she had talked to well over 5,000 doctors in her career so far!

“Um, this probably isn’t a good idea?” Zhang Fan was quite shaken. Just as a musician would be tempted by a high-quality instrument and a soldier would be tempted by an excellent gun, a surgeon would love a set of personal medical equipment that was excellent for use. Just as the ancient saying went, good tools were a prerequisite to success!

“It really is just a trial product. If you feel like it’s not good to use, you can return it to us at any time. Here’s a form that you need to fill out to use it. We’ll still need to take back this set of medical equipment afterwards. Doctor Zhang, you absolutely can’t lose any of it, otherwise I’ll have to compensate for it! Doctors who are only average in ability wouldn’t even receive this chance to give us recommendations on the medical equipment, since our products are all products from super international pharmaceutical companies. You know, Professor Li really loves to use our medical equipment!” Yang Lu pretended to be all pitiful as she brought out a really formal-looking form that said “Trial Use Medical Equipment Loan Agreement”.

Zhang Fan felt that this was alright, since it would only be loaned to him. The form even had a bold warning that said if the doctor lost or broke the equipment, the doctor would have to pay the price of the medical equipment.

This was actually a common tactic used by the foreign pharmaceutical companies. They actually had no intention of charging any money for this medical equipment. They would even be in charge of maintaining the medical equipment as well as updating the doctor with newer medical equipment. As long as the doctor maintained their skills, they would be provided with private medical equipment which wasn’t mass-produced. Each set of private medical equipment would have its own production serial numbers. In a way, this was the doctors’ academic identity code!

This business tactic was quite low-key and had nothing illegal about it. However, many Chinese merchants wouldn’t be willing to use such low-key tactics. Instead, they would arrogantly do as they pleased in their own market, with all sorts of underhanded and illegal business tactics. They would always be captured by the police eventually and investigated! This was far too deep of a field! Even the author doesn’t understand it!

Zhang Fan carefully checked over the form and didn’t find any problems, so he signed and agreed. The Bayer medical equipment truly was excellent to use. He had found it so easy to perform surgery with it earlier today. Yang Lu gave him the medical equipment which was stored in a case that was roughly the size of three laptops. Even though the case wasn’t particularly large, the price of this medical equipment was actually extremely high. If Zhang Fan really had to buy this medical equipment, with his current income, it would take him an entire year before he would able to pay the price.

Yang Lu had a bright smile as she gave Zhang Fan the medical equipment after he signed the medical equipment loan agreement form. Zhang Fan checked the weight, only to find that it wasn’t that light at all. “Doctor Zhang, I won’t bother you any longer. Here is a little present that we give to all medical equipment trial users. This gift isn’t for free. When you return the medical equipment, you must offer your effective recommendations regarding the equipment!”

As she said this, she placed a small box on top of the medical equipment case, and then left without saying another word or turning around.

Zhang Fan wanted to return the present, but she had said already that this was something additional. Zhang Fan lightly shook the box and found that it was rather light. He figured that what was inside probably wasn’t worth much money.

Zhang Fan finally returned to Shao Hua’s home, where her parents were currently making chicken soup for Zhang Fan. He had been too busy, and was really starving.

Every day, Shao Hua’s parents would do their very best to cook different delicious foods for Zhang Fan. He was a big eater, but he would never gain any weight. In fact, since he had recently spent so much time to grind the English medical textbook, he had actually lost weight. This made Shao Hua’s mother feel really bad for him!

“Hurry over! Zhang Fan, take a look, this is a watermelon that the farm’s secretary gave us. This is a high-tech product on the farm. It’s said that it’s not like the other watermelons. It tastes especially sweet and has no harmful contents. They’re usually sold overseas when they’re ripe!” Since Zhang Fan had helped out once before, the farm secretary had remembered it and brought over many watermelons in the name of coming to visit Shao Hua’s father, an old employee. These winter watermelons were quite large—even for a watermelon!

Shao Hua came out of the study upon hearing the commotion. She took off her glasses, which she rarely wore, although she was slightly near-sighted. She told Zhang Fan, “Hurry and wash your hands. Look at how tired you are. Your lips are so dry and cracked. You must have not had any water at all today again! You really can’t keep doing this.” She dragged Zhang Fan into the bathroom and made him wash his hands. Zhang Fan really enjoyed this sort of nagging. To him, this was the sensation of family.